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Original Article Open Access

Safety and Efficacy of 20% Azelaic Acid Vs 4% Hydroquinone in Melasma: A Comparative Study in A Tertiary Care Hospital

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Annals of Medicine and Medical Sciences Volume 04 (2025), Version 12 October 16, 2025 pp. 1201 - 1205
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Abstract

Introduction: Melasma is an irregular brown or greyish-brown symmetric facial hyper melanosis, causing significant cosmetic concern and psychological morbidity with loss of self-esteem. Objectives: In spite of multiple treatment options, melasma seems to be a re-calcitrant as well as recurrent disease to treat. We tried to compare the treatment results with 4% hydroquinone and 20% azelaic acid. Results: The present study investigated safety and efficacy of two drugs 4% hydroquinone and 20% Azelaic Acid by measuring MASI score and dermatoscopic finding. 60 patients were randomized into two treatment groups.  One group were treated with 4% hydroquinone and other group with 20% azelaic acid for 4 months. Every month patients were evaluated by MASI score and dermatoscopy. Conclusion: The study revealed that 4% hydroquinone was more efficacious than 20% azelaic acid in terms of pigment clearance, however, considering the short duration of the study, long term adverse effect of the drugs cannot be monitored.

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