Publication:

A clinical and therapeutic study of efficacy of 40% glycolic acid facial peels in melasma

Background Melasma is an acquired hyperpigmentation of face predominantly affecting women with multiple factors like high estrogen states, genetic factors, sunlight, cosmetics & autoimmune thyroid disease implicated in its etiology. Current therapeutic modalities are beneficial for many patients but for some they may remain ineffective. The objective of the study was on clinical study of melisma and to study efficacy of 40% glycolic acid facial peels in melasma.

Methods Woods lamp examination was done and patients were classified as having epidermal, dermal or mixed type. 40% glycolic acid peel was carried for a period of 20-30 seconds and was left for a period of 3 minutes or till the development of erythema. The peel was terminated by dilutional effect of washing with cold water. Six peelings were done at 15 days interval.

Results In total 50 patients, 56% belong to 31-40 years. Females constitute 82%. Majority were housewives (64%). Malar distribution was most common type (90%). Family history was present in 38%. Photo aggravation was present in 56% patients. Onset of melasma was associated with pregnancy in 22%. Epidermal melasma was seen in 62%. >75% improvement in 2%, 51-75% improvement in 14% and 25-50% improvement in 40% patients. Erythema (54%) and burning sensation (56%) were common side effects.

Conclusions So management of melasma in our patients with superficial glycolic acid peels alone is not highly rewarding.