Efficacy and safety of 2% kojic acid containing formulation versus modified Kligman’s formula in melasma - a comparative study
DOI:
https://doi.org/10.66344/jpad.v26i3.19Keywords:
Melasma, kojic acid, modified Kligman’s formulaAbstract
Objective To compare therapeutic efficacy of modified Kligman’s formula containing 2% hydroquinone, 0.025% tretinoin, 0.01% fluocinolone acetonide (group A), and 2% kojic acid + octinoxate + allantoin (group B) in treatment of melasma.
Methods 30 patients each, men and nonpregnant women > 18 years and < 45 years of age with epidermal melasma, were included in each group for the clinical study. Group A was given modified Kligman’s formula (MKF) containing 2% hydroquinone, 0.025% tretinoin, 0.01% fluocinolone acetonide cream and group B was prescribed 2% kojic acid + octinoxate + allantoin containing gel daily at night. Patients were followed-up monthly for 3 months.
Results Patients in group A had a mean baseline MASI (MASI0) score 7.93±4.62 compared to patients in group B, who had mean baseline (MASI0) MASI score 10.02.±5.81. After completion of treatment i.e. after 3 follow-ups (MASI3), the mean MASI score was 5.85 ±3.96 in group A compared to 3.35±4.25 in group B. The mean reduction in MASI score was 2.08 (26.22%), 6.67 (66.5%) at the end of treatment in group A and group B, respectively. In both the groups the reduction in MASI was statistically highly significant. In group A, there was a significant decrease in MASI score at the end of 3 months (P < 0.001) but, there was no significant change at the end of one month (P = 0.759). In group B, there was a significant decrease in MASI at the end of 3 months (P ≤ 0.0001). However unlike group A, there was a significant decrease in MASI one month and 2 months (P < 0.0001). In comparison between the two groups, at the end of first month, second month and third month, group A showed better effect (P <0.0001 HS) compared to group B. So, at the end of study period, group A showed statistically better efficacy than group B.
Conclusion For initial induction of remission in melasma, modified Kligman’s formula is recommended and subsequent long-term maintenance can be achieved with 2% kojic acid containing formulations. Long-term follow-up of the patients could not be done in our study to see for relapse after stopping treatment.
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Copyright (c) 2016 Pradeep Vittal Bhagwat, Soumya Manangi, Abhilash Dani, Chandramohan Kudligi
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