Efficacy and Tolerability of Aminoacid Filaggrin based Antioxidants Compared with Hydroquinone 4% Cream in Skin Type Iv (Fitzpatrick) Mexican Women with Mixed, Centrofacial Melasma.

Background
Melasma is a common disorder of pigmentation, characterized by symmetric brown or brown-gray patches in sun-exposed facial areas.
Hydroquinone (HQ) is the most effective agent in melasma treatment; however it has some adverse events (AE) that limit its extensive
use. We evaluated the clinical response of aminoacid filaggrin-based antioxidants (AFBA) in Mexican patients with centrofacial
melasma.
Methods
Fifty-three Mexican female patients with centrofacial melasma were included in this five-week, single-center, comparative, open-label
study. The patients were divided into two groups. One group (twenty-eight patients) received AFBA once a week for five weeks and the
second group (twenty-five patients) received HQ 4% cream once daily at night for five weeks.
Results
The AFBA group exhibited a baseline MASI score of 8.96 ± 4.83 and a 5-week MASI score of 4.99 ± 3.27. The HQ baseline MASI score
was 7.32 ± 5.81 and a 5-week MASI score was 4.98 ± 4.2. No statistically significant differences were observed between the two groups
according to the Melasma Area and Severity Index (MASI). There were more AE in the AFBA group compared with the HQ group (P=
.001). The reported AE did not require further treatment or discontinuation in either group.
Conclusions
AFBA was as effective as HQ 4% cream, however AE such as itching and skin irritation were more frequently seen in the AFBA group,
but such AE did not require treatment or withdrawal. Further controlled, blinded, multicenter studies are required to support these results.