Superficial chemical peeling with glycolic acid in melasma

ABSTRACT

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. 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. A prospective therapeutic trial was carried out in the Department of Dermatology, Mayo Hospital Lahore Pakistan from May 1 999 to February 2000.Twenty adult females [age range 18-38 years] with melasma [epidermal n=1 5, 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. 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%]. Superficial chemical peeling with glycolic acid is safe and effective treatment modality for melasma in our population