Objective: This research aims to assess the effectiveness, patient satisfaction, and adverse effects of non-hydroquinone therapy with 5% methimazole cream compared to those using 4% kojic acid in the treatment of melasma. Methods: A single-blind study of 45 patients with melasma, right-and left-sided treatment was performed by comparing with 5% methimazole cream and night time 4% kojic acid in random order. Sun protection factor 30 sunscreen was used in the morning and afternoon. The evaluation was carried out every 2 weeks by assessing the Melasma Area and Severity Index (MASI), mexameter score, patient satisfaction and adverse effects. Results: Decreases in MASI score and pigment amount were higher by using 5% methimazole cream than 4% kojic acid. Patient satisfaction, concerning the use of 5% methimazole cream was higher than with 4% kojic acid. Adverse effects were mostly found with the use of 5% methimazole cream.
Conclusion:A comparison of the MASI score, pigment amount and patient satisfaction scales showed that 5% methimazole cream was superior to 4% kojic acid. Five percent methimazole cream can be used as an alternative therapy in the treatment of melasma.