Comparison between the efficacy of 10% zinc sulfate solution with 4% hydroquinone cream on improvement of melasma

Authors
Fariba Iraji
Nabet Tagmirriahi
Keyvan Gavidnia
Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Melasma, a common disorder of hyperpigmentation, is often difficult to treat. Although 10% zinc sulfate solution has been reported to be useful for patients with melasma, controlled trials are lacking.
Materials and Methods: 72 women with moderate to severe melasma were divided randomly into 2 groups. Group A were treated with 10% zinc sulfate solution and group B with 4% hydroquinone cream twice-daily. The results were evaluated by photoevaluation by patients based on subjective satisfaction and a blinded dermatologist using MASI score. Assessments were obtained at baseline and at 2 and 6 months after starting treatment.
Results: According to MASI score changes during treatment, there was a reduction in both groups at 2 months, however, the reduction in group B was more significant (the reduction in mean ± SD MASI was 0.7 ± 0.7 in group A vs. 2.7 ± 1.6 in group B). In addition, the patients in group B continued to decrease MASI score for the remainder of the study period at 6 months follow-up (0.3 ± 0.5) in comparison with patients in group A who did not show more reduction in MASI score.
Conclusions: The study indicates that topical zinc sulfate is not as effective in treating disease as was observed in the previous open study. A comparative study with sunscreen and placebo is necessary to determine if topical zinc sulfate is truly superior to sunscreen and placebo in this respect.

Keywords

1. Pawaskar MD, Parikh P, Markowski T, McMichael AJ, Feldman SR, Balkrishnan R. Melasma and its impact on health-related Quality of life in Hispanic women. J Dermatolog Treat 2007;18:5-9.  Back to cited text no. 1
[PUBMED]    
2. Grimes PE. Melasma: Etiologic and therapeutic considerations. Arch Dermatol 1995;131:1453-7.  Back to cited text no. 2
[PUBMED]    
3. Grimes PE. Management of hyperpigmentation in darker racial ethnic groups. Semin Cutan Med Surg 2009;28:77-85.  Back to cited text no. 3
[PUBMED]    
4. Gupta AK, Gover MD, Nouri K, Taylor S. Treatment of melasma: A review of clinical trials. J Am Acad Dermatol 2006;55:1048-65.  Back to cited text no. 4
[PUBMED]    
5. Bukviæ Mokos Z, Lipozenèiæ J, Ceoviæ R, Stulhofer Buzina D, Kostoviæ K. Laser therapy of pigmented lesions: pro and contra. Acta Dermatovenerol Croat 2010;18:185-9.  Back to cited text no. 5
    
6. Kligman AM, Willis I. A new formula for depigmenting human skin. Arch Dermatol 1975;111:40-8.  Back to cited text no. 6
    
7. Taylor SC, Torok H, Jones T, Lowe N, Rich P, Tschen E, et al. Efficacy and safety of a new triple-combination agent for the treatment of facial melasma. Cutis 2003;72:67-72.  Back to cited text no. 7
    
8. Rendon M, Berneburg M, Arellano I, Picardo M. Treatment of melasma. J Am Acad Dermatol 2006;54(Suppl):S272-81.  Back to cited text no. 8
    
9. Ennes SBP, Paschoalick RC. Mota de Avelar Alchorne M. A double-blind, comparative, placebo-controlled study of the efficacy and tolerability of 4% hydroquinone as a depigmenting agent in melasma. J Dermatolog Treat 2000;11:173-9.  Back to cited text no. 9
    
10. Palumbo A, d'ischia M, Misuraca G, Prota G. Mechanism of inhibition of melanogenesis by hydroquinone. Biochim Biophys Acta 1991;1073:85-90.  Back to cited text no. 10
    
11. Rostan EF, DeBuys HV, Madey DL, Pinnell SR. Evidence supporting zinc as an important antioxidant for skin. Int J Dermatol 2002;41:606-11.  Back to cited text no. 11
    
12. Iraji F, Faghihi G. A randomized double-blind placebo controlled clinical trial of two strengths of topical zinc sulphate solution against recurrent herpes simplex. Arch Iran Med 2003;6:13-5.  Back to cited text no. 12
    
13. Shrquie KE, Khoesheed AA, Al-nuaimy AA. Topical zinc sulphate solution for treatment of viral wart. Saudi Med J 2007;28:1418-21.  Back to cited text no. 13
    
14. Shrquie KE, Al-Mashhadani SA, Salman HA. Topical 10% zinc sulfate solution for treatment of melasma. Dermatol Surg 2008;34:1346-9.  Back to cited text no. 14
    
15. Miot HA, Miot LD. Re:Topical 10%zinc sulfate solution for treatment of melasma. Dermatol Surg 2009;352050-1.  Back to cited text no. 15
    
16. Pandya A, Berneburg M, Ortonne JP, Picardo M. Guidelines for clinical trials in melasma: Pigmentation Disorders Academy. Br J Dermatol 2006;156(Suppl):S21-8.  Back to cited text no. 16
    
17. Leenutaphong V, Nettakul A, Rattanasuwon P. Topical isotretinoin for melasma in Thai patients a vehicle-controlled clinical trial. J Med Assoc Thai 1999;82:867-75.  Back to cited text no. 17
    
 
Advanced Biomedical Research
Volume 2012, August
August 2012
Pages 1-5