Search

Objective: Skin lightening agents are popular in southern Asia, but there is dearth of evidence on their effectiveness on Fitzpatrick IV/V skin types. This study was designed to assess the depigmenting efficacy of commercially available and specifically formulated ointments using the Mexameter® (MX 18).Methods: This single center prospective study was performed to test five commercially available preparations (Eldopaque®, Aziderm®, Garnier Dark Spot Corrector®, Ban a Tan Cream® and Neostrata Pigment Lightening Gel) on 28 healthy female volunteers in Phase 1, while five single active ingredients in lipophilic dispersion (hydroquinone 4%, ascorbyl palmitate 1%, resveratrol 1% arbutin 5% and azelaic acid 20%) were tested on a different group of 26 healthy female volunteers in Phase 2. The test agents were applied twice a day for five days per week and continued for six weeks in both study phases. Weekly Mexameter® measurements were obtained from test sites and negative controls.Results: Significant hypopigmentation when compared to untreated controls was observed with Aziderm cream (p<0.05, MWU) and the Neostrata Pigment Lightening Gel (p<0.05, MWU). All formulated preparations showed significant reduction in pigmentation; however, only the arbutin (5%) containing formulation revealed significant attenuation of pigmentation in comparison to the inactive control (p<0.05, MWU).Conclusion: All applications containing active ingredients showed significant skin lightening; however, only arbutin was able to demonstrate significant diminution of pigmentation when compared to the inactive control. [ABSTRACT FROM AUTHOR]

Exogenous ochronosis (EO) is a cutaneous disorder characterized by blue‑black pigmentation resulting as a complication of long‑term application of skin‑lightening creams containing hydroquinone but may also occur due to topical contact with phenol or resorcinol in dark‑skinned individuals. It can also occur following the use of systemic antimalarials such as quinine. EO is clinically and histologically similar to its endogenous counterpart viz., alkaptonuria, which, however, exhibits systemic effects and is an inherited disorder. Dermoscopy and in vivo skin reflectance confocal microscopy are noninvasive in vivo diagnostic tools. It is very difficult to treat EO, a cosmetically disfiguring and troubling disorder with disappointing treatment options. [ABSTRACT FROM AUTHOR]

Background Melasma is an acquired, chronic hypermelanosis for which therapy remains a challenge. Objectives To compare the efficacy and safety of a triple combination [TC: fluocinolone acetonide 0·01%, hydroquinone (HQ) 4%, tretinoin 0·05%] vs. HQ 4% after 8 weeks of treatment of moderate to severe facial melasma in Asian patients. Methods This was a multicentre, randomized, controlled, investigator-blinded, parallel comparison study. East and South-East Asian patients aged 18 years or older, with a clinical diagnosis of moderate to severe melasma, were enrolled in this study. Patients were enrolled at baseline and treated daily for 8 weeks with TC cream (one application at bedtime) or HQ cream (twice daily). There were four study visits: at baseline and weeks 2, 4 and 8. The primary efficacy variable was the melasma global severity score (GSS). Other outcome measures included Melasma Area and Severity Index, global improvement and patient satisfaction. Safety was assessed through the reporting of adverse events. Results TC had superior efficacy to HQ for the primary variable: 77/120 patients (64·2%) on TC had GSS ‘none’ or ‘mild’ at week 8 vs. 48/122 patients (39·4%) on HQ ( P < 0·001). The secondary efficacy variables confirmed these results. Patient satisfaction was in favour of TC (90/127, 70·8%, vs. 64/129, 49·6%; P = 0·005). More patients had related adverse events on TC (63/129, 48·8%) than on HQ (18/131, 13·7%) but most were mild and none was severe. Conclusions Efficacy in Asians and patient satisfaction were superior with the fixed TC than with HQ 4%. [ABSTRACT FROM AUTHOR]

Patients with dermal or mixed-type melasmas are often refractory to various treatments. Intense pulsed light has been used to treat melanocytic lesions with promising results. The purpose of this study was to clarify the effectiveness of intense pulsed light for refractory melasma in Asian persons. Seventeen patients were treated with intense pulsed light, during four sessions at 4-week intervals. The patients were also given 4% hydroquinone cream and broad-spectrum sunscreens to prevent and treat postinflammatory hyperpigmentation. Sixteen patients in the control group were treated with hydroquinone cream and sunscreens. The treatment efficacy was evaluated using reflectance spectrophotometer and patient satisfaction questionnaire. Patients in the intense pulsed light group achieved an average of 39.8% improvement in relative melanin index, compared to 11.6% improvement in the control group (p<0.05) at Week 16. Six (35%) patients in the intense pulsed light group had more than 50% improvement, compared to two (14%) patients in the control group. Two patients in the intense pulsed light group, however, experienced transient postinflammatory hyperpigmentation, and partial repigmentation was noted 24 weeks after the last treatment session. Intense pulsed light is a safe and effective treatment for refractory melasma in Asian persons, with minimal side effects. Further treatment sessions are required for maintenance therapy. CHIA-CHEN WANG, MD, CHUNG-YEE HUI, MD, YUH-MOU SUE, MD, WEN-ROU WONG, MD, AND HONG-SHANG HONG, MD, PHD HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [ABSTRACT FROM AUTHOR]