The role of topical and oral melatonin in management

الملخص EN

This novel study was designed to evaluate the possible effects of topically formulated melatonin cream alone or in combination with sunscreen and oral melatonin for the management of melasma patients in comparison with hydroquinone as a standard therapy.

This study carried out in the dermatology department at the AL-Karama teaching hospital, Baghdad, Iraq.

In a double blind manner, this preliminary clinical study was performed on 36 patients with epidermal melasma and 10 healthy subjects as control.

They were diagnosed as having melasma and they were under dermatologist supervision during the entire period of treatment.

The patients were allocated into four groups (A, B, C, and D), and treated with topical melatonin only, topical melatonin and sunscreen, topical and oral melatonin, and 4 % hydroquinone cream, respectively for a period of 90 days followed by 30 days treatment with placebo.

The severity of melasma was evaluated using the Melasma Area & Severity Index (MASI) before starting treatment and after each 15 days for 120 days.

To evaluate the oxidative stress status, malondialdehyde (MDA) and glutathione (GSH) levels in plasma were measured before starting treatment and after 45, 90, and 120 days of treatment.

At the end of treatment period (90 days) ; all melasma patients demonstrated significant reduction in MASI score in different levels.

In addition, the plasma MDA levels were decreased and plasma GSH levels were increased in different scales after 90 days of treatment.

The overall results of this preliminary study suggested that topical melatonin could be used as a hypopigmenting agent in treatment of melasma, and this effect is augmented by the oral administration of the drug and the use of sunscreen, possibly by its antioxidant activity or by other mechanisms unrelated to antioxidant effect.