Comparison of efficacy of topical 2% liquiritin, topical 4% liquiritin and topical 4% hydroquinone in the management of melasma

Background Melasma is an acquired irregular brownish hyperpigmentation of face and occasionally neck with a poorly understood etiology. Hydroquinone-based formulations remain the mainstay of treatment. Objectives To compare the efficacy of topical 2% liquiritin, topical 4% liquiritin and topical 4% hydroquinone for management of melasma. Patients and methods 90 patients of melasma coming through out-patient department of Nishtar Hospital, Multan, Pakistan between January, 2007 to July, 2007 were enrolled. Detailed history and clinical examination were entered in the pro forma. Patients were divided into three groups (A, B and C). Group A was treated with 4% hydroquinone, group B with 4% liquiritin and group C with 2% liquirtin for 8 weeks. Patients were followed up for another 4 weeks and efficacy was assessed at week 16 by change in the intensity of pigmentation, size of melasma and improvement in photographic appearance. Results Study included 90 patients between ages 18-40 years. There were 3 males and 87 females. Patients had melasma for an average of 5.80 years. 68 were married and 22 were unmarried. Clinical examination showed that 50 patients had centrofacial distribution, 35 had malar distribution and 5 had mandibular pattern. In group A (4% hydroquinone) 22 (73.3%) patients improved, 5 patients (16.7%) had no change and 3 patients (10%) deteriorated. In group B (4% liquiritin), 29 patients (96.7%) improved, one patient (3.3%) had no change. In group C (patients using 2 % liquiritin) 26 patients (86.7%) improved and 4 patients (13.3%) had no significant improvement. None of the patients developed any complication. Conclusion Topical 4 % liquiritin is significantly more effective than topical 2% liquiritin and topical 2% liquiritin is also significantly more effective than 4% hydroquinone.