111 Application of Kojic Acid in Treatment of Melasma Figure II. Geographic distribution of the studies included in this scoping review.

Table II Characteristics of the Intervention Regarding Pharmaceutical Forms of KA Delivery, Concentration, Treatment Time, and Frequency of Application Author/year Association/pharmaceutical form/concentration Frequency of application/ treatment duration Reduced severity of stains Improving the quality of life Adverse effect Sardesai et al. ,2013 (11) Group A: 3% KA and 2% vitamin C cream Group B: 5% Arbutin, 10% GA, and 3% KA cream Daily use, at night, for 3 months In both groups, there was a statistically significant mean MASI score reduction. However, Group A showed a more significant improvement than Group B. It does not apply Group A: erythema and burning Group B: erythema, burning, flaking, and itching Monteiro et al.2013 ,(12) 0.75% KA and 2,5% vitamin C cream Daily use, at night, for 12 weeks The mean reduction of the MASI score was significant from week 0 to week 12 (≤0.001). There was no significant change from week 0 to week 4 (=0.121), however from week 0 to week 8 there was a significant reduction (0.001). It does not apply Erythema Cameli et al. ,2014 (13) 1% KA, 1% uva-ursi, 1% arbutin, 1% pineapple, 1% green tea, 1% Capparis spinosa extract, 1% vitamin C palmitate, 1% papaya, and 1% aloe transdermal gel administered by monopolar radiofrequency (Phytogel) Six sessions with an interval of 1 week. Patients were evaluated before treatment, after 1 month, and 6 months after treatment. One month after the completion of treatment, the initial mean MASI score of 21.3 dropped to 15.7 (0.001), and after 6 months of follow-up, the average value was 16.9. These results were confirmed by a statistically significant decrease in the mean melanin score recorded using a Mexameter in T1 (214.46) and in T2 (216.24) compared to baseline T0 (260.76) (0.001). It does not apply It was not reported Yenny, 2018 (14) 4% cream (left cheek) Daily use, at night, for 12 weeks. The evaluation was performed every 2 weeks. Week 0: left face MASI scores 11.7 Week 4: MASI scores 10.9 Week 8: MASI scores 9.9 Week 12: MASI scores 8.6 It does not apply Redness, burning, and itching ()112 JOURNAL OF COSMETIC SCIENCE