title: The combination of glycolic acid and hydroquinone or kojic acid for the treatment of melasma and related conditions.
abstract: BACKGROUND
  Melasma continues to be a difficult problem. Although the cause is genetic, the condition is aggravated with sunlight, birth control pills, and pregnancy. Although hydroquinone is effective and has been available for years, a new product, kojic acid, has the advantage of being pharmaceutically more stable and, also, a tyrosinase inhibitor.
  
  
  OBJECTIVE
  To evaluate on melasma and related conditions two similar formulations of glycolic acid/hydroquinone and glycolic acid/kojic acid. The therapeutic index of the two formulations is examined.
  
  
  METHODS
  Thirty-nine patients were treated with kojic acid on one side of the face and hydroquinone in a similar vehicle on the other side of the face. The results were documented by a clinical investigator and with Wood's light examination combined with ultraviolet light photography.
  
  
  RESULTS
  Fifty-one percent of the patients responded equally to hydroquinone and kojic acid. Twenty-eight percent had a more dramatic reduction in pigment on the kojic acid side; whereas 21% had a more dramatic improvement with the hydroquinone formulation. These results were not statistically different. The kojic acid preparation was more irritating.
  
  
  CONCLUSIONS
  Both glycolic acid/kojic acid and glycolic acid/hydroquinone topical skin care products are highly effective in reducing the pigment in melasma patients. Both formulations should be available to the dermatologist to satisfy the patient's preferences.
authors.forename: A
authors.initials: A
authors.lastname: Garcia
authors.forename: J E
authors.initials: JE
authors.lastname: Fulton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D006016:Glycolates / Q000008:administration & dosage*; D006801:Humans; D006873:Hydroquinones / Q000008:administration & dosage*; D008297:Male; D008548:Melanosis / Q000175:diagnosis / Q000188:drug therapy*; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011753:Pyrones / Q000008:administration & dosage*; D011837:Radiation-Protective Agents / Q000008:administration & dosage*; D013997:Time Factors
chemical_list: D006016:Glycolates; D006873:Hydroquinones; D011753:Pyrones; D011837:Radiation-Protective Agents; C031149:glycolic acid; C011890:kojic acid; C031927:hydroquinone