Comparison of topical 5% Methimazole and 4% Hydroquinone effect on melasma in patients referring to Sina hospital in fall and winter 1401

Abstract

The complex pathology of melasma and its recurring nature have led to the difficulty of treating this disease. Melasma is routinely treated with topical medications including hydroquinone (which inhibits tyrosinase), tretinoin, corticosteroids, and combination creams with various formulations. The use of hydroquinone has a long history, but there are concerns about its side effects, and the use of safer alternative treatments is preferred. This study aims to compare the effects of topical methimazole 5% and hydroquinone 4% on melasma in patients referred to the skin clinic of Sinai Hospital in 2022. Materials and Methods: In this study, 50 patients with melasma were investigated in two intervention groups: methimazole (n=25) and hydroquinone intervention group (n=25). In the methimazole group, 5% topical methimazole cream formulated in the faculty of pharmacy using methimazole powder was prescribed and the patients were asked to apply this cream once a day to their cheeks. In the hydroquinone group, patients were asked to apply 4% topical hydroquinone cream to their cheeks once a day. The duration of the patient's treatment was 8 weeks and for the last 4 weeks, the patient used only sunscreen. Patients were followed up at intervals of 4, 8, and 12 weeks. Doctor's satisfaction level, patients' satisfaction, and also MASI Score were evaluated during the follow-up times. Also, thyroid function tests were evaluated again in the 8th week after the intervention. Side effects were evaluated at the end of week 12. Results: The average age of the patients was 37.53 ± 7.33 years with a range of 19 to 49 years. The values of MASI at baseline in the methimazole and hydroquinone groups were 7.6 and 6.9, respectively, and in the 8th week, they were 2.8 and 3.3. The rate of satisfaction with recovery after treatment was higher in the hydroquinone group. At the time of evaluation, the most common side effects reported by patients were related to erythema, burning sensation, and dryness of the skin.