Successful short-term and long-term treatment of melasma and postinflammatory hyperpigmentation using vitamin C with a full-face iontophoresis mask and a mandelic/malic acid skin care regimen

J Drugs Dermatol. 2013 Jan;12(1):45-50.


Background: Treatment of melasma and postinflammatory hyperpigmentation is often challenging. No ideal short-term and long-term treatment is available. Vitamin C alone and in combination with iontophoresis has been studied and found to be useful; however, no long-term studies have been published.

Methods: In this study, 35 patients (34 female, 1 male) were treated with a novel full-face iontophoresis mask (FFIM) and a proprietary vitamin C (ascorbyl glucoside) preparation. Patients received one in-office treatment and 12 to 24 at-home treatments over 1 to 2 months in conjunction with a strict maintenance regimen consisting of a mandelic/malic acid skin care regimen, broad-spectrum ultraviolet A/ultraviolet B sunblock, a wide-brimmed hat, and sun-avoidance behavior. Follow-up after the initial in-office treatment ranged from 1 to 54 months (mean, 26 months). Four independent observers graded improvement of melasma and PIH using a 4-point scale. Before the study, high-performance liquid chromatography was used to verify iontophoretic penetration of vitamin C into the skin to a level of 0.2 cm in healthy volunteers (2 male, 2 female).

Results: A mean 73% improvement in abnormal pigmentation was observed at the end of FFIM/vitamin C treatment. Greater than 25% improvement was observed in 32 of 35 patients, and greater than 50% improvement in 22 of 35 patients. Melasma Area and Severity Index scores demonstrated substantial improvement from baseline for all patients, with a mean improvement of 15.7.

Conclusions: Full-face iontophoresis of vitamin C appears to be an effective short-term treatment for melasma and postinflammatory hyperpigmentation. A protocol of strict sun avoidance in combination with a mandelic/malic acid skin care regimen appears to be useful in maintaining the improvement.

MeSH terms

  • Adult
  • Ascorbic Acid / administration & dosage
  • Ascorbic Acid / pharmacokinetics
  • Ascorbic Acid / therapeutic use*
  • Chromatography, High Pressure Liquid
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperpigmentation / complications
  • Hyperpigmentation / drug therapy*
  • Iontophoresis
  • Malates / administration & dosage
  • Malates / therapeutic use*
  • Male
  • Mandelic Acids / administration & dosage
  • Mandelic Acids / therapeutic use*
  • Masks
  • Melanosis / complications
  • Melanosis / drug therapy*
  • Middle Aged
  • Skin / chemistry
  • Skin Absorption
  • Sunscreening Agents / therapeutic use
  • Treatment Outcome
  • Vitamins / administration & dosage
  • Vitamins / pharmacokinetics
  • Vitamins / therapeutic use*


  • Malates
  • Mandelic Acids
  • Sunscreening Agents
  • Vitamins
  • malic acid
  • mandelic acid
  • Ascorbic Acid