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Background and purpose: Melasma is a pigmentation of facial area that is seen mostly in women. Endocrine disorders are involved in development of melasma. This study was designed to evaluate the topical effect of a triple combination therapy in patients with melasma. Materials and methods: This clinical trial was conducted in 70 patients with melasma attending a Dermatology Clinic. All patients with melasma received triple combination (hydroquinone 5%, salicylic acid 4%, and fluocinolone 0.01%) and vitamin C 2% for 6 months. The efficacy of treatment was evaluated based on Melasma Area and Severity Index (MASI) Score and patients’ satisfaction was evaluated according to a questionnaire based on Satisfaction Index (SI). Data analysis was performed applying qui square test, binomial test, and repeated measures ANOVA. Results: Among the patients 93% were women and the mean age of participants was 35.21±7.5. Mean MASI Score was 27.07±10.24 at the beginning of the treatment and a significant decrease was seen at the end of first month (7.17±3.64), second (6.97±2.97), third (8.64±3.77), fourth (8.96±4.77), and sixth months (7.77±4.86). Conclusion: Triple combination therapy (hydroquinone 5%, salicylic acid 4%, and fluocinolone 0.01%) was found effective in treatment of melasma and could be used as a new protocol.

Keywords: Melasma, treatment, hydroquinone, fluocinolone, salicylic acid

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