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December 2002

Efficacy of Glycolic Acid Peels in the Treatment of Melasma

Author Affiliations

From the Department of Dermatology, University of Texas Southwestern Medical Center, Dallas. Dr Hurley is now with North Dallas Dermatology Associates, PA.

Arch Dermatol. 2002;138(12):1578-1582. doi:10.1001/archderm.138.12.1578

Background  Melasma is an acquired hypermelanosis that is often recalcitrant to treatment with hypopigmenting agents.

Objective  To assess the efficacy of 4% hydroquinone cream vs 4% hydroquinone cream combined with glycolic acid peels as treatment for melasma.

Methods  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 global evaluation.

Results  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).

Conclusions  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.