Publication:

Evaluation of glycolic acid and trichloroacetic acid peels in the treatment of melasma

Background Melasma is a chronic acquired hypermelanosis of the skin mainly affecting women. The etiopathogenesis of melasma is not fully understood but multiple factors like genetic influences, sunlight exposure, pregnancy, estrogen ingestion and family history are implicated. The present study was aimed to evaluate the therapeutic, efficacy of glycolic acid (GA) and trichloroacetic acid (TCA) superficial chemical peels in melasma patients.

Methods Fifty patients with clinically diagnosed melasma of either sex attending the outpatient clinic of department of dermatology of Mamata medical college and hospital, Khammam during the period of April 2007 to March 2008 constituted the subject material.

Results Distribution of melasma patients by duration of lesions showed the duration varied from 6 months to 6 years in both the groups, the difference in the duration of disease in two groups was statistically non-significant. Whereas site involvement showed malar region (96%) was the most commonly affected site followed by forehead (80%) and chin (20%). Study also showed sunlight was the main precipitating factor and the most frequent Fitzpatrick skin phototype was type V. The majority of cases in both the groups pigmentation was homogenous. In both the groups, at the end of three peels, it was observed that maximum cases had moderate improvement. Burning sensation was significantly high in group B compared to group A, erythema was seen in more in group B.

Conclusions This study proposes to combine both their modalities of chemical peels for better results TCA peels are used initially to get prompt response and then followed by GA peels to further reduce the pigmentation and maintain the effect.