A comparative study of topical 5% cysteamine versus 4% hydroquinone in the treatment of facial melasma in women: the devil is in the detail

Lee, Chun-Man

doi:10.1111/ijd.15373

Cited by 5 publications

(5 citation statements)

References 2 publications

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“…However, the mMASI score and quality of life changes were more prominent in the hydroquinone‐treated patients. Nevertheless, after the trial results were published, an analysis of the contents of the formulation of cysteamine 5% gel cream (Dermage) that was used in this trial revealed to actually contain a much lower concentration of cysteamine at 0.56% 24 …”

Section: Discussionmentioning

confidence: 96%

“…Nevertheless, after the trial results were published, an analysis of the contents of the formulation of cysteamine 5% gel cream (Dermage) that was used in this trial revealed to actually contain a much lower concentration of cysteamine at 0.56%. 24 This reduced concentration of stabilized cysteamine likely impacted the clinical outcomes of this trial.…”

Section: Ta B L Ementioning

confidence: 97%

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Comparison of the efficacy of cysteamine 5% cream and hydroquinone 4%/ascorbic acid 3% combination cream in the treatment of epidermal melasma

Sepaskhah

Karimi

Bagheri

et al. 2022

J of Cosmetic Dermatology

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Background: Few safe and effective treatments are available for melasma. Cysteamine, a non-melanocytotoxic molecule is a safer alternative to hydroquinone and usable for long-term use. Aim:To evaluate the effect of cysteamine 5% cream in the treatment of melasma.Methods: Sixty-five of 80 patients completed this single-blind, randomized, controlled trial. The patients received cysteamine 5% or hydroquinone 4%/ascorbic acid 3% (HC) cream. The therapeutic response was evaluated by modified MASI (mMASI) and melanin index (SkinColorCatch) after 2 and 4 months of treatment. The effect of treatment on the quality of life was also assessed. Results:The decrease in mMASI score was from 6.69 ± 2.96 to 4.47 ± 2.16 in the cysteamine group and from 6.26 ± 3.25 to 3.87 ± 2.00 in the HC group after 4 months (p values < 0.001). The melanin index decreased from 37.72 ± 10.17 to 31.47 ± 11.90 in the cysteamine group and from 36.37 ± 10.80 to 23.16 ± 8.83 in the HC group after 4 months (p-value = 0.003 and <0.001, respectively). The difference between mMASI score at baseline and month 4 was not significant between both groups (pvalue > 0.05). The difference between the melanin index at baseline and month 4 was significantly more pronounced in the HC group (p-value = 0.002). Quality of life improved in both groups (p-value < 0.05), but was not significantly different between groups (p-value > 0.05). Conclusion:Cysteamine was confirmed to be an effective treatment for melasma, with equivalent results to HC in reducing mMASI score and improving quality of life, despite lesser melanin index reduction observed. Cysteamine and HC efficacy was confirmed in patients recalcitrant to previous treatments, by a significant reduction of mMASI and melanin index.

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Section: Discussionmentioning

confidence: 96%

Section: Ta B L Ementioning

confidence: 97%

Comparison of the efficacy of cysteamine 5% cream and hydroquinone 4%/ascorbic acid 3% combination cream in the treatment of epidermal melasma

Sepaskhah

Karimi

Bagheri

et al. 2022

J of Cosmetic Dermatology

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“…We read with consternation the correspondence from Dr. Chun‐Man Lee, which reported the finding of a very low concentration of a derivative (cysteamine‐NPM complex) in a sample from Clarité Cysteamin (Brazil) through HPLC‐UV performed in a Swiss laboratory 7 …”

Section: Study Sample Size (Of the Cysteamine Group) Mean Masi Reduction (Time To Evaluation) Cysteamine Provider (Country)mentioning

confidence: 99%

Concerns on comparing drugs in dermatologic treatments from different suppliers

et al. 2020

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Concerns on comparing drugs in dermatologic treatments from different suppliers Dear Editor, We appreciate the opportunity to discuss crucial aspects of the role of different product suppliers for dermatologic treatments. As long as pharmaceutical technology evolves, drugs and their additives can be sourced from different suppliers. Moreover, products can be processed through different techniques by their manufacturers. The solubility, stability, absorption rate, distribution, and pharmacokinetics of the metabolites can vary among brands. This concern is a recurrent issue in dermatologic practice (e.g. botulinum toxin brands, suppliers of isotretinoin, micronized itraconazole, and biosimilars in the treatment of psoria

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“…Cysteamine is a thiol compound 8 and a promising agent for treating hyperpigmentation as an inhibitor of tyrosinase and peroxidase, primary enzymes involved in melanin biosynthesis 5,9 . Accordingly, cysteamine could be a non‐hydroquinone topical agent for patients with melasma 7 .…”

Section: Introductionmentioning

confidence: 99%

“…5,6 Other topical treatments such as retinoids, tranexamic acid, azelaic acid, alpha-hydroxy acids, and ascorbic acid typically exhibit minimal lightening effects when employed as monotherapy, and combination therapy has been deemed more successful. 7 Cysteamine is a thiol compound 8 and a promising agent for treating hyperpigmentation as an inhibitor of tyrosinase and peroxidase, primary enzymes involved in melanin biosynthesis. 5,9 Accordingly, cysteamine could be a non-hydroquinone topical agent for patients with melasma.…”

mentioning

confidence: 99%

Combination of 5% cysteamine and 4% nicotinamide in melasma: Efficacy, tolerability, and safety

Crocco,

Torloni,

Fernandes

et al. 2024

J of Cosmetic Dermatology

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BackgroundMelasma is a chronic dermatosis that impacts the patient's quality of life and can present considerable challenges in terms of effective treatment.ObjectiveTo evaluate the effectiveness, tolerability, and safety of 5% cysteamine combined with 4% nicotinamide in female subjects with melasma.MethodsThis single‐center, single‐arm, prospective, open‐label study evaluated patients with melasma using a combination cream of 5% cysteamine and 4% nicotinamide in a progressive regimen (60 min in the first month, 120 min in the second month, and 180 min in the third month).ResultsOverall, 35 treated subjects exhibited reduced modified Melasma Area and Severity Index (mMASI) (p < 0.001) and decreased MelasQoL scores (p < 0.001), accompanied by improved brightness, luminosity, homogeneity, and spot intensity (p < 0.001). Photographic and colorimetric analysis revealed smaller spots and improved homogeneity.LimitationsAdherence to progressive daily treatment could not be evaluated long‐term.ConclusionA combination cream comprising 5% cysteamine and 4% nicotinamide was effective, tolerable, and safe for treating melasma.

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A comparative study of topical 5% cysteamine versus 4% hydroquinone in the treatment of facial melasma in women: the devil is in the detail

Cited by 5 publications

References 2 publications

Comparison of the efficacy of cysteamine 5% cream and hydroquinone 4%/ascorbic acid 3% combination cream in the treatment of epidermal melasma

Comparison of the efficacy of cysteamine 5% cream and hydroquinone 4%/ascorbic acid 3% combination cream in the treatment of epidermal melasma

Concerns on comparing drugs in dermatologic treatments from different suppliers

Combination of 5% cysteamine and 4% nicotinamide in melasma: Efficacy, tolerability, and safety

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