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Author Spotlight: Non-Surgical Treatment of Melasma– Microneedling with Tranexamic Acid
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Does Systemic Metformin Have a Role in Treating Melasma?

Sahar A Ismail1, Ghada A Mohamed2, Karima N Mohamedeen3

  • 1Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University Hospitals, Assiut, Egypt.

Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [Et Al.]
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Summary

Systemic metformin combined with trichloroacetic acid (TCA) peeling significantly improved melasma. Metformin offers a safe and promising new treatment option for this common pigmentary condition, especially for patients with darker skin tones.

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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.