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

Gheisari, Mehdi; Dadkhahfar, Sahar; Olamaei, Elham; Moghimi, Hamid; Niknejad, Nasim; Nobari, Niloufar Najar

doi:10.1111/jocd.12987

Cited by 22 publications

(19 citation statements)

References 21 publications

(65 reference statements)

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“…Moreover, melasma is known to have a high relapse rate which makes efficacy maintenance challenging ( 3 ). For instance, in a trial with 12 weeks follow-up, patients reported a melasma relapse with retrogressed MASI within 4 weeks of HQ cessation ( 35 ). By contrast, in one of the included trials, a cream containing lycopene and wheat bran caused a significant decrease in MASI during 12 weeks of treatment, with no recurrence within 4 weeks of phytotherapy cessation ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Topical Therapy With Botanical Products for Melasma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Wang

et al. 2022

Front. Med.

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Botanical products have been increasingly popular in topical therapies for melasma, as presumed safer and milder than fully synthetic products. Although the efficacy of different topical botanicals has recently been substantiated through randomized controlled trials (RCTs), there is a lack of sufficiently pooled evidence on their efficacy and safety for the treatment of melasma. Herein, a systematic review and meta-analysis was conducted on the efficacy and safety of topical botanical products for the treatment of melasma, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). All RCTs on the use of topical botanical products for the treatment of melasma in humans were included, except for trials enrolling pregnant patients. The primary outcome was Melasma Area and Severity Index (MASI) or its variation. The secondary outcomes included Mexameter® reading, melasma improvement evaluated by participants, and any reported adverse events (AEs). As a result, twelve eligible trials comprising 695 patients with melasma from 6 different countries were included. The topical botanical products contained active ingredients which varied among trials as follows: herb-derived molecule, extracts of a single herb, and extracts of compound herbs. Topical therapy with botanical products significantly improved melasma with a large effect on MASI reduction (SMD −0.79, 95% CI −1.14 to −0.44, p < 0.00001), and a moderate effect on Mexameter® reading reduction (SMD −0.52, 95% CI −0.81 to 0.23, p = 0.0005), when compared with placebo. It also showed a similar improvement of melasma with a better safety profile (RR 0.37, 95% CI 0.15–0.88, p = 0.02), when compared with active-comparators. Botanical products were well-tolerated across studies, with no serious AEs reported. Despite the limitations such as small sample size, short duration of follow up and varied botanical products, this work still represents the best level of evidence currently available on topical use of botanical products on melasma. Moreover, it should be noted that more well-designed studies are needed before recommending topical botanical products as a viable treatment option for melasma.Systematic Review RegistrationPROSPERO, identifier: CRD42021256328.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Topical Therapy With Botanical Products for Melasma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Wang

et al. 2022

Front. Med.

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“…40 Methimazole might be an alternative for the treatment of melasma problems or in combination therapy with other medications, according to Gheisari et al, who conducted research on fifty patients with melasma and compared it to 4% hydroquinone 41 (Table 2). 33,35,[37][38][39][40][41][42]…”

Section: Me Thima Zole a S A Ne Wfound Tre Atment For Mel A S Mamentioning

confidence: 99%

Efficacy of cysteamine and methimazole in treating melasma: A comparative narrative review

Niazi

Gheisari

Moravvej

et al. 2022

J of Cosmetic Dermatology

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Melasma is a chronic and acquired pigmentary condition that primarily affects women and undermines patient satisfaction and confidence. Melasma mostly affects females, accounting for 90% of all cases. It affects people of all races, particularly those with skin types IV and V who live in areas with lots of UV radiation. According to the studies, Melasma lesions are seen throughout the face in centrofacial, malar, and mandibular patterns. Melasma lesions on the forehead, cheeks, nose, upper lip, and/or chin are the most prevalent centrofacial pattern. Melasma lesions can also be detected along the periorbital area, especially in Asian people. Melasma is notably resistant to treatment, with many patients experiencing only temporary relief and relapses. Combining therapies that target numerous pathologic components, including photodamage, inflammation, aberrant vascularity, and abnormal pigmentation, generally results in the most dramatic therapeutic improvements. Treatments for dark circles include topical depigmenting medicines like hydroquinone, kojic acid, azelaic acid, and topical retinoic acid, and physical treatments such as chemical peels, surgical adjustments, and laser therapy. The objective of therapy should be to figure out what is causing the hyperpigmentation and what is contributing to it. This article provides an overview of melasma therapies and the efficacy of methimazole and cysteamine for melasma therapy.

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] Because various hypersensitivities have been reported for hydroquinone, all patients first applied Milamin R and Miramix R on their cheeks for 5 days to check for reactions, such as irritation, redness, or itching. [14][15][16] In patients without any hypersensitivities, the ZO R treatment with 0.1% RA was initiated. Patients who showed hypersensitivities were treated with a cream (Buraitalive R ) containing brightonil instead of hydroquinone.…”

Section: Patients and Study Designmentioning

confidence: 99%

Combination treatment algorithm for pigmentary disorders of the face: A prospective observational study in Asian patients

Takekawa

Fukumoto

Haraoka

et al. 2021

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Background: Most patients with facial pigmentary disorders have multiple disorders. However, there is no definitive treatment algorithm improving various pigmentary disorders simultaneously. Objectives: To investigate the clinical efficacy and safety of the combination of the Q-switched alexandrite and the carbon dioxide lasers with ZO SKIN HEALTH R for facial pigmentary disorders. Patients/methods: This prospective observational study enrolled 251 patients with at least one facial pigmentary disorder. We assessed treatment efficacy and investigated which disorders were most responsive to combination treatment and the relationship between doctors' skills, outcomes, and dropout rates. Results: There were 246 patients with lentigo senilis, 186 with moles, 79 with melasma, 53 with seborrheic keratosis, 17 with acquired dermal melanocytosis (ADM), and 16 with freckles. Overall, 227 patients completed treatment. Post-treatment outcomes were excellent in 97, Abbreviations: ADM, acquired dermal melanocytosis; CO 2 , carbon dioxide; LS, lentigo senilis; RA, retinoic acid; TA, tranexamic acid.

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

Cited by 22 publications

References 21 publications

Efficacy and Safety of Topical Therapy With Botanical Products for Melasma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Efficacy and Safety of Topical Therapy With Botanical Products for Melasma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Efficacy of cysteamine and methimazole in treating melasma: A comparative narrative review

Combination treatment algorithm for pigmentary disorders of the face: A prospective observational study in Asian patients

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