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Dermatology Research and Practice
Volume 2011 (2011), Article ID 379173, 5 pages
http://dx.doi.org/10.1155/2011/379173
Clinical Study

A Double-Blind, Randomized Clinical Trial of Niacinamide 4% versus Hydroquinone 4% in the Treatment of Melasma

1Department of Dermatology, Hospital Central, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
2Department of Dermatology, Hospital Central “Dr. Ignacio Morones Prieto”, 2395 Venustiano Carranza Avenue, CP 78210, San Luis Potosí, SLP, Mexico
3Department of Pathology, Hospital Central, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, Mexico
4Coordinación para la Innovación y la Aplicación de la Ciencia y la Tecnología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, Mexico

Received 16 January 2011; Revised 16 May 2011; Accepted 8 June 2011

Academic Editor: D. J. Tobin

Copyright © 2011 Josefina Navarrete-Solís et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Multiple modalities have been used in the treatment of melasma with variable success. Niacinamide has anti-inflammatory properties and is able to decrease the transfer of melanosomes. Objective. To evaluate the therapeutic effect of topical niacinamide versus hydroquinone (HQ) in melasma patients. Patients and Methods. Twenty-seven melasma patients were randomized to receive for eight weeks 4% niacinamide cream on one side of the face, and 4% HQ cream on the other. Sunscreen was applied along the observation period. They were assessed by noninvasive techniques for the evaluation of skin color, as well as subjective scales and histological sections initially and after the treatment with niacinamide. Results. All patients showed pigment improvement with both treatments. Colorimetric measures did not show statistical differences between both sides. However, good to excellent improvement was observed with niacinamide in 44% of patients, compared to 55% with HQ. Niacinamide reduced importantly the mast cell infiltrate and showed improvement of solar elastosis in melasma skin. Side effects were present in 18% with niacinamide versus 29% with HQ. Conclusion. Niacinamide induces a decrease in pigmentation, inflammatory infiltrate, and solar elastosis. Niacinamide is a safe and effective therapeutic agent for this condition.