Observational study shows 62.9% reduction in melasma severity after treatment in women, indicating a promising therapeutic approach.
Background: Melasma is a chronic hyperpigmentation disorder, often therapy-resistant. Minimally invasive combinations of chemical stimulators and serums show promise. This study evaluated trichloroacetic acid stabilized with hydrogen peroxide and kojic acid, plus a serum with niacinamide, tranexamic acid, lactoferrin, ferulic acid, alpha-lipoic acid, and physic acid. Methods: Ten female volunteers with clinically diagnosed melasma underwent six treatment sessions. Each procedure involved application of the chemical stimulator followed by the serum, with strict photoprotection advised. Clinical improvement was assessed using the modified Melasma Area and Severity Index (mMASI) by three independent experts. Objective analysis of pigmentation and texture was performed with photographic documentation processed by the Grey Level Co-Occurrence Matrix (GLCM), measuring contrast and homogeneity in selected facial regions. Results: After six treatments, significant improvement was observed. Mean mMASI scores decreased by 62.3% after 2 weeks and 62.9% after 8 weeks. GLCM confirmed pigmentation reduction, showing decreased contrast and increased homogeneity across all regions, with the chin responding best. Correlation analysis indicated a positive trend between mMASI reduction and contrast changes. No serious adverse events or post-inflammatory hyperpigmentation were reported. Conclusions: The combined protocol significantly reduced melasma hyperpigmentation both clinically and objectively. GLCM analysis complements traditional scales and may provide a valuable quantitative tool for future research.
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Deda et al. (2025) studied this question.
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