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Updated: Jul 2, 2025

Author Spotlight: Non-Surgical Treatment of Melasma– Microneedling with Tranexamic Acid
Published on: January 19, 2024
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.
Background:
Melasma is a common pigmentary condition that affects the patients' quality of life and all the prescribed treatment options till now are not satisfactory, especially in dark-skinned patients.
Objective:
To evaluate the efficacy and safety of systemic metformin (1,000 mg and 500 mg) combined with trichloroacetic acid (TCA) peeling versus TCA alone in the treatment of melasma.
Patients And Methods:
The study included 60 melasma patients divided into 3 groups: Group A received systemic metformin (1000 mg/d), Group B received systemic metformin (500 mg/d) and Group C received placebo. The 3 treatment groups were treated by TCA 25% over the whole face bimonthly for a total of 6 sessions. Melasma area and severity index (MASI), and Melasma impact Quality of life Scale (MELASQOL) were used to assess the outcome.
Results:
There was a statistically significant decrease in the MASI, and the MELASQOL in the 3 studied groups after treatment with significantly better improvement in Group (A) than Group (C) ( p = .045).
Conclusion:
Systemic metformin is a safe and promising therapeutic option for treating melasma.
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