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A randomized controlled trial enrolled 40 adults with melasma and compared 30% topical metformin cream versus TCC over eight weeks. Melasma severity was quantified using MASI at baseline and week 8. MASI decreased significantly in both groups, with no statistically significant between-group difference. Metformin cream showed a favorable safety profile.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/safety-and-efficacy-of-topical-metformin-30-cream-versus-triple-combination-cream-kligmans-formula-in-treating-melasma-a-randomized-controlled-study/542149/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/safety-and-efficacy-of-topical-metformin-30-cream-versus-triple-combination-cream-kligmans-formula-in-treating-melasma-a-randomized-controlled-study/542149.png","ImageObject",300,407,{"name":92,"@type":93},"Blitz","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-20","2026-10-10",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"How many participants were included, and how were they assigned to treatments?","Question",{"text":112,"@type":113},"The trial recruited about 40 patients with melasma and randomly divided them into two groups of 20 each. Group 1 received 30% metformin cream and Group 2 received TCC for eight consecutive weeks.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What outcome measure was used to assess melasma severity?",{"text":117,"@type":113},"Melasma severity was assessed using the Melasma Area and Severity Index (MASI) at baseline and after 8 weeks of treatment.",{"name":119,"@type":110,"acceptedAnswer":120},"Did metformin cream perform better than triple combination cream in reducing MASI?",{"text":121,"@type":113},"Both treatments significantly reduced MASI scores. However, no significant difference was reported between the two treatment modalities regarding reduction in melasma over the study period (p = 0.968).",{"name":123,"@type":110,"acceptedAnswer":124},"What safety conclusion was drawn from the study?",{"text":125,"@type":113},"The study concluded that metformin cream is a safe and potentially effective treatment for melasma, while recommending confirmation by long-term, large-scale studies in different populations.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},542149,1791743468,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":143,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":144,"faqs":145,"seo_title":146,"seo_description":67,"update_tm":147,"read_time":46},24464137899374,"https://us-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Received: 8 November 2021  \nRevised: 3 March 2022  \nAccepted: 28 March 2022  \nDOI: 10. 1111/jocd.14953  \nOR I G I NAL ART I C L E  \nSafety and efficacy of topical metformin 30% cream versus triple combination cream (Kligman's formula) in treating melasma: A randomized controlled study  \nEman Said AboAlsoud MD1 | Ramadan Mohamed Eldahshan MD1 | Hassan AbouKhodair Mohammed MD1 | Mohamed L. Elsaie MD2   \n1Department of Dermatology, Venereology and Andrology Damietta Faculty of Medicine, Al-Azhar University, New Damietta, Egypt  \n2Department of Dermatology, National Research Centre, Cairo, Egypt  \nCorrespondence  \nMohamed L. Elsaie, Department of Dermatology, National Research Centre, Cairo, Egypt.  \nEmail: [egydoc77@yahoo.com](egydoc77@yahoo.com)  \nAbstract  \nBackground: Melasma is an acquired common pigmentary condition that mostly presents as pigmented macules on the face. Triple combination creams (TCC), commonly known as kligman's formula, had been regarded as the mainstay of treatment for years. Topical metformin was recently studied for its melanopenic effects and potential use in melasma.  \nAim of the work: This study aimed to evaluate the efficacy and safety of using 30% metformin cream to that of triple combination creams (Kligman's formula) in treating melasma.  \nPatients and Methods: About 40 patients complaining of melasma were recruited for this controlled randomized trial and were divided into 2 groups. Group 1 (n = 20) subjects received 30% metformin cream whereas group 2 (n = 20) were treated with TCC for eight consecutive weeks. Pigmentation severity and improvements were assessed using the melasma area severity index (MASI) at baseline and after 8 weeks of using treatment.  \nResults: MASI score decreased dramatically from 12.18 ± 9.33 before treatment to 5.59 ± 4.61 at Week 8 with a mean decrease percentage of 55.97 ± 16.77 for group 1 (p = 0.001) and from 16.05 ± 8.73 to 7.54 ± 5.77 with a mean decrease percentage of 56.50 ± 19.44 for group 2 (p = 0.001) . No significant difference was reported between the two treatment modalities regarding the reduction in melasma throughout the study period (p = 0.968) .  \nConclusion: Metformin cream is a safe, potential effective treatment for melasma, which needs to be verified by long-term large scale studies in diffident populations.  \nK E Y WO R D S  \ndermoscopy, melasma, metformin, triple combination creams  \n1 | INTRODUCTION  \nMelasma, also known as chloasma or mask of pregnancy, is a recurrent, acquired, hyperpigmentary disorder usually affecting females.1 Despite of prevalence rates varying between 3% and 33% among different populations, the exact mechanism for pathogenesis of  \nmelasma remains to be fully elucidated.2 The pathogenesis of melasma remains largely unknown with ultraviolet exposure being a major triggering factor. Other common contributing factors include genetic predisposition, pregnancy, oral contraceptives, endocrine dysfunction, hormonal treatments, drugs containing phototoxic agents, and stress.3  \n2508 | © 2022 Wiley Periodicals LLC [wileyonlinelibrary.com/journal/jocd](wileyonlinelibrary.com/journal/jocd) J Cosmet Dermatol. 2022;21:2508–2515 .  \nManagement of melasma is challenging owing to its recurrent nature and requirement for longer duration of treatment. No single approach exists to combat melasma; however, triple combination creams (TCC) remains to be the golden standard of treatment, however, with associated side effects on long-term application.4  \nMetformin, though primarily an antidiabetic drug, has found to play an important role in a number of cutaneous disorders. Because of its role in improving hyperinsulinemia, it has proven beneficial in hormonal acne, hidradenitis suppurativa (HS), and acanthosis nigricans.5 Recently, metformin has also been shown to express a downregulating effect on melanogeneiss and could be of potential use in hyperpigmentary disorders.6  \nHence, this study was undertaken to evaluate the safety and efficacy ","cbCaivWaE09J30SV","https://ap.wps.com/l/cbCaivWaE09J30SV","pdf",1345030,"English","# Abstract\n## Background\n## Aim of the work\n## Patients and Methods\n## Results\n## Conclusion\n# Introduction\n# Materials and Methods","[{\"question\":\"How many participants were included, and how were they assigned to treatments?\",\"answer\":\"The trial recruited about 40 patients with melasma and randomly divided them into two groups of 20 each. Group 1 received 30% metformin cream and Group 2 received TCC for eight consecutive weeks.\"},{\"question\":\"What outcome measure was used to assess melasma severity?\",\"answer\":\"Melasma severity was assessed using the Melasma Area and Severity Index (MASI) at baseline and after 8 weeks of treatment.\"},{\"question\":\"Did metformin cream perform better than triple combination cream in reducing MASI?\",\"answer\":\"Both treatments significantly reduced MASI scores. However, no significant difference was reported between the two treatment modalities regarding reduction in melasma over the study period (p = 0.968).\"},{\"question\":\"What safety conclusion was drawn from the study?\",\"answer\":\"The study concluded that metformin cream is a safe and potentially effective treatment for melasma, while recommending confirmation by long-term, large-scale studies in different populations.\"}]","Safety and efficacy of topical metformin 30% cream versus triple combination cream (Kligman's formula) in treating melasma: A randomized controlled study | PDF",1791671451]