{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:18:46Z","timestamp":1792063126264,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T00:00:00Z","timestamp":1652659200000},"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":[[2022,7]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Few safe and effective treatments are available for melasma. Cysteamine, a non\u2010melanocytotoxic molecule is a safer alternative to hydroquinone and usable for long\u2010term use.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n To evaluate the effect of cysteamine 5% cream in the treatment of melasma.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Sixty\u2010five of 80 patients completed this single\u2010blind, randomized, controlled trial. The patients received cysteamine 5% or hydroquinone 4%\/ascorbic acid 3% (HC) cream. The therapeutic response was evaluated by modified MASI (mMASI) and melanin index (SkinColorCatch) after 2 and 4\u00a0months of treatment. The effect of treatment on the quality of life was also assessed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The decrease in mMASI score was from 6.69\u00a0\u00b1\u00a02.96 to 4.47\u00a0\u00b1\u00a02.16 in the cysteamine group and from 6.26\u00a0\u00b1\u00a03.25 to 3.87\u00a0\u00b1\u00a02.00 in the HC group after 4\u00a0months (\n p<\/jats:italic>\n values\u00a0<\u00a00.001). The melanin index decreased from 37.72\u00a0\u00b1\u00a010.17 to 31.47\u00a0\u00b1\u00a011.90 in the cysteamine group and from 36.37\u00a0\u00b1\u00a010.80 to 23.16\u00a0\u00b1\u00a08.83 in the HC group after 4\u00a0months (\n p<\/jats:italic>\n \u2010value\u00a0=\u00a00.003 and <0.001, respectively). The difference between mMASI score at baseline and month 4 was not significant between both groups (\n p<\/jats:italic>\n \u2010value\u00a0>\u00a00.05). The difference between the melanin index at baseline and month 4 was significantly more pronounced in the HC group (\n p<\/jats:italic>\n \u2010value\u00a0=\u00a00.002). Quality of life improved in both groups (\n p<\/jats:italic>\n \u2010value\u00a0<\u00a00.05), but was not significantly different between groups (\n p<\/jats:italic>\n \u2010value\u00a0>\u00a00.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Cysteamine was confirmed to be an effective treatment for melasma, with equivalent results to HC in reducing mMASI score and improving quality of life, despite lesser melanin index reduction observed. Cysteamine and HC efficacy was confirmed in patients recalcitrant to previous treatments, by a significant reduction of mMASI and melanin index.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jocd.15048","type":"journal-article","created":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T07:51:18Z","timestamp":1651737078000},"page":"2871-2878","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Comparison of the efficacy of cysteamine 5% cream and hydroquinone 4%\/ascorbic acid 3% combination cream in the treatment of epidermal melasma"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8773-0019","authenticated-orcid":false,"given":"Mozhdeh","family":"Sepaskhah","sequence":"first","affiliation":[{"name":"Department of Dermatology School of Medicine Shiraz University of Medical Sciences Shiraz Iran"},{"name":"Molecular Dermatology Research Center Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0005-5090","authenticated-orcid":false,"given":"Fatemeh","family":"Karimi","sequence":"additional","affiliation":[{"name":"Department of Dermatology School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6239-2925","authenticated-orcid":false,"given":"Zahra","family":"Bagheri","sequence":"additional","affiliation":[{"name":"Department of Biostatistics School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behrooz","family":"Kasraee","sequence":"additional","affiliation":[{"name":"Scientis SA Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20143063"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2011.11.009"},{"issue":"5","key":"e_1_2_9_4_1","first-page":"46","article-title":"Willingness\u2010to\u2010pay and time trade\u2010off: the burden of disease in patients with benign hyperpigmentation","volume":"12","author":"Maymone MBC","year":"2019","journal-title":"J Clin Aesthet 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