Efficacy and safety of three combined method in the treatment of chloasma

Abstract

Objective To analyze efficacy and safety of three combined methods in the treatment of chloasma. Methods 60 female patients with chloasma in our hospital from August 2015 to July 2017 were randomly divided into 3 groups, 20 cases in each group. Group A was treated with oral tranexamic acid 0.25 g twice a day for 12 weeks, topical use of sensitivity relief cream twice a day and clarity sunblock every 3 hours during the daytime for 20 weeks; group B was treated with 20%-35% glycolic acid skin peeling every 2 weeks for 12 weeks on the basis of the therapy of group A; group C was treated with topical use of 5% arbutin essence twice a day for 20 weeks on the basis of the therapy of group B. Efficacy was evaluated after treatment with mMASI, patients’ subjective evaluation and satisfaction rate. Side effects of three groups were recorded. Results There was no statistically significant difference in clinical effect among the 3 groups (P>0.05); the clinical efficacy increased with the number of treatment, the results were the best in 12th week with the effective rate of 80%, 80%, and 85% respectively. mMASI score increased in all 3 groups in the 20th week after treatment after the withdrawal of tranexamic acid in the 12th week, there was statistically significant difference in group A between the 20th week and the 12th week (P=0.01), there were no statistically significant differences in group B or C, which showed that cholasma relapsed at 8 weeks after the withdrawal of tranexamic acid in group A. The patient satisfaction rate was 45.0%, 60.0%, 70.0% in group A, B, C respectively in the 20th week after treatment. Side effects of 3 groups were mild and transient. Conclusion Three kinds of combined methods are safe and effective in the treatment of chloasma. The combination of skin peeling and arbutin essence can improve overall skin condition of patients with chloasma and reduce the recurrence of chloasma after the withdrawal of oral tranexamic acid. Arbutin essence can be used as one of the maintenance treatment for chloasma. Key words: Chloasma; Tranexamic acid; Glycolic acid; Arbutin