Evaluation of the efficacy of cysteamine 5% cream in the treatment of epidermal melasma: a randomized double-blind placebo-controlled trial

Mansouri, Parvin; Farshi, Susan; Hashemi, Zahra Sadat; Kasraee, Behrooz

doi:10.1111/bjd.13424

Cited by 75 publications

(121 citation statements)

References 34 publications

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“…A double‐blind, randomized, vehicle‐controlled clinical study performed by Mansouri et al in 2015 on 50 melasma patients showed significant efficacy of cysteamine for the treatment of melasma . A second well‐controlled clinical trial also confirmed the efficacy of cysteamine for melasma treatment …”

Section: Discussionmentioning

confidence: 90%

“…Body cells produce cysteamine through the conversion of coenzyme A to pantethine which is then broken to cysteamine. 6 The depigmenting action of cysteamine has been shown by Chavin et al 7,8 and Frank et al 9 Their findings were indicative of a more potent depigmenting affect for cysteamine com- Considering the results of the two well-controlled clinical studies that confirm its efficacy in the treatment of melasma 13,14 and its high safety profile, cysteamine might replace mutagenic and potentially hazardous depigmenting agents in future.…”

Section: Discussionmentioning

confidence: 92%

“…The present case report points to the possibility of cysteamine efficacy in patients resistant to conventional melasma treatments. Considering the results of the two well‐controlled clinical studies that confirm its efficacy in the treatment of melasma and its high safety profile, cysteamine might replace mutagenic and potentially hazardous depigmenting agents in future.…”

Section: Discussionmentioning

confidence: 99%

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Significant therapeutic response to cysteamine cream in a melasma patient resistant to Kligman's formula

Kasraee¹,

Mansouri

Farshi

2018

J of Cosmetic Dermatology

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Summary L‐Cysteamine is a biological antioxidant produced during the coenzyme A metabolism cycle and is naturally present in all mammalian cells. The efficacy of topical cysteamine for the treatment of melasma has been recently shown in two double‐blind, randomized, and placebo‐controlled clinical trials. Herein, we report a 44‐year‐old patient with melasma resistant to Kligman's formula (Pigmanorm cream), who was successfully treated with topical cysteamine as a new depigmenting agent. Skin colorimetric measurements, MASI score determination, and standard photographies after 2 and 4 months of once daily application of cysteamine cream showed a marked improvement of the hyperpigmented lesions. Telangiectasia and perilesional hypopigmentation improved rapidly after the discontinuation of Kligman's formula and starting the treatment with topical cysteamine. After 4 months, the therapeutic results were maintained through a biweekly application regimen of cysteamine cream. The use of cysteamine cream was well tolerated and did not induce any side effects during the 3‐year follow‐up of the patient. Cysteamine is a natural molecule with an excellent safety profile and known antimutagenic, antimelanoma, and anticarcinogenic effects. Considering the high efficacy of cysteamine cream, it is possible that it could replace mutagenic and carcinogenic depigmenting agents such as hydroquinone in near future.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Significant therapeutic response to cysteamine cream in a melasma patient resistant to Kligman's formula

Kasraee¹,

Mansouri

Farshi

2018

J of Cosmetic Dermatology

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“…A recent change in the formulation of cysteamine led to the reduction in the sulfur odor and skin irritability, allowing its use as a cream that has proven to be effective in the topical treatment of melasma. [11][12][13] However, to date no study has compared this formulation of topical cysteamine to 4% hydroquinone in the treatment of melasma.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of topical 5% cysteamine versus 4% hydroquinone in the treatment of facial melasma in women

Lima¹,

Dias²,

Cassiano

et al. 2020

Int J Dermatology

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Objective To assess the efficacy and safety of topical 5% cysteamine versus 4% hydroquinone in the treatment of facial melasma in women. Topical 5% cysteamine is an antioxidant and tyrosinase inhibitor that has been shown to be effective in the treatment of melasma. However, to date, no study has compared the performance of topical cysteamine to hydroquinone for facial melasma. Methods A quasi-randomized, multicenter, evaluator-blinded clinical trial was conducted on 40 women with facial melasma who were submitted to the nightly application of 5% cysteamine (CYS) or 4% hydroquinone (HQ) on hyperpigmented areas for 120 days. Both groups were required to use tinted sunscreen (SPF 50; PPD 19). Subjects were assessed at the inclusion and after 60 and 120 days of treatment for mMASI, MELASQoL, and the difference in colorimetric luminosity between melasma and the adjacent unaffected skin. The Global Aesthetic Improvement Scale was used to assess the difference in the appearance of the skin through standardized photographs. Results The mean reduction of the mMASI scores was 24% for CYS and 41% for HQ (P = 0.015) at 60 days, and 38% for CYS and 53% for HQ (P = 0.017) at 120 days. The photographic evaluation revealed up to 74% improvement for both groups, without statistically significant difference between them (P = 0.087). The MELASQoL score showed a progressive decrease for both groups over time, despite the greater reduction for HQ after 120 days (P = 0.018). Colorimetric assessment disclosed progressive depigmenting in both groups, without statistically significant difference between them (P > 0.160). No severe adverse effects were identified in either group. Erythema and burning were the most important local adverse effects with cysteamine, although their frequency did not differ between groups (P > 0.170). Conclusion Cysteamine proved to be safe, well-tolerated, and effective, despite its inferior performance to hydroquinone in decreasing mMASI and MELASQoL in the treatment of melasma.

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“…In a randomized, double-blind trial of 40 patients, a significant improvement in melasma lesions was observed compared with patients who were treated with placebo. Mansouri et al (2015) assessed the efficacy of 5% cysteamine in 50 patients with melasma. Cysteamine induced significant reductions in MASI scores at 16 weeks compared with placebo.…”

Section: New Topical Agentsmentioning

confidence: 99%

New oral and topical approaches for the treatment of melasma

Grimes

Ijaz

Nashawati

et al. 2019

International Journal of Women's Dermatology

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Melasma is a common, therapeutically challenging, and universally relapsing disorder of hyperpigmentation that is most often observed in women and individuals with Fitzpatrick Skin Types III through VI. The pathogenesis of melasma is complex and protean. Contributing factors that are often implicated in the etiopathogenesis of this condition include a genetic predisposition, intense ultraviolet radiation exposure, and hormonal influences. Therapeutic interventions for melasma include a multimodality approach incorporating photoprotection agents, topical and oral skin lighteners, and resurfacing procedures. Given our expanding knowledge of the pathogenesis of melasma, new and effective treatments are expanding our therapeutic armamentarium. This article reviews new and emerging oral and topical treatments for melasma.

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Evaluation of the efficacy of cysteamine 5% cream in the treatment of epidermal melasma: a randomized double-blind placebo-controlled trial

Abstract: Cysteamine cream showed significant efficacy in the treatment of melasma.

Cited by 75 publications

References 34 publications

Significant therapeutic response to cysteamine cream in a melasma patient resistant to Kligman's formula

Significant therapeutic response to cysteamine cream in a melasma patient resistant to Kligman's formula

A comparative study of topical 5% cysteamine versus 4% hydroquinone in the treatment of facial melasma in women

New oral and topical approaches for the treatment of melasma

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