The effect of topical nano vitamin-C iontophoresis versus the effect of trichloroacetic acid 20% peel in treatment of melasma

Abstract

BackgroundMelasma is a common acquired condition of symmetric hyperpigmentation, typically occurring on the face, with higher prevalence in females and darker skin types. Multiple etiologies, including light exposure, hormonal influences, and family history, have been implicated in the pathogenesis of this disorder. Various topical, oral, and procedural therapies have been successfully used to treat melasma. Traditional topical therapies, including hydroquinone, tretinoin, corticosteroids, and triple-combination creams.ObjectiveThis study was designed to assess the efficacy of topical nano vitamin C enhanced with iontophoresis and to compare its effect with topically applied trichloroacetic acid 20% chemical peeling in the treatment of melasma.Patients and methodsA right–left comparative study included 30 female patients with their age ranging from 20 to 52 years, who participated for treatment of facial melasma, with melasma duration ranging from 1 to 12 years selected from the cosmetology outpatient clinic of Dermatology Department, Menoufia University Hospitals during the period from September 2020 to March 2021. History and clinical examinations were done for each patient.ResultsThere was a significant positive correlation between Melasma Area and Severity Index score in the sixth session on right sides and age, disease duration, number of pregnancies, and duration from the last pregnancy. There was a significant positive correlation between Melasma Area and Severity Index score in the sixth session on the left sides and the amount of pregnancy and mean percentage of improvement was more on the right than the left side, 58.9 ± 18.8 versus 51.2 ± 18.8, but did not reach the significance level (P > 0.05).ConclusionNanosomal vitamin C with iontophoresis is an easy, safe, effective, painless, and noninvasive method in the treatment of melasma and trichloroacetic acid 20% peel was found as effective in the treatment of melasma.