title: Intermittent therapy for melasma in Asian patients with combined topical agents (retinoic acid, hydroquinone and hydrocortisone): clinical and histological studies.
abstract: Melasma is a common problem in Asians, but treatments have not been satisfactory. In the present study, we evaluated the efficacy of a new formula containing 0.1% tretinoin, 5% hydroquinone, and 1% hydrocortisone (RHQ) in Korean patients with melasma. Twenty-five Korean females with therapy recalcitrant melasma applied RHQ on their faces for 4 months and were evaluated before and 4 weeks after treatment clinically and histologically. They were also evaluated clinically 4 months after treatment. To minimize unavoidable side effects (erythema or peeling), we applied RHQ twice a week instead of the usual daily application. However, we obtained clinical and histological results comparable to other reports from white populations. Statistically significant depigmentation in clinical and histological studies and increased subepidermal collagen synthesis were observed in this study. These effects were seen as early as 4 weeks after treatment with RHQ. We used mMASI scoring, a modified version of the original MASI, to quantify the effects of RHQ more objectively and easily.
authors.affiliation: Department of Dermatology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: W H
authors.initials: WH
authors.lastname: Kang
authors.forename: S C
authors.initials: SC
authors.lastname: Chun
authors.forename: S
authors.initials: S
authors.lastname: Lee
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D044466:Asian People; D020405:Dermis / Q000473:pathology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004817:Epidermis / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage* / Q000009:adverse effects; D006873:Hydroquinones / Q000008:administration & dosage* / Q000009:adverse effects; D007641:Keratolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008548:Melanosis / Q000188:drug therapy* / Q000208:ethnology / Q000473:pathology; D008875:Middle Aged; D011837:Radiation-Protective Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000893:Anti-Inflammatory Agents; D006873:Hydroquinones; D007641:Keratolytic Agents; D011837:Radiation-Protective Agents; D014212:Tretinoin; D006854:Hydrocortisone; C031927:hydroquinone