We found no systematic review. We found one RCT35 (Japan, 3-month follow up; 176 women and 2 men with diagnosis of melasma). Melasma was present in 136 people (76%) and pigmented contact dermatitis in 42 (24%). Specific results for melasma were available from the study report. The RCT compared oral vitamin E (50 people), vitamin C (45 people) and a combination of vitamins E and C (41 people). The study excluded pregnant women and people suffering from systemic diseases. After 12 weeks, physician-rated colour difference and photographic findings were used to assess changes. Using colour photographs, an improvement was noticed in 69% of those receiving a combination therapy of vitamins E and C, 60% of those receiving vitamin E and 50% of people receiving vitamin C. These differences did not reach statistical significance. In the objective clinical improvement evaluation,

72% of the participants in the combined-therapy group showed improvement compared with 63% in the vitamin E group and 44% in the vitamin C group. The difference between the combined-therapy and vitamin C groups reached statistical significance (P< 0-05).

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