Abstract Number: 22

Evaluation of the efficacy of cysteamine cream compared to hydroquinone in the treatment of melasma: a randomised, double-blinded, trial

J. Nguyen1,2, L. Remyn3, I. Y. Chung4, A. Honigman5, I. Wutami3, S. Mane6, C. Wong6,7, M. Rodrigues5,7

Meeting: 2021 Dermcoll

Session Information

Date: -

Session Title: The Pigment Disorder Symposium

Session Time: -

Background: Melasma is an acquired cutaneous disorder characterised by prominent hyperpigmentation which pre- sents with brown macules or patches on photo-exposed areas. Current first-line treatments for melasma include non-pharmacological measures as photoprotection, cos- metic camouflage and topical therapies such as hydro- quinone.1 Although hydroquinone remains as the gold standard treatment for melasma, its actions are limited by side effects and potential relapses.1 More recently cys- teamine cream has been trialled as an alternative therapy
for melasma and an early trial has shown benefits com- pared to placebo.2 There have been no direct comparisons between cysteamine cream and hydroquinone cream.

Objective: Our study aims to determine the efficacy of cys- teamine cream compared to hydroquinone cream in the treatment of melasma.

Method: Female patients, 18 years and older, with at least three months history of moderate to severe melasma and satisfied the exclusion criteria were included in the study. Patients were randomised to the two study arms; the control was advised to apply hydroquinone daily for
16 weeks and the treatment group was advised to apply cysteamine cream daily for 16 weeks. Both groups were advised on regular sunscreen application. The primary endpoint measurement was the modified Melasma Area and Severity Index (mMASI) score.

Results: 20 patients have satisfied the inclusion/exclusion criteria and are enrolled in the study. Results to be updated prior to the conference.

Conclusion: This randomised control study will evaluate the efficacy of cysteamine cream for the treatment of mel- asma and whether it may be superior compared to the cur- rent gold standard treatment hydroquinone.


1. Rodrigues M, Pandya AG. Melasma: clinical diagnosis and man- agement options. The Australasian journal of dermatology.
2. Farshi S, Mansouri P, Kasraee B. Evaluation of the efficacy of cysteamine 5% cream in the treatment of epidermal melasma: a randomized double-blind placebo-controlled trial. 2015; 173(1):