A double-blind randomized trial of 5% ascorbic acid vs. 4% hydroquinone in melasma.
BACKGROUND
Melasma is an acquired treatment-resistant hyperpigmentation of the skin.


METHODS
Sixteen women with idiopathic melasma were included in our trial. After randomization by another clinician, they were instructed to use, at night, 5% ascorbic acid cream on one side of the face and 4% hydroquinone cream on the other side, for 16 weeks. Sunscreen was applied daily throughout the period of observation. They were evaluated every month by colorimetry, digital photography, and regular color slides. Subjective evaluation by each patient was also taken into account.


RESULTS
The best subjective improvement was observed on the hydroquinone side with 93% good and excellent results, compared with 62.5% on the ascorbic acid side (P < 0.05); however, colorimetric measures showed no statistical differences. Side-effects were present in 68.7% (11/16) with hydroquinone vs. 6.2% (1/16) with ascorbic acid.


CONCLUSIONS
Although hydroquinone showed a better response, ascorbic acid may play a role in the therapy of melasma as it is almost devoid of side-effects; it could be used alone or in combination therapy.
Espinal-Perez
Liliana Elizabeth
LE
Department of Dermatology, Hospital Central, University of San Luis Potosí, Mexico.
Moncada
Benjamin
B
Castanedo-Cazares
Juan Pablo
JP
D000287:Administration, Topical; D000328:Adult; D001205:Ascorbic Acid / Q000008:administration & dosage*; D003879:Dermatologic Agents / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006873:Hydroquinones / Q000008:administration & dosage*; D008548:Melanosis / Q000188:drug therapy*; D016896:Treatment Outcome
D003879:Dermatologic Agents; D006873:Hydroquinones; D001205:Ascorbic Acid; C031927:hydroquinone