Comparison of effects of 5% hydroquinone cream plus non-ablative fractional 1540 erbium YAG laser and 5% hydroquinone cream alone in the treatment of melasma

Background: Melasma is an acquired Hypermelanosis often difficult to treat. In this study, we assessed efficacy and safety of 5% hydroquinone cream plus non-ablative fractional 1540 erbium YAG laser and 5% hydroquinone cream alone in the treatment of melasma Methods: We selected 40 patients of melasma aged between 18 and 60 years for the study. Group 1 were treated with a cream of 5% hydroquinone and group 2 treated with a solution of hydroquinone 5% plus three sessions of non-ablative fractional 1540 erbium YAG laser at monthly interval. Improvement was assessed by the melasma-area-and-severity-index (MASI) score. Results: The two groups did not differ significantly in (MASI( score in the first month of treatment (p = 0/135), while during the second to fifth months, there were significant differences between the two groups (p <0.05) and (MASI( score was more reduced in the second group. The two groups did not show significant differences in the incidence of complications (erythema, hyperpigmentation, hypopigmentation). (p= 0/746, 0/158, 0/574, 0/135, 0/135 respectively, the first month, second month, third month and fourth month) Conclusion: A combination of hydroquinone and laser therapy had better results in the treatment of melasma. But due to some disagreements about the use of lasers in the treatment of melasma we recommend more studies with larger sample size to be taken to definitely show better therapeutic effect of laser.