The Impact of Intense-pulsed Light and Modified Kligman’s Formula for Management of the Moderate to Severe Melasma: A Comparative Study

Background: Melasma is a common pigmentary disorder that poses therapeutic challenges, so a variety of treatment modalities have been used in targeting pigmentation of melasma such as laser, Intense-pulsed light (IPL) and topical depigmented agents. Objective: To compare the efficacy and safety of Intense-pulsed light (IPL) with modified kligman formula (triple combination) versus IPL alone in the treatment of melasma. Methods: Forty-one patients with melasma (20 group-A and 21 group -B) were selected, mostly of skin type III, IV and V.  Treatment is performed by using a session of IPL then daily use modified kligman formula at night and glycerin cream as moisturizer in the morning and with use of sunscreen in group -A for 4 sessions while group -B patients were treated by IPL alone at 4-week intervals. All the patients were photographed before starting the therapy and at the end of four IPL sessions.  Results: Most of the patients in both groups had showed a good improvement in their melasma with the use of our treatment with adequate sun protection. The Melasma Area and Severity Index (MASI) scores significantly decreased in both groups after the treatment especially in epidermal types and also mixed types though no statistical difference was established among final MASI values of patients with dermal type in group-B. Conclusion:  The use of IPL sessions and triple mixture cream seems to be more effective than IPL sessions alone.  It is an easy and a good option for patients with melasma. Adverse effects were minimal and acceptable with good satisfaction rate among patients.