Melasma30% Topical Metformin vs. Kligman's Regimen for Melasma in Middle-Aged Women

Melasma is a skin condition that causes brown patches on the face, primarily affecting middle-aged women. This study is about finding a new approach to manage melasma, comparing the effectiveness of a topical cream containing 30% metformin and the current standard treatment known as Kligman's regimen. The goal is to see if metformin, an antidiabetic drug with antioxidant and anti-pigment properties, can offer a safer and equally effective alternative for treating melasma. The study specifically targets middle-aged women with epidermal melasma, aiming to improve care and address the challenges associated with current treatments. Participants in this study will be divided into two groups. One group will apply the 30% metformin cream once every night, while the other will use Kligman's regimen in the same manner. The study will last for 8 weeks, during which the effectiveness of each treatment will be evaluated using the modified Melasma Area and Severity Index (mMASI) score. This score measures the size and darkness of pigmentation on different parts of the face. The study will also monitor any side effects such as redness, burning, irritation, peeling, or skin discoloration. The hypothesis is that topical 30% metformin may be more effective than Kligman's regimen in reducing mMASI score after 8 weeks.