DOI: 10.1097/dss.0000000000004092 ISSN: 1076-0512

Does Systemic Metformin Have a Role in Treating Melasma?

Sahar A. Ismail, Ghada A. Mohamed, Karima N. Mohamedeen, Rehab S.A. Sotohy, Radwa M. Bakr
  • Dermatology
  • General Medicine
  • Surgery


Melasma is a common pigmentary condition that affects the patients' quality of life and all the prescribed treatment options till now are not satisfactory, especially in dark-skinned patients.


To evaluate the efficacy and safety of systemic metformin (1,000 mg and 500 mg) combined with trichloroacetic acid (TCA) peeling versus TCA alone in the treatment of melasma.


The study included 60 melasma patients divided into 3 groups: Group A received systemic metformin (1000 mg/d), Group B received systemic metformin (500 mg/d) and Group C received placebo. The 3 treatment groups were treated by TCA 25% over the whole face bimonthly for a total of 6 sessions. Melasma area and severity index (MASI), and Melasma impact Quality of life Scale (MELASQOL) were used to assess the outcome.


There was a statistically significant decrease in the MASI, and the MELASQOL in the 3 studied groups after treatment with significantly better improvement in Group (A) than Group (C) (p = .045).


Systemic metformin is a safe and promising therapeutic option for treating melasma.

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