Azza Farag1,2,3,4,5, Mostafa Hammam1,2,3,4,5, Nada Alnaidany1,2,3,4,5, Eman Badr1,2,3,4,5, Mustafa Elshaib1,2,3,4,5, Aliaa El-Swah1,2,3,4,5, Wafaa Shehata1,2,3,4,5. 1. Drs. Farag, Hammam, El-Swah, and Shehata are with the Dermatology, Andrology and Venereology Department, Faculty of Medicine, Menoufia University in Al Minufya, Egypt. 2. Dr. Alnaidany is with the Clinical Pharmacy Department, Faculty of Pharmacy, MSA University in 6th of October City, Egypt. 3. Dr. Badr is with the Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Menoufia University in Al Minufya, Egypt. 4. Dr. Shehata is with the Faculty of Medicine, Menoufia University in Al Minufya, Egypt. 5. Mr. Elshaib is a medical student at Menoufia University in Al Minufya, Egypt.
Abstract
BACKGROUND:Melasma is a chronic hypermelanotic disorder that is challenging to treat; no single effective therapeutic agent for it has been discovered. Methimazole, an oral antithyroid drug, has a skin depigmenting effect when used topically. OBJECTIVE: We sought to evaluate the efficacy and safety of methimazole, applied during microneedling sessions and additional topical use in between sessions, for the treatment of melasma. METHODS: This split-face study included 30 Egyptian patients with melasma, each of whom received 12 microneedling sessions once per week for 12 weeks followed bytopical methimazole on the right side of face and placebo on the left side. In between the sessions, topical methimazole 5% cream was applied twice per day on the right side and placebo on the left side. Assessments were performed using the Hemi-melasma Area and Severity Index (hemi-MASI) percentage of improvement, patient satisfaction, dermoscopy, and thyroid-stimulating hormone (TSH) serum levels. RESULTS: There were significant clinical and dermoscopic improvements; hemi-MASI scores on the methimazole-treated right sides were decreased (p<0.001). The percent of hemi-MASI score improvement was significantly associated with the malar pattern (p=0.031) and epidermal type (p=0.04) of melasma. About 70 percent of our studied patients reported being satisfied with their treatment response (7% excellent, 33% good, 30% fair). No significant local or systemic side effects were observed. Pre- and posttreatment serum TSH levels were within the normal range in all treated cases. CONCLUSIONS:Methimazole has the potential to be a safe and promising therapeutic agent for the treatment of melasma via dermapen-delivered microneedling sessions with topical use in between sessions.
RCT Entities:
BACKGROUND: Melasma is a chronic hypermelanotic disorder that is challenging to treat; no single effective therapeutic agent for it has been discovered. Methimazole, an oral antithyroid drug, has a skin depigmenting effect when used topically. OBJECTIVE: We sought to evaluate the efficacy and safety of methimazole, applied during microneedling sessions and additional topical use in between sessions, for the treatment of melasma. METHODS: This split-face study included 30 Egyptian patients with melasma, each of whom received 12 microneedling sessions once per week for 12 weeks followed by topical methimazole on the right side of face and placebo on the left side. In between the sessions, topical methimazole 5% cream was applied twice per day on the right side and placebo on the left side. Assessments were performed using the Hemi-melasma Area and Severity Index (hemi-MASI) percentage of improvement, patient satisfaction, dermoscopy, and thyroid-stimulating hormone (TSH) serum levels. RESULTS: There were significant clinical and dermoscopic improvements; hemi-MASI scores on the methimazole-treated right sides were decreased (p<0.001). The percent of hemi-MASI score improvement was significantly associated with the malar pattern (p=0.031) and epidermal type (p=0.04) of melasma. About 70 percent of our studied patients reported being satisfied with their treatment response (7% excellent, 33% good, 30% fair). No significant local or systemic side effects were observed. Pre- and posttreatment serum TSH levels were within the normal range in all treated cases. CONCLUSIONS:Methimazole has the potential to be a safe and promising therapeutic agent for the treatment of melasma via dermapen-delivered microneedling sessions with topical use in between sessions.
Authors: Ji Ho Lee; Jong Gap Park; Sook Hee Lim; Jo Yong Kim; Kun Young Ahn; Mi-Yeon Kim; Young Min Park Journal: Dermatol Surg Date: 2006-05 Impact factor: 3.398
Authors: B Kasraee; G H Safaee Ardekani; A Parhizgar; F Handjani; G R Omrani; M Samani; M Nikbakhsh; N Tanideh; A Eshraghian; O Sorg; J H Saurat Journal: Skin Pharmacol Physiol Date: 2008-07-31 Impact factor: 3.479