ABSTRACT
BACKGROUND: Melasma is a widely common condition that intractably affects the patient's quality of life. Metformin is a cheap, well tolerated, and relatively safe medication that is widely prescribed for the treatment of Diabetes. Topical metformin has shown promising results in treating melasma, as well as several other dermatological conditions such as acne and recalcitrant central centrifugal cicatricial alopecia. OBJECTIVES: to study the efficacy and safety of a once weekly topical metformin 30% loaded peel-off mask in treating of melasma. METHODS: Twenty female patients with melasma were recruited for the application of a metformin mask and placebo mask to either side of the face once weekly for 12 weeks. Hemi-MASI was calculated at baseline, at each visit, and 12 weeks after the end of treatment. RESULTS: At baseline, the hemi-MASI score matched between both metformin and placebo sides (708±2.62 & 7.08±2.62 respectively (p = 1). At the end of the active treatment period, the metformin side showed a significantly better improvement in hemi-MASI score in comparison to placebo (68%±0.23 improvement on the metformin side in contrast to 20%± 0.176 on the placebo side). Although scores decreased 3 months after stopping the active treatment (52%±0.23 improvement on the metformin side compared to the placebo side 15%±0.197), they were still significantly better than the baseline. No adverse effects were reported. CONCLUSIONS: Topical metformin loaded peel-off mask can be a promising, safe, and effective treatment for melasma. Although applied once weekly, metformin peel-off mask shows comparable efficacy to previously reported daily usage formulations.
