Superficial chemical peeling with glycolic acid in melasma

Abstract

Background Melasma is an acquired hyperpigmentation of exposed parts of face and neck,for which various treatment options are available. Chemical peeling is an establishedtreatment modality for melasma.Objective The aim of this study was to assess the safety and efficacy of glycolic acid peel inour 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 ofDermatology, Mayo Hospital Lahore Pakistan from May 1999 to February 2000.Twentyadult females (age range 18-38 years) with melasma (epidermal n=15, mixed n=3, dermaln=2) were enrolled. Trial was conducted as a series of six fortnightly hospital-based peelingsessions with increasing concentration of glycolic acid (20%-50%), and nightly application oftretinoin, 5% glycolic acid and 2% hydroquinone. Patients were followed up for a period oftwo months after completion of treatment.Results The mean pre-peel and post-peel melasma area and severity index (MASI) scoreswere 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 ascompared to the centrofacial. Mild and reversible complications noted were erythema (90%),peeling (70%), crusting (55%), post-inflammatory hyperpigmentation (20%) and moistmaceration (10%).Conclusion Superficial chemical peeling with glycolic acid is safe and effective treatmentmodality for melasma in our population.