Bari A U.
Efficacy of facial chemical peeling with salicylic acid and role of 4% hydroquinone as an adjuvant treatment modality in melasma.
J Pak Assoc Derma Jan ;12(4):183-9.

Back ground: Salicylic acid peeling has recently been rediscovered as an effective treatment modality in various pigmentary disorders including melasma. Objective: The study aimed to assess the efficacy of superficial chemical peeling with salicylic acid in patients of melasma having predominant Fitzpatrik skin type IV and V and to see the effects of 4% hydroquinone as an adjuvant treatment modality. Methods: Forty patients of either sex and in the age group between 21-45 years, having melasma of all types and of variable duration, were included in the study. These were divided randomly into two groups of twenty each.. Six fortnightly facial peeling sessions with salicylic acid (20%-30%) were performed in all patients. Group I patients were treated with 4% hydroquinone cream for subsequent three months while no such treatment was offered to group II patients. Avoidance of sun exposure and regular use of broad spectrum sunscreen was emphasized throughout in all patients. Evaluation was done before and after treatment. Results. Moderate to excellent response to chemical peeling was observed in all patients (p<0.05). The results were significantly better in patients who were given 4% hydroquinone subsequently ( p<0.05). Mild and transient adverse reactions like burning, stinging, irritation, erythema and dryness were seen in most of the patients. No serious side effect was noted. Conclusion. Use of hydroquinone in post peeling phase can significantly enhance the efficacy of chemical peeling with salicylic acid in melasma.

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