Efficacy of Combination of Glycolic Acid Peeling With Topical Regimen in Treatment of Melasma

October 2013 | Volume 12 | Issue 10 | Original Article | 1149 | Copyright © October 2013


Savita Chaudhary MD Fellow ISDa and Surabhi Dayal MDb

aDepartment of Dermatology, Era’s Lucknow Medical College and Hospital, Lucknow, India
bDepartment of Dermatology, Pt. BD Sharma, PGIMS, Rohtak, India

table 2
patients had burning and stinging sensation for which ice cooling was done and calamine lotion was applied (Table 3). None of the patients in either of the groups experienced any severe and persistent side effects.

DISCUSSION

This study demonstrated that combining topical regimen of hydroquinone plus tretinoin plus hydrocortisone acetate to serial glycolic acid peeling is better than topical regimen alone for treatment of melasma in dark complexioned individuals. Very few side effects were encountered and none was severe and persistent. This might be because all the three components of the topical regimen have unique importance when used with glycolic acid peeling. Hydroquinone acts as a priming agent and also decreases the post inflammatory hyperpigmentation especially in Indian skin ie, Fitzpatricks type III –V which has more tendency towards post inflammatory hyperpigmentation.31 Tretinoin also acts as a priming agent which increases the penetration of hydroquinone and glycolic acid,35 thereby making peel more effective and protects from the side effects of topical steroids like atrophy. The third component ie, hydrocortisone decreases the chance of post peel hyperpigmentation due to its anti inflammatory action.
This study demonstrated that the combination of serial glycolic acid peeling with topical regimen of 2% hydroquinone plus 0.05% tretinoin plus 1% hydrocortisone is a well-tolerated and highly effective treatment stratergy for melasma.

DISCLOSURES

None of the authors have disclosed any relevant conflicts of interest.

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