Experience of cosmetology in rural Central India: a clinico-epidemiological profile and comparative study of 35% glycolic acid peel and 15% trichloroacetic acid peel in melasma

Abstract

Background: Melasma, an acquired hypermelanosis, is challenging to treat rural population more exposed to ultraviolet (UV) rays in Central India. Chemical peeling is a new, safe and cost-effective treatment with very few studies comparing Glycolic acid (GA) peel and Trichloroacetic acid (TCA) peel in pigmented patients (Fitzpatrick skin type IV and V) in melasma using both subjective and objective methods; melasma area severity index (MASI) of evaluation. Aim: To study the clinico-epidemiological profile and to compare the therapeutic efficacy of chemical peeling with 35% GA and 15% TCA in melasma patients. Methods: 50 epidermal melasma patients were enrolled divided into two groups, 25 patients in each. These groups were treated with 35% of GA (Group A) and 15% TCA peel (Group B), respectively. They were primed and test peeled. Three sessions of peeling two weeks apart with follow up after 3 months were evaluated using subjective response and MASI score. Results: The mean age of onset was 35.20±7.11 with male to female ratio was 1: 5. The mean duration of melasma was 3.57±2.58. Positive family history (32%) was present with centrofacial (56%) was the most common pattern. Subjective evaluation in the GA group and TCA group showed good and very good response in 92% and 84% respectively. The MASI score at baseline and at 3 month for Group A was 11.8 and 3.66, while it was 10.5 and 3.7 for group B. Conclusion: Both GA and TCA peels proved to be an equally effective treatment in epidermal melasma in our study.

Keywords

• chemical peeling
• glycolic acid
• melasma
• trichloroacetic acid