| Summary: | Objective To evaluate the therapeutic efficacy of a combination of compound middle-layer acid and 30% supramolecular salicylic acid for melasma. Methods Five female patients with melasma who were admitted to our hospital from May 2022 to December 2022 were enrolled in this study. A self-parallel controlled study was carried out. The patients' treated side was treated with compound middle-layer acid while the control side was treated with 30% supramolecular salicylic acid at weeks 0 and 4. On week 8, the treated side and control side were treated with 30% supramolecular salicylic acid and compound middle-layer acid, respectively. We compared the area score of facial lesions, skin color, sebum, water content and the severity of melasma-related psychological stress between the two sides. Results The combination therapy significantly decreased the area scores on the forehead, cheek and chin (P<0.05). In contrast, only the area scores on the forehead were decreased on the control side. Although the color scores were decreased on the forehead, cheek and chin of both sides, significant decrease was observed on the treated side (P<0.05 vs. the control side). Similarly, both treatments increased sebum content, with a prominent increase on the treated side (P<0.05 vs. the control side). The changes in water content did not differ significantly between these two treatments (P>0.10). Moreover, the combination therapy decreased both SAS (from 21.62±5.99 to 20.86±6.44, P<0.05) and SDS scores (from 25.05±4.21 to 23.33±5.12, P<0.05). Conclusions The combination therapy of compound middle-layer acid and 30% supramolecular salicylic acid can significantly improve the facial skin lesions and psychological state of patients with melasma. Better results can be achieved by using compound middle-layer acid first, followed by 30% supramolecular salicylic acid.
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