الفهرس 
Introduction and aim of workOnly 14 pages are availabe for public view
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Abstract
Background: Melasma is an acquired symmetrical dyschromia affecting photoexposed areas, more commonly seen in adult women. Antioxidants (selenium,vitamins A, C and E) may serve as reactive oxygen radicals scavengers to reduce the oxidative stress caused mainly by ultraviolet rays in melasma.
Aim of the work: To evaluate the clinical efficacy of selenium, vitamins A, C and E as a new modality in melasma treatment and its effect on serum MDA level as the main indicator of oxidative stress.
Patient and Methods: Thirty female patients with facial melasma were treated with selenium and vitamins A, C and E tablets. All cases were assessed by Melasma area and severity index (MASI) score, photos before and after treatment and patient and physician satisfaction scoring. Also MDA was measured before and after treatment.
Results: There was no statistically significant difference with p-value
>0.05 between before and after treatment regarding patient and physician satisfaction. Most results reported poor physician and patient satisfaction. The mean MASI score was (22.09±10,95) changed after treatment to (22,44±10,34). The median MDA score was (11,87) changed after treatment to (8,02).
Conclusion: In conclusion, selenium and vitamins A, C and E only are not considered an effective treatment for melasma. Howevever, It can be considered as a treatment or prophylaxasis in disesases due to oxidative stress. Further studies on larger scales are required.
Keywords: Melasma- Selenium -Vitamins A-Vitamin C -Vitamin E – Malondialdhyde