Does Systemic Metformin Have a Role in Treating Melasma?

Area of Science:

• Dermatology
• Cosmetic Science
• Pharmacology

Background:

• Melasma is a prevalent pigmentary disorder impacting patient quality of life.
• Current melasma treatments are often unsatisfactory, particularly for individuals with darker skin.
• There is a need for more effective and safe melasma therapies.

Purpose of the Study:

• To assess the efficacy and safety of oral metformin combined with trichloroacetic acid (TCA) peeling for melasma treatment.
• To compare the combination therapy against TCA peeling alone.
• To evaluate different dosages of systemic metformin (1,000 mg and 500 mg).

Main Methods:

• A study involving 60 melasma patients divided into three groups.
• Group A: 1,000 mg/day oral metformin + TCA 25% peeling.
• Group B: 500 mg/day oral metformin + TCA 25% peeling.
• Group C: Placebo + TCA 25% peeling.
• Treatment involved facial TCA peeling every two weeks for six sessions.
• Outcomes measured using Melasma Area and Severity Index (MASI) and Melasma Quality of Life Scale (MELASQOL).

Main Results:

• All treatment groups showed a statistically significant reduction in MASI and MELASQOL scores post-treatment.
• Group A (1,000 mg metformin + TCA) demonstrated significantly better improvement compared to Group C (placebo + TCA).
• The study indicates a positive response to systemic metformin in melasma treatment.

Conclusions:

• Systemic metformin, in conjunction with TCA peeling, presents a safe and effective therapeutic approach for melasma.
• Metformin shows promise as a novel treatment option for melasma, offering improved outcomes.
• The findings suggest that metformin can enhance the results of standard treatments like TCA peeling.