A Double Blind Randomized Trial of Efficacy and Safety of 5% Methimazole Versus 2% Hydroquinone in Patients with Melasma

Abstract

Background: Melasma is an acquired facial hyperpigmentation that is chronic and resistant to treatment. This study aimed at comparing the therapeutic response and safety of 5% methimazole cream versus 2% hydroquinone cream in Iranian females with melasma.Methods: This was a randomized, controlled, double-blind clinical trial. Fifty-eight patients aged 18 to 50, and who had been clinically diagnosed with melasma were enrolled. They were randomly divided to 2 groups: those treated with 5% methimazole cream and those treated with 2% hydroquinone once nightly for 8 weeks. Their responses to treatment were evaluated using the Melasma

The efficacy and safety of topical 5% methimazole vs 4% hydroquinone in the treatment of melasma: A randomized controlled trial

“…19 Although there were some concerns about the adverse effect of methimazole on thyroid glands via systemic absorption, some of the aforementioned studies confirmed the lack of systemic side effect of methimazole indicated by serum TSH level. 17,18 In a study by Kasraee et al, there were no alterations in the serum level of TSH, free thyroxin, and free triiodothyronine of 20 patients with melasma, who were treated with once daily application of topical methimazole for 6 weeks. 20 In concordance to former studies, no clinical or TA B L E 2 Physician and patient global evaluation of the therapies at pre-determined time points laboratory changes in thyroid functions were detected in our patients emphasizing the safety of methimazole.…”

“…15 These unique characteristics of methimazole confirmed its potential role as a safe depigmenting agent which led to several clinical studies investigating the safety and efficacy of methimazole in melasma treatment. 17,18 Malek et al presented 2 cases with hydroquinone-resistant melasma who achieved clinical improvement after 8 weeks application of topical 5% methimazole. 17 Moreover, in a clinical trial by Atefi et al 18 , methimazole was found to be more effective than 2% hydroquinone in treatment of melasma.…”

“…17,18 Malek et al presented 2 cases with hydroquinone-resistant melasma who achieved clinical improvement after 8 weeks application of topical 5% methimazole. 17 Moreover, in a clinical trial by Atefi et al 18 , methimazole was found to be more effective than 2% hydroquinone in treatment of melasma. The result of our study was consistent with previous studies with regard to safety and efficacy of methimazole in treatment of melasma compared to 4%…”

“…Additionally, other advantages of methimazole have been demonstrated by other studies including being odorless, reducing ultraviolet‐induced erythema, and not readily undergoing auto‐oxidation . These unique characteristics of methimazole confirmed its potential role as a safe depigmenting agent which led to several clinical studies investigating the safety and efficacy of methimazole in melasma treatment . Malek et al presented 2 cases with hydroquinone‐resistant melasma who achieved clinical improvement after 8 weeks application of topical 5% methimazole …”

“…Although there were some concerns about the adverse effect of methimazole on thyroid glands via systemic absorption, some of the aforementioned studies confirmed the lack of systemic side effect of methimazole indicated by serum TSH level .…”