An Open-Label Comparative Study on the Effects of Platelet-Rich Plasma Therapy with Hydroquinone 4% Versus Hydroquinone 4% Alone in Melasma

Introduction:
Melasma is a common acquired melanosis of the face characterized by symmetric hyperpigmented patches. Management is difficult. Numerous treatment options have been tried.

Objective:
To compare the effects of platelet-rich plasma (PRP) combined with 4% hydroquinone versus 4% hydroquinone alone in melasma.

Material and methods:
This study was conducted on 112 patients of melasma, divided into two groups. In Group A patients, injections of PRP were given at an interval of 2 weeks, followed by topical application of hydroquinone 4% at night. Group B patients were offered only topical hydroquinone 4% at night. Clinical improvement was evaluated by calculating mMASI score at baseline and before each session for up to 3 months after the end of treatment.

Results:
Our study included 32 (28.57%) males and 80 (71.42%) females. Majority of the patients had epidermal melasma (76.7%). At the end of the study, Group A patients responded better than Group B. The mean mMASI score decreased from 4.04 ±1.54 to 1.53 ±0.72 in Group A (PRP + HQ 4%) whereas mean mMASI score decreased from 3.89 ±1.16 to 2.26 ±0.98 in Group B (HQ 4%). Hormonal evaluation was not done in our patients. We did not include a control group comparing inj. PRP + hydroquinone vs. inj. placebo + hydroquinone as the needling component of PRP alone would cause some improvement in melasma.

Conclusions:
The findings indicated that a combination of PRP and hydroquinone 4% is more effective than hydroquinone 4% alone in treating melasma.