{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T14:33:18Z","timestamp":1785853998066,"version":"3.56.0"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T00:00:00Z","timestamp":1568073600000},"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":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Melasma is a common acquired pigmentary disorder characterized by symmetric hyperpigmented macules on the face. Triple combination cream (TCC) remains the gold standard treatment but its prolonged use often causes adverse effects. Recently, studies have shown that topical metformin has melanopenic action.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate the safety and efficacy of topical metformin in the treatment of melasma and to compare its efficacy with TCC (hydroquinone 2%\u00a0+\u00a0tretinoin 0.025%\u00a0+\u00a0fluocinolone acetonide 0.01%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a randomized controlled study conducted on 40 patients with melasma aged more than 18\u00a0years. Patients in group 1 (n\u00a0=\u00a020) were treated with 30% metformin lotion, whereas group 2 patients (n\u00a0=\u00a020) were treated with TCC for 8\u00a0weeks. Pigmentation was assessed using Melasma Area and Severity Index (MASI) at baseline and after 8\u00a0weeks. Outcome measures included global improvement scale (grades 1\u20104) and patient satisfaction. Safety was assessed according to adverse events and patch testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 40 patients completed the study. Out of 20 patients in group 1, 11 showed grade 1 improvement (1% to &lt;25%) and grade 2 (25%\u201050%) and grade 3 (&gt;50%\u201075%) improvements were seen in one patient each. In group 2, grades 1, 2, 3, and 4 improvements were seen in 14, 2, 1, and 1 patients, respectively. However, the difference was not statistically significant. Adverse events were noted in three patients in group 2 and none in group 1.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Topical metformin is a novel, safe, and almost as effective modality as TCC to treat melasma.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.13145","type":"journal-article","created":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T09:05:40Z","timestamp":1568106340000},"page":"1161-1164","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Topical metformin in the treatment of melasma: A preliminary clinical trial"],"prefix":"10.1111","volume":"19","author":[{"given":"Ravikumar","family":"Banavase Channakeshavaiah","sequence":"first","affiliation":[{"name":"Department of D.V.L Hassan Institute of Medical Sciences Hassan Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5442-1615","authenticated-orcid":false,"given":"Naveen Kumar","family":"Andanooru Chandrappa","sequence":"additional","affiliation":[{"name":"Department of D.V.L Hassan Institute of Medical Sciences Hassan Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,10]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/2229-5178.142484"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2009.03778.x"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.143.3.424"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1967.03120090043007"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-61-1-28"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2004.02470.x"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1995.01690240119022"},{"key":"e_1_2_5_9_1","first-page":"4219","article-title":"The first clinical experience on efficacy of topical flutamide on melasma compared with topical hydroquinone: a randomized clinical trial","volume":"9","author":"Adalatkhah H","year":"2015","journal-title":"Drug Des Devel Ther"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.12152"},{"key":"e_1_2_5_11_1","first-page":"67","article-title":"Efficacy and safety of a new triple\u2010combination agent for the treatment of facial melasma","volume":"72","author":"Taylor SC","year":"2003","journal-title":"Cutis"},{"key":"e_1_2_5_12_1","first-page":"57","article-title":"Hydroquinone 4%, tretinoin 0.05%, fluocinolone acetonide 0.01%: a safe and efficacious 12\u2010month treatment for melasma","volume":"75","author":"Torok HM","year":"2005","journal-title":"Cutis"},{"key":"e_1_2_5_13_1","first-page":"592","article-title":"A large 12\u2010month extension study of an 8\u2010week trial to evaluate the safety and efficacy of triple combination (TC) cream in melasma patients previously treated with TC cream or one of its dyads","volume":"4","author":"Torok H","year":"2005","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_5_14_1","first-page":"153","article-title":"Cost\u2010effectiveness of a fixed combination of hydroquinone\/tretinoin\/fluocinolone cream compared with hydroquinone alone in the treatment of melasma","volume":"6","author":"Cestari T","year":"2007","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2008.08717.x"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2011.255"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2011.04135.x"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2014.5580"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0022-202X.2003.22134.x"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2014.245"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2013.10.025"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2014.202"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1994.01690060057005"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjocd.13145","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.13145","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocd.13145","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.13145","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T19:56:48Z","timestamp":1694030208000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.13145"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,10]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1111\/jocd.13145"],"URL":"https:\/\/doi.org\/10.1111\/jocd.13145","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,10]]},"assertion":[{"value":"2019-05-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}