The application of liposomal azelaic acid, 4-n butyl resorcinol and retinol serum enhanced by microneedling for treatment of malar pattern melasma: A case series

Melasma is a common hypermelanosis disorder that can be frustrating both for patients and physicians because it is very difficult to treat. Azelaic acid, 4-n-butylresorcinol and retinol is some of treatment modalities for melasma, but until now there is no clinical trial studies about combination of these three agents. We reported three mixed type melasma patients whom we treated using liposomal serum containing azelaic acid, 4-n-butylresorcinol and retinol combined with microneedling. We measured the improvement with modified Melasma Severity Index (MASI), Melasma Severity Scale (MSS) and Melas-QoL quesionner. At the start of the trial the average MASI score of all patients was 5.9, MSS was moderate and Melas QoL was 55.3. We re-applied treatment every 14 days for four times. There were improvements in their MASI with the ranged of 41.7%-85%, and Melas-QoL 38.8-83.3%. All of MSS in these three patients was classified into mild in the end of therapy.