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 Deo et al. ,2013 (27) Group A: 1% KA cream Group B: 1% KA and 2% HQ cream Group C: 1% KA, and 0.1% betamethasone cream Group D: 1% KA, 2% HQ, and 0,1% betamethasone cream Daily use, at night, for 12 weeks. Patients were evaluated at weeks 4, 8, and 12. Group A: the mean percentage of improvement in the MASI score was 58.72% Group B: the mean percentage of improvement in the MASI score was 71.87%, with an excellent response at 60%, good at 30%, and regular and poor at 5% each Group C: showed the lowest improvement (36.46%) Group D: the mean percentage of improvement in the MASI score was 54.03%, with 25% showing excellent improvement, a good response at 35%, a reasonable at 35%, and a poor at 5% It does not apply A: burning B: burning C: it was not reported D: acneiform rashes Arunnair et al.2021 ,(28) HQ, KA, GA, and vitamin E cream The treatment lasted 3 months, with three visits for follow-up. Frequency of unreported application. It does not apply The DLQI score at baseline was 9.65. On the first visit, there was a reduction of 7.84. On the second, it decreased to 5.75. And on the third visit, there was a reduction to 3.12. The DLQI scores from the beginning to the end of the study and from the beginning until each visit were significant with a p 0.01. Erythema, itching, irritation, and dryness of the skin ()117 Application of Kojic Acid in Treatment of Melasma
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 Garcia Fulton Jr., 1996 (29) KA gel (on only one side of the face) Daily use, twice a day, for 3 months 28% of patients had an improvement with the use of KA. Note: the difference in pigment reduction between KA and HQ (comparator) was not significant (0.05). It does not apply Burning and flaking Srivastava et al.2020 ,(30) 12% HQ, 6% KA, and 5% vitamin C cream. Treatment lasted from 8 to 36 weeks, varying between patients. Frequency of unreported application. Before and after treatment, MASI scores decreased on average by 63.77 ± 22.10% (=0.0002) It does not apply Erythema, telangiectasia, atrophy, and flaking Cotellessa et al.,1999 (31) 50% GA and 10% KA gel (peeling) The sessions were held every 2 weeks for 3 to 6 months 30% of patients had a complete reduction of melasma, 60% had a partial reduction, and 10% of the patients had no reduction It does not apply Light erythema, light flaking Lim et al. ,1999 (32) 2% KA, 10% GA, and 2% HQ gel. (on only one side of the face) Daily use, twice a day, for 12 weeks. The evaluations were performed every 4 weeks. Melasma improvement was observed in week 4 and continued throughout the study. Only two patients had their melasma gone, and more than half of the melasma was eliminated in 24 of 40 patients (or 60%). It does not apply Redness, burning, and light exfoliation Wali et al. ,2013 (33) KA cream Daily use, at night. The patients were followed up during the third, sixth, and ninth weeks. In 40% of the patients, there was a slight improvement. In 35%, there was a moderate improvement, which may be noticeable. In 20% there was an obvious improvement. And in 5% there was a very marked improvement. It does not apply It was not reported DLQI: dermatology life quality index EDTA: ethylenediamine tetraacetic acid GA: glycolic acid HQ: hydroquinone HEPES: hydroxyethylpiperazine ethane sulfonic acid KA: kojic acid MASI: melasma area and severity index mMASI: modified melasma area and severity index MI: melanin index MELASQol: melasma quality of life scale TXA: tranexamic acid. 118 JOURNAL OF COSMETIC SCIENCE
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