Introduction: Melasma is an acquired and progressive hyperpigmentation of photoexposed areas. For being a recurrent and refractory dermatosis, its treatment continues to be a challenge.Objective: To evaluate the efficacy and security of the Skin Whitening Complex in the treatment of the facial melasma,and to compare it to the hydroquinone. Materials and methods: Double-blind Comparative study of 13 women bearers of melasma. All received two different formulations, labelled as “right side of the face" and left "side of the face". The formulations were applied twice a day for 90 consecutive days. Only the pharmacist responsible for the formulations had knowledge of their content. The tests of Wilcoxon and 2 of McNemar-Bowker were employed in the statistical analysis. Results: Ten of the 13 patients presented the global clinical improvement of the melasma. Four patients presented total improvement and six (p = 0004) presented partial improvement in the hemiface treated with hydroquinone 4%. In the hemiface treated with Skin Whitening Complex 5%, the improvement was total in two patients, and partial in six (p = 0007).There were no statistically significant differences between the two treatments (p = 0223). Conclusions: Although the treatment with hydroquinone 4% presents better clinical results, there were no statistically significant differences between the two treatments. Skin Whitening Complex 5% has shown efficient and safe in the treatment of the melasma.

Keywords: MELANOSIS/THERAPY, HYPERPIGMENTATION, HYDROQUINONES

Introduction: Melasma is a common, acquired, long-lasting skin disorder that is often resistant to treatment and causes negative psychological effects on patients.
Objectives: To evaluate the efficacy, safety, and tolerability of the topical combination of kojic acid, arbutin, sepiwhite® and achromaxyl ® compared to 2% and 4% hydroquinone in the treatment of facial melasma.
Methods: A single-blind, comparative, monocentric clinical study with 120 volunteers (aged 18-50, I to IV Fitzpatrick skin types) was conducted. The study population was divided into 3 groups: Group A (n = 40; Blancy®, 2 times a day), Group B (n = 40, 2% hydroquinone at night), and Group C (n = 40, 4% hydroquinone at night), and instructed to use the study product for 90 consecutive days. Clinical (classification and quantification of melasma) and photographic evaluations were carried out, and a questionnaire assessed the impact on the patients'''''''' quality of life and the products'''''''' general efficacy.
Results: Most volunteers (n = 102, 85%) completed the study (Group A = 34, Group B = 33, Group C = 35). The Melasma Area Severity Index metrics presented a statistically significant decrease (i.e., improvement) throughout the study in all three groups (p-value < 0.001).
Conclusion: The topical use of the kojic acid, arbutin, sepiwhite® and achromaxyl® combination proved to be an effective and safe alternative for treating melasma.

Keywords: MELANOSIS, HYDROQUINONES, ARBUTIN, QUALITY OF LIFE

Exogenous Ochronosis is a rare skin disease. It is usually associated with the topical use of hydroquinone, resulting in a grayish or bluish black hyperpigmentation due to dermal deposition of ocher pigment. There is no gold standard treatment and the therapeutic options are generally not effective. We report a case of a patient with exogenous achronosis after use of Hydroquinone, treated with CO₂ Laser and showing very good results.

Keywords: HYDROQUINONES; LASER THERAPY; OCHRONOSIS

This letter is a reflection that arose from the lecture given by Professor Fatimata Ly, from University Cheikh Diop in Dakar (Africa) in the latest Congress of the European Academy of Dermatology and Venereology in Paris. Professor F. Ly gave the lecture "Depigmentation: when, where and how”. An even skin tone is one of the criteria for beauty. This letter does not concern those patients that come to our practices and are carefully followed and monitored by thorough dermatologists. She wants to raise attention to those that do not come to our practices, that use prescriptions given to acquaintances, or that use a dermatologist prescription indefinitely, after a single consultation. I was recently part of "discussion” forums over the internet, anonymously, of lay people on melasma. The intensity and speed of sharing of what they recommend using are impressive. They are very creative suggesting the use of products that could cause harm. Among the most used lightening products are steroids, hydroquinone, mercury and acids. There must be an awareness campaign to warn the population regarding the dangers of using skin depigmenting agents without a specific indication by the dermatologist.

Keywords: Hyperpigmentation; Melanosis; Skin Care; Skin Pigmentation; hidroquinones

Atrophic acne scars result from an abnormal wound-healing response that can be treated with microneedling (MN). Insulin may play a role in wound healing. The effectiveness and safety of combining MN with topical insulin as an alternative therapy for atrophic acne scar revision have not yet been widely reported. We report the case of a 33-year-old woman with an atrophic acne scar on the middle third of her face. The patient was treated with MN and topical insulin for four sessions at two-week intervals. MN plus insulin can be considered an alternative for acne scar revision.

Keywords: Acne Vulgar; Insulina; Cicatriz; Hiperpigmentação