Melasma is a disorder of symmetrical hyperpigmentation
predominantly affecting the faces of women with Fitzpatrick skin types III and IV. Sun exposure and hormone stimulation of localized hyperpigmentation are considered to be exacerbating factors.1-5 A comprehensive review
of melasma etiopathogenesis and treatment has recently been published.6,7 Postinflammatory hyperpigmentation (PIH) is abnormal pigment darkening in areas of trauma, inflammation,
and irritation.8 Melasma and PIH are more common in skin of color than in white skin.
The most common treatment for melasma and PIH is the topical application of hydroquinone, alone or in combination with other ingredients such as tretinoin and a corticosteroid. Other topical agents used to treat melasma include retinoids, azelaic acid, kojic acid, α-hydroxy acids, β-hydroxy acids, beta carotene, mequinol, arbutin and deoxyarbutin, licorice extract, rucinol, resveratrol, 4-hydroxyanisole, 2,5-dimethyl-4-hydroxy-
3(2H)-furanone, N-acetylglucosamine, soybean trypsin inhibitor, and tranexamic acid.6,7 Superficial and deep chemical
peels, lasers, and intense pulsed light have all been used with mixed success.6,7 Vitamin C is an excellent agent for the treatment of abnormal pigmentation; however, its instability and lack of penetration into the skin prevent it from being a highly effective means of treating melasma and PIH.9-12 None of the aforementioned treatments provide an ideal short-term and long-term solution for melasma and PIH.
Iontophoresis is the use of a direct electrical current consisting of a negative (–) and a positive (+) charge to push an ionic molecule with the same charge (either + or –) through the epidermal barrier
of the skin. Positively charged ions are driven into the skin at the anode, while negatively charged ions are driven into the skin at the cathode. Historically, iontophoresis has been used by medical professionals to deliver certain drugs through the skin to treat a wide range of conditions, including inflammation, pain, scar tissue, and calcium deposits, as well as providing dermal anesthesia.13-15 Iontophoresis is a well-established drug delivery