Clinical Comparison of Azelaic Acid 20% versus Hydroquinone 4% in the Treatment of Melasma

Abstract

Introduction: Whitening agents that are used in the treatment
of cholasma are different with variable results. Hydroquinone
and azelaic acid are both characterized by their inhibitory
effects on tyrosinase enzymes. This study was conducted to
compare the post-treatment success of hydroquinone versus
azelaic acid.
Materials and Methods: This is a single blind-randomized
clinical trial study. Patients were randomized in a single-blind
manner. Fifty patients with malar and centrofacial melasma
were randomized. A total of 25 patients received hydroquinone
and 25 other received azelaic acid for ten weeks. Treatment
success were evaluated by skin color lightening observation
through melasma area severity index (MASI) and dermoscopy.
Results: Hydroquinone-used patients were showed more
pigmentation improvement than azelaic acid used patients,
61% of patients who were used hydroquinone showed good
to excellent improvement and 31% of them experienced side
effects. The azelaic acid used group responded well in 34%
of patients, but side effects were experienced just by 21% of
patients.
Conclusion: Hydroquinone induces great improvement.
However, side effects such as irritation and redness are
common to occur.