Efficacy and safety of 70% glycolic acid versus Q Switched Nd:YAG laser in the treatment of melasma: acomparative study

Abstract
Background: Melasma is an acquired hypermelanosis characterized by light-to-deep brown pigmentation over cheeks, forehead, upper lip, and nose. Treatment of this condition is difficult and associated with high recurrence rates. Among newer therapies, there is interest in the use of glycolic acid peels and Q-switched Nd:YAG laser (QSNYL). The aim of the present study was to compare the therapeutic efficacy and in melasma. Methods: 60 patients of melasma were included. They were randomly divided in two groups (Group A = 30 patients treated with glycolic acid and Group B = 30 patients treated with QSNYL). Out of the 60 patients included, 26 patients in Group A, 24 patients in Group B completed the study. Response to treatment was assessed using MASI scores. Results: The peak incidence of melasma was seen in the age group 31-40 years. Female preponderance was seen in the study (F: M-6.6:1). Sunlight was the common aggravating factor in both the groups (30%). Malar type was the most common (51.7%) observed in both the groups. MASI scores improved from 7.14 to 4.99 with glycolic acid peel and from 6.17 to 4.67 in the laser group at the end of the study. The common adverse effect observed in the study was erythema in both the groups. Postinflammatory hyperpigmentation was frequent in laser treated patients.Conclusion: 70% Glycolic peels were better than Q switched Nd:YAG laser for the treatment of melasma. Among patients treated with laser postinflammatory hyperpigmentation was a significant side effect especially in darker skin types.