Efficacy of overnight leave-on sandwich therapy with 5% cysteamine and ectoine cream compared to hydroquinone 4% cream for treatment of melasmaKusumawardani, Arie (Avtor) Murasmita, Alamanda (Avtor) Rosmarwat, Ervina (Avtor) Ashadi, Lilik Norawati (Avtor) Setiawan, Silvia V. (Avtor) Nikolovska, Suzana (Avtor) Murlistyarini, Sinta (Avtor) Wahyu Fitriyani, Nurrahma (Avtor) cysteaminehydroquinonetherapeuticquality of lifemelasmaIntroduction: Melasma is a common hypermelanosis presenting as dark patches on sun-exposed skin. Its treatment remains challenging due to slow response, especially in chronic cases. This study compares the efficacy of 5% cysteamine with ectoine cream versus 4% hydroquinone with ectoine cream in treating melasma. Methods: A double-blind randomized controlled trial was conducted from January to March 2024 across three centers in Indonesia: Dr. Moewardi Hospital (Surakarta), Gatot Soebroto Army Hospital (Jakarta), and Dr. Saiful Anwar Hospital (Malang). Participants were randomly assigned to Group A (5% cysteamine + ectoine) or Group B (4% hydroquinone + ectoine). Efficacy was evaluated using the modified Melasma Area and Severity Index (mMASI) and the JANUS-I skin analyzer. Quality of life was assessed using Melasma Quality of Life Scale (MELASQoL) and Dermatology Life Quality Index (DLQI) questionnaires. Results: Both groups demonstrated reduced mMASI and JANUS-I scores, with slightly greater improvement in Group A, although the difference was not statistically significant (p > 0.05). Quality of living also improved in both groups, with no significant difference between them (p > 0.05). Conclusions: Both treatment regimens effectively improved melasma pigmentation and QoL. Either 5% cysteamine with ectoine or 4% hydroquinone with ectoine can be considered viable treatment options for melasma.20252026-06-09 08:37:58Neznano29901UDK: 616.5:579ISSN pri članku: 1318-4458DOI: 10.15570/actaapa.2025.4COBISS_ID: 260264451sl