Treatment of melasma with glycolic versus trichloroacetic acid peel: comparison of clinical efficacy

Abstract

Melasma is one of the most common, therapy-resistant forms of acquired hyperpigmentation. The aim of the present study was to assess the efficacy and side effects of chemical peels with 35% glycolic and 15% trichloroacetic acid (TCA) in conjunction with 20% azelaic acid cream in the treatment of melasma. Twenty-six women aged 22-54 years with different forms of melasma have been treated. Six of them were with phototype II, 11 with phototype III and 9 with phototype IV. Disease severity was assessed at the beginning and at the end of therapy according to the Melasma Area and Severity Index (MASI). Patients were randomly divided in two groups – Group I (n=12) treated with 35% glycolic acid and Group II (n=14) treated with 15% TCA. A significant reduction in MASI values after therapy was observed in all patients without significant difference between Group I and Group II (t=0,12; ð>0,05). No statistical difference was established among final MASI values of women with phototypes II, III and IV (t=0,25; ð>0,05). Side effects were light and negligible. Therapy was positively assessed by the patients. In conclusion, chemical peels with 15% TCA and 35% glycolic acid in conjunction with 20% azelaic acid reduce significantly MASI values after therapy and are equally effective in the treatment of melasma.