Comparison of Combination of Silymarin, Petrowhite and Soy Extract Versus Combination of Arbutin, Octylmethoxycinnamate, and Vitamin E in Melasma Treatment- A Retrospective Study

Abstract

Objective: To compare the efficacy and safety of a combination of silymarin, petrowhite and soy extract (Isoflavones) and a combination of arbutin, octylmethoxycinnamate and vitamin E in the treatment and management of melasma in Indian patients. Methods: A retrospective study was carried out on 153 adult patients with melasma. The patients were divided into two treatment groups. Group A (n=102) received topical silymarin, petrowhite and soy extract (Isoflavones) and group B (n=51) received a combination cream of arbutin, octylmethoxycinnamate, and vitamin E. The treatment duration varied from 30 to 180 days depending on the response and the response was evaluated by a change in MASI score from baseline. Treatment-related side effects were monitored. Results: The mean MASI score was significantly reduced after treatment with silymarin, petrowhite and soy extract (Isoflavones) (10.73 ± 8.00 vs 4.74 ± 5.53, p<0.001). Similarly, in the group B, the mean MASI score was significantly reduced after treatment (9.65 ±6.09 Vs. 4.36 ±4.01, p<0.001). It was also observed that patients with side effects had higher mean MASI score in both treatment groups (Group A 9.30 ± 7.69 vs. 3.76± 4.43, p<0.001) (Group B 8.40 ± 4.64 vs. 3.50 ± 3.33, p=0.003) when compared with patients without side effects. Conclusion: Though both treatment modalities seem to be effective in treating melasma, silymarin, petrowhite and soy extract (Isoflavones) seemed to be moderately superior compared to combination cream (considering the differences in the mean values before and after treatment). The drug-related side effects may influence the treatment outcome.