(3.76 [±0.79]; Table 5. Baseline scores for individual facial photodamage parameters were for lentigines 2.03 (±1.10), tactile roughness 2.58 (±0.75), laxity 2.67 (±0.69), mottled hyperpigmentation 3.33 (±0.69), fine wrinkling 2.79 (±0.55), coarse wrinkling 2.24 (±0.87), and crepiness 2.39 (±0.83); Table 5.Baseline patient self-assessment of skin condition is summarized in Table 6. Almost everyone (93.9%) was embarrassed or selfconscious about their skin discoloration to some extent. Most bothersome were feelings of being unattractive (“very much” or “a lot” in 75.8% of patients) or having to hide skin discoloration from others (“very much” or “a lot” in 69.7% of patients).Efficacy
The 4% HQ system plus retinol 1.0% regimen was associated with a significant reduction in baseline melasma disease severity and pigmentation intensity from week 8 and week 4, respectively (P<.001, Figures 1 and 2). In addition, there were significant reductions in MASI and overall integrated facial photodamage from week 4 (P=.003 and P=.044, respectively).By week 24, investigators reported a 37.1% mean improvement in melasma disease severity [from 4.27 (±0.94) to 2.68 (±1.17), P<.001], a 47.7% mean improvement in melasma pigmentation intensity [from 4.88 (±1.39) to 2.58 (±1.15), P<.001], and a 64.1% reduction in MASI [from 15.32 (±6.87) to 5.58 (±4.24), P<.001; Figure 3]. The MASI improved in 96.8% of patients, with improvements in melasma disease severity and pigmentation intensity in 83.9% and 93.5% of patients, respectively.Investigators also reported a 42.4% mean change in overall integrated facial photodamage [from 3.76 (±0.79) to 2.19 (±0.79), P<.001; Figure 3]. Improvements were noted in 96.8% of patients. Changes in specific aspects of photodamage were significant from week 4 (mottled hyperpigmentation, P<.001), week 8 (lentigines, tactile roughness, laxity, fine wrinkling [all P<.001], and crepiness [P=.006]), or week 18 (coarse wrinkling, P=.002; Figure 4).At week 24, 90.4% of patients considered their study treatment was “more effective” or “much more effective” than other treatments; 93.6% percent were “very satisfied” or “satisfied” with the overall effectiveness; and 67.8% considered the study treatment “easy” or “very easy” to apply. Skin felt “smoother” or “much smoother” to 96.8% of patients.The majority of patients reported improvements in other skin characteristics. A “good”, “very good”, or “excellent” improvement in skin texture (roughness) was reported at weeks 12 and
