Efficacy of cysteamine cream in the treatment of epidermal melasma, evaluating by Dermacatch as a new measurement method: a randomized double blind placebo controlled study

Farshi, Susan; Mansouri, Parvin; Kasraee, Behrooz

doi:10.1080/09546634.2017.1351608

Cited by 55 publications

(111 citation statements)

References 33 publications

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“…A double‐blind, randomized, vehicle‐controlled clinical study performed by Mansouri et al in 2015 on 50 melasma patients showed significant efficacy of cysteamine for the treatment of melasma . A second well‐controlled clinical trial also confirmed the efficacy of cysteamine for melasma treatment …”

Section: Discussionmentioning

confidence: 90%

“…Body cells produce cysteamine through the conversion of coenzyme A to pantethine which is then broken to cysteamine. 6 The depigmenting action of cysteamine has been shown by Chavin et al 7,8 and Frank et al 9 Their findings were indicative of a more potent depigmenting affect for cysteamine com- Considering the results of the two well-controlled clinical studies that confirm its efficacy in the treatment of melasma 13,14 and its high safety profile, cysteamine might replace mutagenic and potentially hazardous depigmenting agents in future.…”

Section: Discussionmentioning

confidence: 94%

“…The present case report points to the possibility of cysteamine efficacy in patients resistant to conventional melasma treatments. Considering the results of the two well‐controlled clinical studies that confirm its efficacy in the treatment of melasma and its high safety profile, cysteamine might replace mutagenic and potentially hazardous depigmenting agents in future.…”

Section: Discussionmentioning

confidence: 99%

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Significant therapeutic response to cysteamine cream in a melasma patient resistant to Kligman's formula

Kasraee¹,

Mansouri

Farshi

2018

J of Cosmetic Dermatology

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Summary L‐Cysteamine is a biological antioxidant produced during the coenzyme A metabolism cycle and is naturally present in all mammalian cells. The efficacy of topical cysteamine for the treatment of melasma has been recently shown in two double‐blind, randomized, and placebo‐controlled clinical trials. Herein, we report a 44‐year‐old patient with melasma resistant to Kligman's formula (Pigmanorm cream), who was successfully treated with topical cysteamine as a new depigmenting agent. Skin colorimetric measurements, MASI score determination, and standard photographies after 2 and 4 months of once daily application of cysteamine cream showed a marked improvement of the hyperpigmented lesions. Telangiectasia and perilesional hypopigmentation improved rapidly after the discontinuation of Kligman's formula and starting the treatment with topical cysteamine. After 4 months, the therapeutic results were maintained through a biweekly application regimen of cysteamine cream. The use of cysteamine cream was well tolerated and did not induce any side effects during the 3‐year follow‐up of the patient. Cysteamine is a natural molecule with an excellent safety profile and known antimutagenic, antimelanoma, and anticarcinogenic effects. Considering the high efficacy of cysteamine cream, it is possible that it could replace mutagenic and carcinogenic depigmenting agents such as hydroquinone in near future.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Significant therapeutic response to cysteamine cream in a melasma patient resistant to Kligman's formula

Kasraee¹,

Mansouri

Farshi

2018

J of Cosmetic Dermatology

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“…The results of other trials revealed a mean 38-58% decrease in mMASI scores promoted by topical cysteamine after 120 days, which is consistent with our results. 12,13,23 Moreover, the assessment after 240 days of topical cysteamine disclosed an additional 18% mMASI reduction. 12 A substantial variability was evident in the mMASI and colorimetric reduction for both groups, leading to the hypothesis that other variables interfered with the performance of the treatments.…”

Section: Discussionmentioning

confidence: 92%

“…A recent change in the formulation of cysteamine led to the reduction in the sulfur odor and skin irritability, allowing its use as a cream that has proven to be effective in the topical treatment of melasma. [11][12][13] However, to date no study has compared this formulation of topical cysteamine to 4% hydroquinone in the treatment of melasma.…”

Section: Introductionmentioning

confidence: 99%

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

Lima¹,

Dias²,

Cassiano

et al. 2020

Int J Dermatology

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Objective To assess the efficacy and safety of topical 5% cysteamine versus 4% hydroquinone in the treatment of facial melasma in women. Topical 5% cysteamine is an antioxidant and tyrosinase inhibitor that has been shown to be effective in the treatment of melasma. However, to date, no study has compared the performance of topical cysteamine to hydroquinone for facial melasma. Methods A quasi-randomized, multicenter, evaluator-blinded clinical trial was conducted on 40 women with facial melasma who were submitted to the nightly application of 5% cysteamine (CYS) or 4% hydroquinone (HQ) on hyperpigmented areas for 120 days. Both groups were required to use tinted sunscreen (SPF 50; PPD 19). Subjects were assessed at the inclusion and after 60 and 120 days of treatment for mMASI, MELASQoL, and the difference in colorimetric luminosity between melasma and the adjacent unaffected skin. The Global Aesthetic Improvement Scale was used to assess the difference in the appearance of the skin through standardized photographs. Results The mean reduction of the mMASI scores was 24% for CYS and 41% for HQ (P = 0.015) at 60 days, and 38% for CYS and 53% for HQ (P = 0.017) at 120 days. The photographic evaluation revealed up to 74% improvement for both groups, without statistically significant difference between them (P = 0.087). The MELASQoL score showed a progressive decrease for both groups over time, despite the greater reduction for HQ after 120 days (P = 0.018). Colorimetric assessment disclosed progressive depigmenting in both groups, without statistically significant difference between them (P > 0.160). No severe adverse effects were identified in either group. Erythema and burning were the most important local adverse effects with cysteamine, although their frequency did not differ between groups (P > 0.170). Conclusion Cysteamine proved to be safe, well-tolerated, and effective, despite its inferior performance to hydroquinone in decreasing mMASI and MELASQoL in the treatment of melasma.

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Melasma hyperpigmentation: An overview of current topical therapeutics

AlSalem

Alexis

2022

Dermatological Reviews

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Background Melasma is a common disorder of hyperpigmentation that affects populations globally and can adversely affect quality of life. Topical therapies—including hydroquinone and nonhydroquinone‐containing formulations—play a central role in the management of melasma. Methods A literature review was conducted using PubMed and Google Scholar. Search keywords included a combination of the following: “melasma,” “chloasma,” and “topical treatment.” We identified and included seminal and high‐quality peer‐reviewed publications, systematic reviews, randomized controlled trials, case series, case reports, consensus statements, and expert opinions. Results Topical therapies are widely used for the treatment of melasma. Triple combination cream containing hydroquinone, fluocinolone, and tretinoin is the most studied formulation with the strongest evidence among treatment options. Numerous other prescription‐based and nonprescription topical agents, including a growing list of cosmeceuticals, have been used in the treatment of melasma, albeit in smaller studies. Conclusion A growing range of topical agents is available for the treatment of melasma. While larger, more robust studies are warranted, nonhydroquinone cosmeceuticals may be useful adjuncts or alternatives to the gold standard of triple‐combination hydroquinone cream.

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Efficacy of cysteamine cream in the treatment of epidermal melasma, evaluating by Dermacatch as a new measurement method: a randomized double blind placebo controlled study

Abstract: Cysteamine cream showed significant efficacy in decreasing melanin content of the lesions, as established by Dermacatch as a new measuring method.

Cited by 55 publications

References 33 publications

Significant therapeutic response to cysteamine cream in a melasma patient resistant to Kligman's formula

Significant therapeutic response to cysteamine cream in a melasma patient resistant to Kligman's formula

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

Melasma hyperpigmentation: An overview of current topical therapeutics

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