The Treatment of Melasma 20% Azelaic Acid versus 4% Hydroquinone Cream


  • The following physieians, each from the Department of Dermatology at his or her respective institution, participated in this multicenter study: Shirlei S. Borelli, M.D. (Santo Andre Hospital, Sao Paulo, Brazil), Antonio Di Paola, M.D. (Navy Hospital, Lima, Peru), Mario Grinblat, M.D. (Albert Einstein Hospital, Sao Paulo, Brazil), Eustaquio Montero, M.D. (Policial Hospital, Montevideo, Uruguay), Diltor Opromolla, M.D. (Lauro Souza Lima Hospital. Baurú, Brazil), Jaime Piquero, M.D. (University Hospital Vargas, Caracas, Venezuela), Sebastiao A. P. Sampaio, M.D. (University Hospital, Sao Paulo, Brazil), and Alberto Woscoff, M.D. (Durand Hospital, Buenos Aires, Argentina).

Address correspondence to: Luis M. Baliña, M.D., Av. Alvear 1888, 1129 Buenos Aires, Argentina.


Abstract: The efficacy of 20% azelaic acid cream and 4% hydroquinone cream, both used in conjunction with a broad-spectrum sunscreen, against melasma was investigated in a 24-week, double-blind study with 329 women. Over the treatment period the azelaic acid cream yielded 65% good or excellent results: no significant treatment differences were observed with regard to overall rating, reduction In lesion size, and pigmentary intensity. Severe side effects such as allergic sensitization or exogenous ochronosis were not observed with azelaic acid.