A Randomized, Double-Blind, Placebo-Controlled, Split-Face Study of the Efficacy of Topical Epidermal Growth Factor for the Treatment of Melasma

September 2018 | Volume 17 | Issue 9 | Original Article | 970 | Copyright © 2018

Alexis Lyons MD,a Joseph Stoll BS,a and Ronald Moy MD FAADa

aMoy, Fincher, Chipps Facial Plastics & Dermatology, Beverly Hills, CA

Abstract

Introduction: Melasma is a condition in which patients develop symmetric, reticulated, hyperpigmented macules and patches on the face which is thought to be the result of ultraviolet (UV) exposure and hormonal influences, although the pathogenesis is not completely understood. The topical application of epidermal growth factor has been used as a whitening agent, moisturizer, and an aid for wound healing. In this study, we explore the efficacy of topical EGF in the treatment of melasma. Materials and Methods: This was a randomized, double-blind, placebo-controlled, split-face study to determine the efficacy of a topical EGF serum in the treatment of melasma. Fifteen women with a mean age of 44 were randomized to treatment side of the face and applied a topical EGF serum and a placebo twice daily to each designated side of the face for eight weeks. Patient satisfaction was assessed by use of the MelasQoL Questionnaire as well as a patient outcome survey. Subjects were evaluated using the Physician Global Aesthetic Improvement Scale (GAIS) by two board-certified dermatologists. Results: GAIS scores showed an improvement in the melasma in 73.4% of subjects vs 13% improvement for the placebo side. The average MelasQoL questionnaire score decreased from 42 to 33 with 73% of subjects having an improvement in their score. In addition, 73% of subjects reported an improvement in their melasma. No adverse events or side effects were reported with use of the topical serum or placebo. Conclusions: This study suggests that topical EGF is a safe, noninvasive, and effective treatment for melasma. J Drugs Dermatol. 2018;17(6):970-973.

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INTRODUCTION

Melasma is a pigmentary condition in which patients de- velop symmetric, reticulated, hyperpigmented mac- ules and patches on the face.The disorder is thought to be the result of ultraviolet (UV) exposure and hormonal influ- ences, although the pathogenesis is not completely understood. It occurs most commonly in women and is more prevalent in darker skinned individuals, but it can occur in all skin types.1 Melasma is a clinical diagnosis and typically falls under three patterns: centrofacial, malar, and mandibular.2 The centrofacial pattern is the most common presentation and occurs in 50-80% of patients.1 Extrafacial melasma has also been described with hyperpigmentation occurring on the arms, neck, chest, or back.3 Melasma is a common reason for dermatology appointments as it can negatively impact patient quality of life.The treatment of melasma has remained a challenge despite its wide prevalence. Epidermal Growth Factor (EGF) promotes cell growth by bind- ing to the EGF receptor (EGFR) on the cell surface. EGF has been used in cosmeceuticals as a whitening agent, moisturizer, and to accelerate wound healing.4-7 In this study, we explore the efficacy of topical EGF serum in the treatment of melasma.

MATERIALS AND METHODS

This was a randomized, double-blind, placebo-controlled, split-face study to determine the efficacy of topical EGF in the treatment of melasma. Fifteen women between the ages of 28 and 57 (mean age, 44) were recruited from a private dermatology office in Beverly Hills, CA. Informed consent was obtained from all subjects. Subjects were excluded if they were under the age of 18, taking oral contraceptive pills, pregnant, breast- feeding, or using any lightening creams within the past month. Subjects who fulfilled the eligibility criteria were randomized to treatment and placebo side of the face and applied a topical EGF serum and placebo twice daily to the designated side of the face for eight weeks. Subjects returned for a follow-up visit at 4 weeks and a final appointment at 8 weeks. Photographs were taken at each visit. Results were reviewed at baseline and at the final visit at eight weeks (Figure 1A, 1B, 1C, 1D, and Figure 2A, 2B, 2C, 2D). Overall improvement was assessed by two board-certified dermatolo- gists using the Physician Global Aesthetic Improvement Scale 

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