medigraphic.com
ISSN 0210-5187 (Electronic)

2005, Number 1

<< Back Next >>

Med Cutan Iber Lat Am 2005; 33 (1)

Depigmentation Cream D4® in the Treatment of Melasma

Mesquita-Guimarães J, Baudrier MT, Mota A, Rute BM, Tavares MR, Barros MA, Resende C

Language: Portugu?s
References: 29
Page: 19-24
PDF size: 269.62 Kb.


ABSTRACT

The treatment of melasma remains a clinical challenge despite a considerable number of topical agents being tested in monotherapy or in association. The aim of this study is to evaluate the efficacy and the safety of the depigmentation cream D4® in the treatment of epidermal melasma, which is mainly an association of glycolic and kojic acids, arbutin and depigmentation factor 174J/276-D. Seventeen female and two male Caucasians patients applied in a twice daily regimen for 12 weeks the depigmentation cream D4® on lesions of epidermal melasma. The response to the treatment was assessed by clinical evaluation, analog linear scale, calculation of the affected area, colorimetry and standard photography at 0, 4, 8 and 12 weeks. The treatment resulted in a progressive, but significative reduction on the intensity of melasma (p= 0.001) and on the extension of the lesions (p= 0.01), with a similar evaluation of the improvement made by both the observers and the subjects at weeks 4, 8 and 12. As a result of the progressive whitening of the lesions, colorimetric measurement revealed a progressive increase of the L (Lightness) parameter in the treated areas with values of 58.8, 60.4, 61.2 and 62.0 at 0, 4, 8 and 12 weeks, respectively. Side-effects, mainly local irritation, affected 43.8% of the patients in the first month of the treatment period, but decreased to 25% by the end of the study. Only one patient discontinued the treatment due to a local adverse effect. The depigmentation cream D4® is an efficacious agent for the treatment of epidermal melasma.


REFERENCES

  1. Yu. RJ, Van Scott EJ. Alpha-hidroxy acids: science and therapeutic use. Cosm Dermatol 1994;(Supl)1- 6.

  2. Cabanes J, Chazarra S, Garcia-Carmona F. Kojic acid, a cosmetic skin whitening agent, is a slow-binding inhibitor of catecholase activity of tyrosinase. J Pharm Pharmacol 1994;46:982-5.

  3. Akiu S, Suzuki Y, Asahara T, Fujinuma Y, Fukuda M. Inhibitory effect of arbutin on melanogenesis: biochemical study using cultured B16 melanoma cells (in Japanese). Nippon Hifuka Gakkai Zasshi 1991;101: 609-13.

  4. Pinnel SR. Cutaneous photodamage, oxidative stress, and topical antioxidant protection. J Am Acad Dermatol 2003;48: 1-18.

  5. Sarkar R, Bhalla M, Kanwar AJ. A comparative study of 20% azelaic acid cream monotherapy versus a sequential therapy in the treatment of melasma in darkskinned patients. Dermatology 2002;205: 249-54.

  6. Huh CH, Seo KI, Park JY, Lim JG, Eun HC, Park KC. A randomized, doubleblind, placebo-controlled trial of vitamin C iontophoresis in melasma. Dermatology 2003;206:316-20.

  7. Guevara IL, Pandya AG. Melasma treated with hydroquinone, tretinoin, and a fluorinated steroid. Int J Dermatol 2001;40:212-5.

  8. Kanvar AJ, Dhar S, Kaur S. Treatment of melasma with potent topical corticosteroids. Dermatology 1994;188:170.

  9. Kunachak S, Leelaudomlipi P, Wongwaisayawan S. Dermabrasion: a curative treatment for melasma. Aesthetic Plast Surg 2001;25: 114-7.

  10. Nouri K, Bowes L, Chartier T, Romagosa R, Spencer J. Combination treatment of melasma with pulsed CO2 laser followed by Q-switched alexandrite laser: a pilot study. Dermatol Surg 1999;25:494-7.

  11. Angsuwarangsee S, Polnikorn N. Combined ultrapulse CO2 laser and Q -switched alexandrite laser compared with Q-switched alexandrite laser alone for refractory melasma: split-face design. Dermatol Surg 2003;29:59- 64.

  12. Kligman AM, Willis I. A new formule for depigmenting human skin. Arch Dermatol 1975;111:40 -8.

  13. Guevara IL, Pandya AG. Melasma treated with hydroquinone, tretinoin, and a fluorinated steroid. Int J Dermatol 2001;40: 210 -5.

  14. Kang WH, Chun SC, Lee S. Intermittent therapy for melasma in Asian patients with combined topical agents (retinoic acid, hydroquinone and hydrocortisone): clinical and histological studies. J Dermatol 1998 ;25:587-96.

  15. Garcia A, Fulton JE Jr. The combination of glycolic acid and hydroquinone or kojic acid for the treatment of melasma and related conditions. Dermatol Surg 1996;22:443-7.

  16. Hurley ME, Guevara IL, Gonzales RM, Pandya AG. Efficacy of glycolic acid peels in the treatment of melasma. Arch Dermatol 2002;138:1578-82.

  17. Sarkar R, Kaur C, Bhalla M, Kanwar AJ. The combination of glycolic acid peels with a topical regimen in the treatment of melasma in dark-skinned patients: a comparative study. Dermatol Surg 2002;28:828-32.

  18. Lawrence N, Cox SE, Brody HJ. Treatment of melasma with Jessner’s solution versus glycolic acid: a comparison of clinical efficacy and evaluation of the predictive ability of Wood’s light examination. J Am Acad Dermatol 1997;36:589-93.

  19. Burns RL, Prevost-Blank PL, Lawvry MA, Lawry TB, Faria DT, Fivenson DP. Glycolic acid peels for post-inflammatory hyperpigmentation in black patients. Dermatol Surg 1997;23:171-5.

  20. Mosher DB, Fitzpatrick TB, Ortonne JP, Hori Y. Hypomelanoses and hypermelanoses; in Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, Fitzpatrick TD (eds): Dermatology in General Medicine, ed 5. New York, Mc Graw-Hill. 1999, pp 996-7.

  21. Newcomer VD, Lindbert MC, Stenbert TH. A melanosis of the face (chloasma). Arch Dermatol 1961;83:284-97.

  22. Grimes PE. Melasma: etiologic and therapeutic considerations. Arch Dermatol 1995;131:1453-7.

  23. Piamphongsant T. Treatment of melasma: a review with personal experience. Int J Dermatol 1998;37:897-903.

  24. Im S, Kim J, On WY, Kang WH. Increased expression of alpha-melanocyte-stimulating hormone in the lesional skin of melasma. Br J Dermatol 2002;146:165-7.

  25. Maeda K, Fucuda M. Arbutin: mechanism of its depigmenting action in human melanocyte culture. J Pharmacol Exp Ther 1996;276:765-9.

  26. Parrish FW, Wiley BJ, Simmons EG, Long L Jr. Production of aflatoxins and kojic acid by species of Aspergillus and Penicillium. Appl Microbiol 1966;14:139.

  27. Fried R. Vereinfachte Methode zur Bestimmung von Arbutin im Barentraubenb latterextrakt. Arch Pharm Ber Dtsch Pharm Ges 1957;290/62:73-4.

  28. Friedrich H. Untersuchungen uber die phenolischen Inhaltsstoffe von Pyrus communis L. IV. Verhalten des Arbutins beim Keinem von Birnensamen und Verteilung in jungen Pflanzen. Pharmazie 1958;13:153-5.

  29. Sugai T. [Clinical effects of arbutin in patients with chloasma] (in Japanese). Hifu (Skin Res) 1992;34:522-9.




2020     |     www.medigraphic.com