A triple-blind, randomized controlled trial on the efficacy and safety of 1.5% Carica papaya latex cream vs. 2% Ketoconazole cream in the treatment of pityriasis versicolor among Filipinos

ABSTRACT

Background@#Carica papaya latex has been found to have antifungal properties rendering an alternative treatment for fungal infections, i.e. pityriasis versicolor. It has remarkable mycelial inhibition, and static effect on fungal growth in cultures. Its keratolytic effect can remove diseased skin cells, and enhance drug penetration. Moreover, it is organic, locally available, and relatively inexpensive.@*Objective@#To compare the efficacy and safety of 1.5% Carica papaya latex cream vs. 2% ketoconazole cream in the treatment of pityriasis versicolor among Filipinos.@*Methods@#A single-center, parallel group, triple-blind, randomized controlled trial in the Dermatology out-patient clinic of Makati Medical Center was conducted. Sixty-four patients with pityriasis versicolor were randomly allocated to the two treatment groups, and received either 1.5% Carica papaya latex cream or 2% ketoconazole cream that they used twice daily for four weeks or until cured. The participants, researcher, and assessor were blinded to the treatment assignments. Therapeutic response was assessed at weeks 1, 2, 3 and 4 based on clinical and mycologic cure. Adverse events were identified. Patients’ assessment of their improvement was done at the end of the treatment.@*Results@#All 64 subjects in both treatment groups (100% in the Carica papaya and 100% in the ketoconazole group) achieved clinical and mycologic cure within the four-week study period. The adverse reactions noted (pruritus and erythema for Carica papaya latex cream, and pruritus for ketoconazole cream) were mild, did not cause disruption of daily activities, and spontaneously resolved.@*Conclusion@#1.5% Carica papaya latex cream is an effective and safe alternative treatment to the first line therapy, ketoconazole cream, for pityriasis versicolor.