Azelaic acid gel effective for melasma

Azelaic acid 15 percent gel can be considered a reasonable alternative to hydroquinone for the treatment of melasma, according to results presented in a poster at MauiDerm 2014.

In a double-blind, randomized study, researchers from the Callender Center for Clinical Research enrolled 30 adults with stable moderate-to-severe melasma. Fifteen of the patients received treatment with azelaic acid 15 percent and another 15 received treatment with hydroquinone 4 percent. Each group was treated twice a day for six months. Safety and efficacy were measured through adverse event reports and monthly evaluations using Mexameter M & E readings, the Melasma Area & Severity Index (MASI), Physician Global Assessment (PGA), Patient Global Assessment Score (PtGAS), according to the abstract.

The researchers found the safety and tolerability to be comparable among the two groups. While neither treatment resulted in substantial improvement, statistically significant improvements from baseline for the different efficacy measures were reported at various time points during the study:

• Significant improvements in PGA scores were reported at months one, two and four for patients treated with azelaic acid 15 percent gel compared with months three, four and the final visit for those treated with hydroquinone.

• Significant improvement from baseline in PtGAS was reported at months one, four, five and six for patients treated with azelaic acid 15 percent gel compared with months three, four, and five for those treated with hydroquinone.

• Significant improvement in MASI scores was reported at months one, two, three, four and final visit for patients treated with azelaic acid 15 percent gel compared with only final visit for those treated with hydroquinone.

• Significant improvements in Mexameter M mean scores were reported at months five and six for patients treated with azelaic acid 15 percent gel, with month five showing a significant improvement over hydroquinone.

• Significant improvement in Mexameter E mean scores were reported at month one for patients treated with azelaic acid 15 percent gel compared with month six for those treated with hydroquinone.

The study was supported by a grant from Bayer HealthCare.