Evaluation of the efficacy of cysteamine cream compared to hydroquinone in the treatment of melasma: A randomised, double-blinded, trial.

Background: Melasma is an acquired cutaneous disorder characterised by prominent hyperpigmentation which presents with brown macules or patches on photo-exposed areas. Current first-line treatments for melasma include non-pharmacological measures as photoprotection, cosmetic camouflage and topical therapies such as hydroquinone. 1 Although hydroquinone remains as the gold standard treatment for melasma, its actions are limited by side effects and potential relapses.1 More recently cysteamine cream has been trialled as an alternative therapy for melasma and an early trial has shown benefits compared to placebo.2 There have been no direct comparisons between cysteamine cream and hydroquinone cream. Objective(s): Our study aims to determine the efficacy of cysteamine cream compared to hydroquinone cream in the treatment of melasma. Method(s): Female patients, 18 years and older, with at least three months history of moderate to severe melasma and satisfied the exclusion criteria were included in the study. Patients were randomised to the two study arms; the control was advised to apply hydroquinone daily for 16 weeks and the treatment group was advised to apply cysteamine cream daily for 16 weeks. Both groups were advised on regular sunscreen application. The primary endpoint measurement was the modified Melasma Area and Severity Index (mMASI) score. Result(s): 20 patients have satisfied the inclusion/exclusion criteria and are enrolled in the study. Results to be updated prior to the conference. Conclusion(s): This randomised control study will evaluate the efficacy of cysteamine cream for the treatment of melasma and whether it may be superior compared to the current gold standard treatment hydroquinone.