Instrumental analysis of the pattern of improvement and that of recurrence of melasma in Thai females treated with Kligman-Willis triple combination therapy: confirmation by using its two different formulae.
BACKGROUND
Melasma is common among females. At present, its most reliable topical treatment is the Kligman-Willis formula.


OBJECTIVE
To evaluate objectively the pattern of pigmentation improvement and recurrence.


METHODS
Thirty-four Thai females with melasma showing similar lesions on both cheeks were randomly assigned to 8-week daily treatment with either one of two different versions of the formula together with strict sun protection. They were objectively evaluated instrumentally with a Mexameter® every 2 weeks, and were followed up for the subsequent 40 weeks.


RESULTS
Thirty of 34 subjects who completed their 8-week treatment displayed a similar improvement pattern with either formulae. All expressed satisfaction with the results of the treatment. Instrumental evaluation detected that the pigmentation reached a nadir after 6 weeks, regardless of the formulae. Twenty-one subjects, who were further followed up, exhibited mild relapse within 2 months after finishing the treatment. Yet, their pigmentation levels remained significantly lower than those before treatment. Both formulae increased transepidermal water loss and skin surface hydration during the treatment period.


CONCLUSIONS
Melasma in Thai females responded well to the Kligman-Willis formula. A relapse that was detected with the instrumental measurement after treatment discontinuation suggests the necessity to continue even intermittent treatment after attaining therapeutic success.
Institute of Dermatology, Bangkok 10400, Thailand. itesatuk@yahoo.com
Walaiorn
W
Pratchyapruit
Niramol
N
Vashrangsi
Jirot
J
Sindhavananda
Hachiro
H
Tagami
D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D044466:Asian People; D002626:Chemistry, Pharmaceutical / Q000379:methods*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006873:Hydroquinones / Q000008:administration & dosage*; D007641:Keratolytic Agents / Q000008:administration & dosage; D008548:Melanosis / Q000188:drug therapy* / Q000473:pathology*; D011837:Radiation-Protective Agents / Q000008:administration & dosage; D012008:Recurrence; D013473:Sunscreening Agents / Q000008:administration & dosage; D013785:Thailand; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage*
D000305:Adrenal Cortex Hormones; D004338:Drug Combinations; D006873:Hydroquinones; D007641:Keratolytic Agents; D011837:Radiation-Protective Agents; D013473:Sunscreening Agents; D014212:Tretinoin; C031927:hydroquinone