摘要

Objectives: To compare the efficacy and safety of a multi-mechanism topical depigmenting cream with 4% hydroquinone cream in patients with melasma. Introduction: Melasma is a multifactorial condition driven by ultraviolet radiation, oxidative stress, genetic susceptibility, and hormonal influences, resulting in increased melanogenesis. Therapeutic strategies that target multiple stages of melanin synthesis may provide comparable efficacy with improved tolerability, particularly for patients requiring long-term management. Materials / method: This randomized, double-blind, split-face clinical trial enrolled Filipino adults with bilateral epidermal melasma. Each participant applied a multi-mechanism depigmenting cream to one facial side and 4% hydroquinone cream to the contralateral side for 12 weeks, with treatment allocation randomized. Outcomes were assessed at baseline and at weeks 4, 8, and 12 using the modified Melasma Area and Severity Index (mMASI) and physician and patient global assessment (PGA) scores. Safety was evaluated through continuous monitoring of adverse events. Data were analyzed using repeated-measures analysis Results: Of 47 patients screened, 42 were enrolled and 40 completed the study (39 females, 1 male; mean age 48.85 ± 5.91 years). All participants had Fitzpatrick skin types II–IV, with melasma duration ranging from 1 to 10 years. Both treatments produced significant reductions in mMASI scores over 12 weeks, with no statistically significant difference in overall efficacy between groups (p > 0.05). The multi-mechanism depigmenting cream demonstrated significantly better physician global assessment scores during the early treatment period (p = 0.003), though this difference was no longer significant by w Conclusion: A multi-mechanism topical depigmenting cream demonstrated comparable efficacy to 4% hydroquinone in reducing melasma severity, with a favorable tolerability profile. This approach may represent a suitable alternative for long-term melasma management.