Topical metformin in the treatment of melasma: A preliminary clinical trial.

Melasma is a common acquired pigmentary disorder that manifests as symmetric hyperpigmented macules and patches on the face,more frequently  affects women of reproductive age with darker skin type. Melasmaposes a therapeutic challenge because of its recalcitrant & recurrent  nature.Ideal treatment option for this cosmetically embarrassing condition is effective depigmentation without any adverse effects. Numerous therapeutic modalities have been tried for this condition,  triple combination cream(hydroquinone+steroid+tretinoin) remains the gold standard of treatment for this condition, but their prolonged use can result in serious adverse effects.Recent studies have shown that  metformin has melanopenic action when applied topically.Hence, this study will be  undertaken to evaluate the efficacy and safety of topical metformin and to compare its efficacy with that of triple combination cream (hydroquinone 2%+ tretinoin 0.025% +fluocinolone acetonide 0.01%), which is already proven to be efficacious in the treatment of melasma. Twenty patients in group 1  will be treated with topical metformin,  20 patients  in group 2 will be treated with TCC i.e, (hydroquinone 2%+ tretinoin 0.025% +fluocinolone acetonide 0.01%)