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Hurley ME, Guevara IL, Gonzales RM, Pandya AG. Efficacy of Glycolic Acid Peels in the Treatment of Melasma. Arch Dermatol. 2002;138(12):1578–1582. doi:10.1001/archderm.138.12.1578
Melasma is an acquired hypermelanosis that is often recalcitrant to
treatment with hypopigmenting agents.
To assess the efficacy of 4% hydroquinone cream vs 4% hydroquinone cream
combined with glycolic acid peels as treatment for melasma.
Twenty-one Hispanic women with bilateral epidermal and mixed melasma
were enrolled in a split-faced prospective trial lasting 8 weeks. Patients
underwent 20% to 30% glycolic acid peels every 2 weeks to one side of the
face only in addition to twice-daily full-face application of 4% hydroquinone
cream and sun protective factor 25 UV-B sunscreen each morning. Pigmentation
was measured objectively using a mexameter and the Melasma Area and Severity
Index and subjectively using a linear analog scale and physician and patient
Hydroquinone treatment alone and treatment with the combination of hydroquinone
and glycolic acid had a significant effect in reducing skin pigmentation compared
with baseline (P<.001). However, no significant
difference was found using combination therapy compared with hydroquinone
alone (P = .75).
Use of 4% hydroquinone and a daily sunscreen is effective in the treatment
of melasma; however, the addition of 4 glycolic acid peels did not enhance
the hypopigmenting effect of hydroquinone treatment alone.
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