A Double-Blind, Randomized Clinical Trial of Niacinamide 4% versus Hydroquinone 4% in the Treatment of Melasma
Navarrete-Solis J, et al.
Published in Dermatology Research and Practice
Methodology
Double-blind randomised split-face trial; 4% niacinamide cream on one side and 4% hydroquinone on the other for eight weeks with sunscreen; non-invasive colorimetry, subjective scales and histological sections.
Key Findings
27 patients with melasma applied 4% niacinamide cream to one side of the face and 4% hydroquinone to the other for eight weeks, with sunscreen throughout. All patients improved with both treatments and colorimetric measures showed no statistical difference between sides, though good to excellent improvement was judged in 44% of patients with niacinamide versus 55% with hydroquinone. Niacinamide markedly reduced mast cell infiltrate and improved solar elastosis on histology, and side effects were less frequent (18% versus 29%).
Conclusions
Niacinamide induces a decrease in pigmentation, inflammatory infiltrate, and solar elastosis and is a safe and effective therapeutic agent for melasma.
Limitations
Only 27 patients over eight weeks with a split-face design that risks carryover; the comparison was against an active drug with no untreated control, and the improvement grading was subjective.
Supplements Studied
Niacinamide induces a decrease in pigmentation, inflammatory infiltrate, and solar elastosis. Niacinamide is a safe and effective therapeutic agent for this condition.
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