Objective: To compare the efficacy and safety of topical silymarin 0.7% with topical hydroquinone 4% in the treatment of melasma. Place and Duration: This Randomized Controlled Trial was conducted at dermatology OPD of Akbar Niazi Teaching Hospital, Bara Kahu, Islamabad, in a period of one year from April 2020 to April 2021. Patients and Methods: Female patients having melasma were included in the study. The severity of melasma was assessed using MASI score. Group A was treated with silymarin 0.7% cream and group B was treated with topical hydroquinone 4% cream. Treatment was given for 3 months and was followed up for the next 3 months to observe relapse. Clinical efficacy was assessed in terms of percent reduction in MASI score from baseline. Results: The mean age in group A (Silymarin 0.7%) was 35.13 ± 3.87 and in group B (Hydroquinone 4%) was 34.16 ± 3.90. Epidermal type of melasma was most common (76.8% vs 62.5%) in both groups. There was no significant (p-value < 0.05) difference between both groups after one and two months treatment but mean MASI score of Hydroquinone 4% group (10.59 ± 5.74) become significantly (p-value < 0.05) less than Silymarin 0.7% group (8.20 ± 4.41) after 3 months. Similar (p-value > 0.05) therapeutic response was observed after one and two months treatment but it become significantly better in Hydroquinone 4% group after three months treatment. Significantly, (P-value < 0.05) higher adverse effects were detected in patients treated with hydroquinone. There was no difference (P-value > 0.05) in recurrence rate and patients satisfaction between both groups. Conclusion: topical silymarin has equal efficacy for the treatment of melasma with comparatively very less adverse effects as compared to hydroquinone.
This study studied post-covid healthcare workers' acne vulgaris rates after prolonged face mask use. Methodology: Rawal Institute of Health Sciences Islamabad conducted this cross-sectional study from July 1, 2021, to June 31, 2022. 196 health staff wore masks having no allergies or dermatoses. Dermatologists rated acne according to GAGS (Global Acne Severity System). Skin type, acne history, comedogenic skin care products, acne area, and severity were noted. Counted acne vulgaris. IBM SPSS 25 used chi square test to correlate acne with gender, rank, past acne, and mask type. Results: 32.40±7.5 years for 196. 83 (42.3%) men, 113 (57.7%) women. 95 (48.5%) docs, 61 (31.1%) nurses, 21 (10.7%) aides, 19 (9.7%) paramedics. 94 (48%). 91 (46.4%) used N95 masks and 93 (47.4%) medical masks. 109 (55.6%) wore masks for 5-10 hours, 67 (34.2%) for >10, and 20 (10.2%) for <5. 62 (31.6%) had acne. N95 mask use affected acne, not gender (p<0.05). Conclusion: Mask-wearing healthcare workers have acne vulgaris regardless of gender. N95 masks cause acne.
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