Title: Methimazole in treatment of patients with melasma: a clinical and dermascopic study

Biography:

Azza Gaber Antar Farag has completed her PhD at the age of 24 years from Menoufia University and Postdoctoral Studies from Menoufia University, Egypt. She is professor, Dermatology, Andrology & STDs department, Faculty of Medicine, Menoufia University. She has published more than 20 papers in reputed journals and has been serving as an editorial board member of repute.

Abstract

Melasma is a chronic challenging hypermelanotic disorder. Till now, there is no single effective therapeutic agent for it. Methimazole, an oral antithyroid drug, has skin depigmenting effect when used topically through inhibition of peroxidase enzyme.

Aims and Objectives: To evaluate the efficacy and safety of methimazole in treatment of melasma through its dermapen delivered microneedling sessions plus its topical use in between sessions.

Patients and methods: This study was carried out on 30 Egyptian female patients who had melasma. Each patient received dermapen microneedling sessions followed by topical methimazole on the right side of face and placebo on the left side, once per week for 12 weeks. In between the sessions, the patients were instructed to use topical methimazole twice per day on the right side and placebo on the left side. Assessment was done clinically using Melasma Area and Severity Index (MASI) improvement percent, patient satisfaction and dermoscopical study. T4 serum level was measured before and at the end of the study. .

Results: There was a significant clinical improvement and a significant improvement in dermoscopic findings (p<0.001 for both). MASI scores mean values showed significant decrease after 8 sessions of methimazole treatment in the right treated side (P<0.001). The percent of MASI score improvement was significantly associated with the malar pattern (P=0.031) and epidermal type (P=0.04) of melasma. About 70% of our studied patients were satisfied with treatment response (7% excellent, 33% good, 30% fair satisfaction). No significant local or systemic side effects were observed. Per and post-treatment T4 serum levels were in normal range in all treated cases.

Conclusion: Methimazole could be considered a new safe promising therapeutic agent for treatment of melasma through its dermapen delivered microneedling sessions plus its topical use in between sessions.