Uzma Ehsan, Samina Khan, Ammara Azeem.
Efficacy and Safety of 40% Glycolic Acid Peels in patients with Melasma.
J Sharif Med Dent Coll Jan ;4(1):8-11.

Objective: To determine the efficacy and safety of 40% glycolic acid peels in patients with melasma in Asian Skin. Methodology: Sixty patients of either gender with melasma of any type (epidermal, dermal, and mixed); having Fitzpatrick's skin type IV and V were included in the study. They were evaluated by Wood's lamp examination before the commencement of therapy. Before, during and after treatment photographs of the patients were also taken after informed and written consent. A total of eight sessions were done at 2 weeks interval. Melasma Area and Severity Index (MASI) score was calculated before and at the end of sessions. Patients were carefully observed for any side effects during the procedure and on follow-up visit. Efficacy was assessed 4 weeks after the last session. Results: Out of 60 patients, 5(8%) were males and 55(92%) were females. Age ranged from 20 to 44 years (mean 30.4+5.8 years). Eight (13.33%) patients had mixed type of melasma, 45(75%) patients presented with epidermal and only 7(11.7%) had dermal melasma. The MASI score declined significantly after the end of peeling sessions (p<0.05). Assessment of efficacy using 4-grade analysis score was also done. Out of 60, 16.7% patients had excellent improvement, good, fair and poor response was observed in 68.3%, 11.7% and 3.3% respectively. Safety was assessed by evaluating the side effects. Majority of the patients had no significant side effects. The only reported side effects were transient erythema and mild burning. Conclusion: Peeling with 40% glycolic acid is effective and safe in the treatment of melasma in Asian skin types. Keywords: Melasma. Glycolic acid. Chemical peeling.

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