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Efektifitas Astaxanthin Oral disertai Gel Astaxanthin Dibandingkan

dengan Astaxanthin Oral disertai Krim Triple Combination


(Hidrokuinon 4%, Tretinoin 0,05%, Fluosinolon Asetonid 0,01%)
dalam Pengobatan Melasma
Faridah Israwaty Lubis, Rointan Simanungkalit, Daratia I. Kadri
Departemen Ilmu Kesehatan Kulit dan Kelamin
Fakultas Kedokteran, Universitas Sumatera Utara
Rumah Sakit Umum Pusat H. Adam Malik, Medan

Abstrak
Latar belakang : Melasma merupakan suatu penyakit kulit hipermelanosis, didapat, dan letaknya
simetris pada daerah yang sering terpapar sinar matahari, terutama wajah. Melasma sering ditemukan
pada wanita. Banyak modalitas terapi yang ada akan tetapi tidak satupun memberikan hasil pengobatan
yang memuaskan.
Tujuan : Mengetahui perbedaan efektifitas pemberian astaxanthin oral disertai gel astaxanthin
dibandingkan astaxanthin oral disertai krim triple combination terhadap pasien melasma.
Subyek dan metode : Penelitian bersifat uji klinis, acak, tersamar ganda. Penelitian dilaksanakan pada
bulan Januari Mei 2011, melibatkan 27 orang penderita melasma yang diobati dengan astaxanthin oral
(sekali sehari) disertai gel astaxanthin (dua kali sehari) sebagai kelompok terapi dan 27 orang penderita
melasma yang diobati dengan astaxanthin oral (sekali sehari) disertai krim triple combination (sekali
sehari) sebagai kelompok kontrol, pengobatan diberikan selama 8 minggu. Terhadap subyek penelitian
dilakukan penilaian derajat keparahan melasma (Melasma Severity Scale), pengukuran skor Melasma
Area and Severity Index (MASI) dan efek samping obat.
Hasil : Astaxanthin oral disertai gel astaxanthin secara statistik lebih efektif bermakna dibandingkan
astaxanthin oral disertai krim triple combination dimana lesi melasma hampir sama dengan warna kulit
disekitarnya setelah 4 minggu kedepan ditemukan sebanyak 23,1% pada kelompok terapi, dibandingkan
16,7% pada kelompok kontrol (p=0,014). Penurunan skor MASI baik kelompok terapi maupun
kelompok kontrol yang diukur mulai mulai minggu ke 0 samping minggu ke 8 secara statistik bermakna
(p=0,0001). Efek samping hanya ditemukan pada kelompok kontrol (22/24, 91,7%).
Kesimpulan : Astaxanthin oral disertai gel astaxanthin lebih efektif dan aman dibandingkan astaxanthin
oral disertai krim triple combination dalam pengobatan melasma.
Kata kunci : Melasma, astaxanthin oral, gel astaxanthin, krim triple combination

Universitas Sumatera Utara

Efficacy of Oral Astaxanthin combined with Astaxanthin Gel


compared with Oral Astaxanthin combined with Triple
Combination Cream (hydroquinone 4%, tretinoin 0,05%,
fluocinolone acetonide 0,01%) in the Treatment of Melasma
Faridah Israwaty Lubis, Rointan Simanungkalit, Daratia I. Kadri
Departement of Dermatology-Venereology
Faculty of Medicine, University of North Sumatera
H. Adam Malik Hospital, Medan

Abstract
Background : Melasma is a common acquired symmetrical hypermelanosis that occurs on sun-exposed
facial areas. Melasma is frequently observed among women. Many modalities of treatment are available
but none is satisfactory.
Aim : To compare the efficacy and safety of oral astaxanthin combined with astaxanthin gel and oral
astaxanthin combined with triple combination cream in the treatment of melasma.
Subject and methods : A double blind, randomize, clinical trial design study was conducted from
January to May 2011, 54 female patient with epidermal melasma were divided into two groups of 27
each. One group received oral astaxanthin (once daily) combined with a topical astaxanthin (twice daily).
The other, a control group, received oral astaxanthin (once daily) combined with a topical triple
combination (once daily) for 8 weeks. Evaluation include static global severity assessment (Melasma
Severity Scale), Melasma Area and Severity Index (MASI) score, and adverse event.
Results : Oral astaxanthin combined with astaxanthin gel was significantly more effective than oral
astaxanthin combined with triple combination cream week 4 onwards: lesion were approximately
equivalent to the surrounding skin in 23,1% of all oral astaxanthin combined astaxanthin gel, compared
to 16,7% of those who used oral astaxanthin combined with triple combination cream (p=0,014). All 54
patients showed marked improvement, as calculated by the MASI score before and after treatment, and
the response was highly statistically significant (p=0,0001). Adverse events were observed on oral
astaxanthin combined with triple combination cream (22/24, 91,7%).
Conclusion : Oral astaxanthin combined with astaxanthin gel was more effective than oral astaxanthin
combined with triple combination cream and safe agent in the treatment of melasma.
Keywords : Melasma, oral astaxanthin, gel astaxanthin, triple combination cream

Universitas Sumatera Utara