{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:25:31Z","timestamp":1784179531760,"version":"3.55.0"},"reference-count":53,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T00:00:00Z","timestamp":1601251200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Melasma can be recalcitrant to treatment, and relapses are common. Pycnogenol has been reported to be effective in treating melasma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the efficacy, safety and tolerability of 75\u00a0mg pycnogenol taken orally twice a day vs. a placebo, in association with the triple combination and broad\u2010spectrum sunscreen for the treatment of facial melasma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A randomized, double\u2010blind, parallel, placebo\u2010controlled study was conducted on 44 women with facial melasma in a single centre from May 2019 through November 2019. Patients with melasma were randomly assigned to orally take 75\u00a0mg pycnogenol (PYC) or a placebo (PLAC) twice a day for 60\u00a0days. Both groups also received tinted sunscreen [Sun Protection Factor (SPF) 50; Persistent Pigment Darkening (PPD) 17] for daytime use and a topical triple combination at bedtime. The primary outcome was a change from the baseline Modified Melasma Area Severity Index (mMASI) score. Secondary outcomes were improvements in the patients' quality of life (MELASQoL), colorimetric indices and Global Aesthetic Improvement Scale (GAIS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All participants completed the trial. The mean (SD) age of the participants was 39 (7) years, and 91% were phototypes III\u2013IV. Both groups exhibited a reduction in mMASI scores, MELASQoL scores and colour contrast (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). The mean (CI 95%) reductions of the mMASI scores were 49% (36\u201361%) for PYC and 34% (16\u201347%) for PLAC. The reductions in mMASI scores and colorimetric contrast were superior for the PYC group (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). The analysis of GAIS resulted in an improvement of 86% (CI 95%: 68\u201396%) for the participants in the PYC group and 55% (CI 95%: 32\u201373%) for those in the PLAC group. There were no adverse effects related to oral treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pycnogenol is well\u2010tolerated and increases the effectiveness of broad\u2010spectrum sunscreen and the triple combination in the treatment of facial melasma in women.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.16896","type":"journal-article","created":{"date-parts":[[2020,8,26]],"date-time":"2020-08-26T07:27:24Z","timestamp":1598426844000},"page":"502-508","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["French maritime pine bark extract (pycnogenol) in association with triple combination cream for the treatment of facial melasma in women: a double\u2010blind, randomized, placebo\u2010controlled 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