A comparative study of the efficacy of triple-combination therapy with and without oral vitamin d in melasma, a randomized controlled study

Background: Melasma is a chronic hyperpigmentation disorder that often proves challenging to treat due to its recurrent nature. While triple combination topical therapy is widely used, adjunct therapies are being explored to improve outcomes. Vitamin D, known for its role in cutaneous physiology, may have a therapeutic role in pigmentary disorders. Objective: To evaluate the efficacy and safety of oral vitamin D supplementation in combination with standard triple combination therapy in patients with melasma. Methods: A randomized, open-label, comparative clinical study was conducted in 30 patients with melasma, divided into two groups of 15 each. Group A received topical triple combination therapy, while Group B received the same therapy plus oral vitamin D (60,000 IU weekly for 12 weeks). Outcomes were assessed using the modified Melasma Area and Severity Index (mMASI) and the Dermatology Life Quality Index (DLQI) at baseline, 6 weeks, and 12 weeks. Adverse effects were also recorded. Results: Group B demonstrated greater reductions in mMASI (56.3%) and DLQI (47.4%) compared to Group A (30.6% and 24.6%, respectively). Differences at both 6 and 12 weeks were statistically significant (p< 0.05). Mild and transient erythema was noted in 6 patients. Conclusion: Oral vitamin D supplementation may serve as an effective and safe adjunct to triple combination therapy in melasma, enhancing clinical and quality-of-life outcomes.