to the 10% mandelic/10% malic acid formula following a few weeks of conditioning with the lower concentration. The pH of both products is 3.1 to 3.3. The personal experience of one author (M.B.T.) has shown mandelic/malic acid to be a less irritating α-hydroxy acid than glycolic acid and better tolerated in PIH-sensitive darker skin types.
This study supports the safe and effective use of a full-face iontophoresis mask for treatment of melasma as an important method for obtaining sufficient concentrations of vitamin C at therapeutic levels and skin depth to effect a favorable clinical response. The long-term use of a novel mandelic and malic acid skin care regimen further supports sustained improvement (mean, 26 months) when used in combination with a strict sun-protection protocol. Compliance with a strict regimen of sun protection and avoidance is difficult to measure. It is assumed that the patients in this study were much less than 100% compliant; however, a satisfactory improvement in melasma and PIH was still achieved.
Dr. Taylor has an equity interest in Cosmion LLC and MCK Labs. Mr. Yanaki has an equity interest in ActivaTek Inc, a manufacturer of iontophoresis products. The other authors have no relevant conflicts of interest to disclose.
- Pathak MA, Riley FC, Fitzpatrick TB. Melanogenesis in human skin following exposure to long-wave ultraviolet and visible light. J Invest Dermatol. 1962;39:435-443.
- Mahmoud BH, Ruvolo E, Nexsel CL, et al. Impact of long-wavelength UVA and visible light on melanocompetent skin. Poster presented at: 2008 American Society for Laser Medicine and Surgery Annual Meeting; April 2-6, 2008; Kissimmee, FL.
- Sharquie KE, Al-Tikreety MM, Al-Mashhadani SA. Lactic acid as a new therapeutic peeling agent in melasma. Dermatol Surg. 2005;31(2):149-154.
- Faghihi G, Shahingohar A, Siadat AH. Comparison between 1% tretinoin peeling versus 70% glycolic acid peeling in the treatment of female patients with melasma. J Drugs Dermatol. 2011;10(12):1439-1442.
- Mahmoud BH, Nexsel CL, Hamzavi IH, Lim HW. Effects of visible light on the skin. Photochem Photobiol. 2008;84(2):450-462.
- Sheth VM, Pandya AG. Melasma: a comprehensive update: part I. J Am Acad Dermatol. 2011;65(4):689-697.
- Sheth VM, Pandya AG. Melasma: a comprehensive update: part II. J Am Acad Dermatol. 2011;65(4):699-714.
- Lakhdar H, Zouhair K, Khadir K, et al. Evaluation of the effectiveness of broad-spectrum sunscreen in the prevention of chloasma in pregnant women. J Eur Acad Dermatol Venereol. 2007;21(6):738-742.
- Khadir K, Amal S, Hafi F, et al. Les signes dermatologiques physiologiques de la grossesse [in French]. Ann Dermatol Venereol. 1999;126:15-19.
- Woolery-Lloyd H, Kammer JN. Treatment of hyperpigmentation. Semin Cutan Med Surg. 2011;30(3):171-175.
- Lawrence N, Bligard CA, Reed R, Perret WJ. Exogenous ochronosis in the United States. J Am Acad Dermatol. 1988;18(5 Pt 2):1207-1211.
- Draelos ZD. Skin lightening preparations and the hydroquinone controversy. Dermatol Ther. 2007;20(5):308-313.
- Comeau M, Brummett R. Anesthesia of the human tympanic membrane by iontophoresis of a local anesthetic. Laryngoscope. 1978;88(2 Pt 1):277-285.
- Glass JM, Stephen RL, Jacobson SC. The quantity and distribution of radiolabeled dexamethasone delivered to tissue by iontophoresis. Int J Dermatol. 19(9):519-525.
- Scientific Evidence page. http://www.activatekinc.com/technology/scientific-evidence. Accessed August 2008.
- Choi YK, Rho YK, Yoo KH, et al. Effects of vitamin C vs. multivitamin on melanogenesis; comparative study in vitro and in vivo. Int J Dermatol. 2010;49(2):218-226.
- Huh CH, Seo KI, Park JY, Lim JG, Eun HC, Park KC. A randomized, double-blind, placebo-controlled trial of vitamin C iontophoresis in melasma. Dermatology. 2003;206(4):316-320.