Superficial chemical peeling with glycolic acid in melasma

Safoora Aamir, Tariq Rashid, Haroon Nabi, Tahir Saeed Haroon


Background Melasma is an acquired hyperpigmentation of exposed parts of face and neck,
for which various treatment options are available. Chemical peeling is an established
treatment modality for melasma.
Objective The aim of this study was to assess the safety and efficacy of glycolic acid peel in
our patients with melasma where the predominant Fitzpatrick skin type is IV and V.
Patients & methods A prospective therapeutic trial was carried out in the Department of
Dermatology, Mayo Hospital Lahore Pakistan from May 1999 to February 2000.Twenty
adult females (age range 18-38 years) with melasma (epidermal n=15, mixed n=3, dermal
n=2) were enrolled. Trial was conducted as a series of six fortnightly hospital-based peeling
sessions with increasing concentration of glycolic acid (20%-50%), and nightly application of
tretinoin, 5% glycolic acid and 2% hydroquinone. Patients were followed up for a period of
two months after completion of treatment.
Results The mean pre-peel and post-peel melasma area and severity index (MASI) scores
were 16.56 and 3.8 respectively, showing a significant reduction of about 75% (p< 0.05).
Among the two clinical patterns seen in our patients, malar distribution responded better as
compared to the centrofacial. Mild and reversible complications noted were erythema (90%),
peeling (70%), crusting (55%), post-inflammatory hyperpigmentation (20%) and moist
maceration (10%).
Conclusion Superficial chemical peeling with glycolic acid is safe and effective treatment
modality for melasma in our population.


Chemical peeling, melasma, glycolic acid

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