Dr.Ramla Kazmi, Dr. Zia ul Mustafa, Dr. Muhammad Zeb Khan, Dr. Saadia Khaleeq , Dr. Daniyal Raza, Dr. Maheen Fawad
Background: Several methods of treatment exist for melasma but the condition is chronic and relapsing. Research is on to discover the most efficacious and safest treatment option for the condition. Objective: To compare the efficacy and safety of topical 4% hydroquinone and 2% alpha arbutin in the treatment of Epidermal Melasma Subjects & Methods: This was a comparative interventional study. After history taking and clinical examination, even number patients (Group A) we retreated with topical 4% hydroquinone while odd number patients(Group B) were treated with topical 2% arbutin. Topical sunscreen of SPF-30 in cream base was applied to both groups at 4 hourly intervals from morning till evening. Six visits, at intervals of 4 weeks each, were carried out in each patient for both procedures. Severity of melasma was assessed by MASI score. Patients were photographed before and after treatment also they were assessed for side effects and clinical improvement. Patients were inquired about side effects of treatment such as burning, erythema and scaling on each visit. In case of side effects of treatment, it was stopped for two weeks to manage the side effects and was restarted after that. Follow-up was done for 2 months after the last session. Results: From 4th week till 32th week follow up time period, it was observed that as per MASI scoring patients in Group-B had significantly excellent results as compared to patients in Group-A. Patients treated with hydroquinone experienced redness, burning, tingling, hypo-pigmentation in one patient only at 28th week post-treatment and swelling during their course of treatment. However, these adverse effects were significantly more frequent with hydroquinone. Conclusion: As per findings of this study clinical efficacy and safety of topical 2% alpha arbutin is higher than the gold standard, 4% hydroquinone in treating epidermal melasma patients. Key Words: Epidermal melasma, Topical 4% hydroquinone, 2% alpha arbutin, MASI score.