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

Introduction: Whitening agents that are used in the treatmentof cholasma are different with variable results. Hydroquinoneand azelaic acid are both characterized by their inhibitoryeffects on tyrosinase enzymes. This study was conducted tocompare the post-treatment success of hydroquinone versusazelaic acid.Materials and Methods: This is a single blind-randomizedclinical trial study. Patients were randomized in a single-blindmanner. Fifty patients with malar and centrofacial melasmawere randomized. A total of 25 patients received hydroquinoneand 25 other received azelaic acid for ten weeks. Treatmentsuccess were evaluated by skin color lightening observationthrough melasma area severity index (MASI) and dermoscopy.Results: Hydroquinone-used patients were showed morepigmentation improvement than azelaic acid used patients,61% of patients who were used hydroquinone showed goodto excellent improvement and 31% of them experienced sideeffects. The azelaic acid used group responded well in 34%of patients, but side effects were experienced just by 21% ofpatients.Conclusion: Hydroquinone induces great improvement.However, side effects such as irritation and redness arecommon to occur.