20.500.12556/DiRROS-29901 Efficacy of overnight leave-on sandwich therapy with 5% cysteamine and ectoine cream compared to hydroquinone 4% cream for treatment of melasma a double-blind randomized controlled trial Introduction: 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. cysteamine hydroquinone therapeutic quality of life melasma cisteamin hidrokinon terapevtsko kakovost življenja melazma true false true Združenje slovenskih dermatovenerologov Angleški jezik Slovenski jezik Na spletni strani revije navedeno: Acta Dermatovenerologica Alpina, Pannonica et Adriatica (ISSN 1318-4458) is an open access medical journal published quarterly by the Association of Slovenian Dermatovenerologists (https://acta-apa.mf.uni-lj.si/index.php); Authors publishing in our journal retain copyright of their work under the Creative Commons Attribution License (CC BY 4.0). This license allows unrestricted use, distribution, and reproduction of the work in any medium, provided the original author(s) and copyright holder(s) are appropriately credited, and the original publication in the journal is properly cited, following established academic practices (https://acta-apa.mf.uni-lj.si/submissions.php). Neznano 2026-06-09 08:37:58 2026-06-15 20:04:56 2026-07-05 23:11:34 0000-00-00 00:00:00 2025 0 Ljubljana 0 str. 1-4 issue 1 Vol. 34 Mar. 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 2024-11-07 2025-02-10 2025-03-01 616.5:579 1318-4458 10.15570/actaapa.2025.4 260264451 https://acta-apa.mf.uni-lj.si/journals/acta-dermatovenerol-apa/papers/10.15570/actaapa.2025.4/actaapa.2025.4.pdf 1 c20f2ac9-63cd-11f1-9215-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=45000 RAZ_Kusumawardani_Arie_2025.pdf RAZ_Kusumawardani_Arie_2025.pdf 1 3484D6502D7E615C76A20BE1CC9413C1 ad11bf64d30b3a2d31d028ec0e92954497692ef44a9af17b93e13a8eedafbcf4 f7c4f4b8-68e4-11f1-aebd-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=45505 Združenje slovenskih dermatovenerologov Acta dermatovenerologica Alpina, Panonica et Adriatica 0 0 0