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Non-hydroquinone Topical Treatment Improves Moderate Facial Melasma

Findings from a recent study showed a topical non-hydroquinone (HQ) and retinol-free therapy was as effective as HQ across most clinical endpoints in the treatment of moderate melasma.

“Melasma is a common disorder of hyperpigmentation that disproportionately affects individuals with skin of color,” the researchers wrote. “There is a paucity of studies evaluating non-HQ topical therapies for the treatment of melasma in darker skin types.”

They evaluated the safety, efficacy, and tolerability of a non-HQ, retinol-free cosmetic topical brightener (CTB) and HQ 4% for the treatment of moderate symmetric facial melasma in patients with Fitzpatrick skin types III through VI. In the randomized, double-blind, split-face clinical trial, 18 participants with facial melasma applied CTB and HQ 4% to different sides of their face twice a day for 12 weeks. Clinical photographs were taken at each visit, and clinical outcomes were assessed using half-face Melasma Area Severity Index (MASI), Overall Hyperpigmentation scale, and Melasma Severity Rating Scale (MSRS). In addition, participants completed the Melasma Quality of Life (MelasQoL) questionnaire.

Compared with baseline, CTB and HQ 4% both showed statistically significant improvements in half-face MASI, Overall Hyperpigmentation, MSRS, and MelasQoL assessments. While HQ 4% showed statistically significant improvements in MSRS at week 12 compared with CTB, it was nonsuperior to CTB for the other clinical endpoints, the researchers wrote.

“HQ-free, retinol-free CTB and HQ 4% both are effective and well-tolerated in the treatment of moderate facial melasma in Fitzpatrick skin types III to VI,” the researchers concluded.


Kaufman BP, Alexis AF. Randomized, double-blind, split-face study comparing the efficacy and tolerability of two topical products for melasma. J Drugs Dermatol. 2020;19(9):822-827. doi:10.36849/JDD.2020.5353

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