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BACKGROUND Multiple modalities have been used in the treatment of melasma, such as bleaching agents, chemical peels, and antioxidants. Topical zinc sulfate has peeling and antioxidant effects.

OBJECTIVE The objective was to evaluate the efficacy and safety of topical 10% zinc sulfate solution in the treatment of melasma.

PATIENTS & METHODS This study was conducted at the Department of Dermatology & Venereology, Baghdad Teaching Hospital. Twenty-eight patients with melasma were treated with 10% zinc sulfate solution. Every patient was instructed to apply the formula twice daily and to be seen every 2 weeks for 2 months. The severity of melasma was assessed before, during, and after treatment with the melasma area and severity index (MASI). All patients were instructed to apply a broad-spectrum sunscreen with SPF>30 before sun exposure during treatment and for the 3-month follow-up period.

RESULTS Fourteen patients were treated with 10% zinc sulfate solution. The mean MASI score before treatment was 9.45, which changed to 4.70 after therapy. This corresponds to a percentage improvement of 49.78% and was statistically significant (p<.0005). No side effects were reported apart from a mild stinging sensation reported in a few patients. Most patients maintained improvement 3 months after cessation of therapy.

CONCLUSION Topical 10% zinc sulfate solution is a new effective, safe, and noncostly formulation in the treatment of melasma.