title: Association of emblica, licorice and belides as an alternative to hydroquinone in the clinical treatment of melasma.
abstract: BACKGROUND
  Melasma is a common skin pigment disorder with a difficult clinical response to treatment.
  
  
  OBJECTIVE
  To evaluate the clinical efficacy and safety of the association of Belides, Emblica and Licorice 7%, compared to Hydroquinone 2%, in the treatment of melasma.
  
  
  METHODS
  After 60 days of exclusive use of an SPF35 sunscreen, 56 women, 18 to 60 years of age, phototypes I to IV, with epidermal or mixed melasma, were divided into two different groups in a mono-blind clinical study: A) cream with Belides, Emblica and Licorice, applied twice a day; B) cream with Hydroquinone 2%, used at night. They were observed in a 60-day study; every 15 days, they were submitted to medical evaluation, self-evaluation, and photographic registration (Visia(®)).
  
  
  RESULTS
  50 volunteers (89%), 23 in Group A and 27 in Group B, concluded the study. Two volunteers in Group A and 7 in Group B had mild skin adverse events. Depigmentation was observed through medical evaluation (Group A: 78.3%; Group B: 88.9%) and volunteers' self-evaluation (Group A: 91.3%; Group B: 92.6%); these results were statistically significant (p<0.001), with no differences between groups (p>0.05). This pattern of results was observed by Visia® in the number (p = 0.001) and size and tone (p<0.001) of the uv stains, for both groups, with no differences between them (p>0.05).
  
  
  CONCLUSIONS
  There were no statistic differences between groups in the improvement of melasma. Group A showed less skin adverse events. Therefore, the association of Emblica, Licorice and Belides is a safe and efficient alternative for the treatment of melasma.
authors.affiliation: Universidade de São Paulo, Brazil. adilson_costa@hotmail.com
authors.forename: Adilson
authors.initials: A
authors.lastname: Costa
authors.forename: Thaís Abdalla
authors.initials: TA
authors.lastname: Moisés
authors.forename: Tatiana
authors.initials: T
authors.lastname: Cordero
authors.forename: Caroline Romanelli Tiburcio
authors.initials: CR
authors.lastname: Alves
authors.forename: Juliana
authors.initials: J
authors.lastname: Marmirori
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000627:therapeutic use*; D019659:Asteraceae / Q000737:chemistry*; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006035:Glycyrrhiza / Q000737:chemistry*; D006801:Humans; D006873:Hydroquinones / Q000627:therapeutic use*; D008548:Melanosis / Q000188:drug therapy*; D008875:Middle Aged; D029842:Phyllanthus emblica / Q000737:chemistry*; D008517:Phytotherapy / Q000379:methods; D010936:Plant Extracts / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000975:Antioxidants; D006873:Hydroquinones; D010936:Plant Extracts; C031927:hydroquinone