Efficacy and safety of serial glycolic acid peels and a topical regimen in the treatment of recalcitrant melasma
- 20 December 2006
- journal article
- research article
- Published by Wiley in The Journal of Dermatology
- Vol. 34 (1), 25-30
- https://doi.org/10.1111/j.1346-8138.2007.00211.x
Abstract
Melasma is a common acquired disorder of facial hyperpigmentation. In this study we investigated the efficacy and safety of a combined treatment regimen including serial glycolic acid peels, topical azelaic acid cream and adapalene gel in the treatment of recalcitrant melasma. Twenty-eight patients with recalcitrant melasma were enrolled in a prospective, randomized, controlled trial lasting 20 weeks. The patients of the group receiving chemical peels underwent serial glycolic acid peels in combination with topical azelaic acid 20% cream (b.i.d.) and adapalene 0.1% gel (q.i.d., applied at night). The control group received only topical treatment including topical azelaic acid and adapalene. The clinical improvement was assessed with the Melasma Area Severity Index (MASI) at baseline and monthly during the 20-week treatment period. The results showed a prominent decrease in MASI scores at the end of the treatment in both groups, although the results were better in the group receiving chemical peels (P=0.048). All patients tolerated the topical agents well with minimal irritation observed in the first few weeks of the therapy. Three patients in the glycolic acid peel group developed a mild-degree postinflammatory hyperpigmentation with total clearance at the end of the treatment period. Therefore, the present study suggests that combined treatment with serial glycolic acid peels, azelaic acid cream and adapalene gel should be considered as an effective and safe therapy in recalcitrant melasma.Keywords
This publication has 23 references indexed in Scilit:
- Effects of alpha‐hydroxy acids on the human skin of Japanese subjects: The rationale for chemical peelingThe Journal of Dermatology, 2006
- Intralesional 5-Fluorouracil as a Treatment Modality of KeloidsDermatologic Surgery, 2004
- Efficacy of Low-Strength Glycolic Acid Application in the Treatment of Melasma—ReplyArchives of Dermatology, 2003
- Exogenous OchronosisAmerican Journal of Clinical Dermatology, 2001
- Comparative tolerance of adapalene 0·1% gel and six different tretinoin formulationsBritish Journal of Dermatology, 1998
- Effect of azelaic acid on melanoma cells in cultureExperimental Dermatology, 1995
- Topical retinoic acid (tretinoin) for melasma in black patients. A vehicle-controlled clinical trialArchives of Dermatology, 1994
- The Treatment of Melasma 20% Azelaic Acid versus 4% Hydroquinone CreamInternational Journal of Dermatology, 1991
- Azelaic AcidDrugs, 1991
- Usefulness of retinoic acid in the treatment of melasmaJournal of the American Academy of Dermatology, 1986