DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20201583

A prospective, randomised, split-face comparative study of 50% glycolic acid peel versus laser toning in the treatment of melasma in Asian skin

Jasleen Kaur, Tanreet Kaur

Abstract


Background: Although various treatment options are available for the management of melasma, still it is challenging disorder to treat. Apart from topical therapies, newer modalities like laser toning and chemical peeling are being explored to manage this notorious dermatosis. To evaluate and compare the efficacy and side effects of laser toning versus 50% glycolic acid peel in the management of melasma.

Methods: A split face comparative study was done in 30 female patients with melasma. Over the right half of patient’s face laser toning was done whereas other half was treated with 50% glycolic acid peel. 4 such sessions were given at an interval of 15 days. Response to treatment was assessed using melasma area and severity index (MASI) score.

Results: Baseline mean MASI score on right and left half of patient’s face was 7.85±3.34 and 6.25±1.56 respectively. After completion of 4 treatment sessions, it was reduced to 4.23±1.45 and 3.71±1.10 respectively with statistically insignificant difference between two halves (p=0.08). Recurrence rate of melasma was higher (46.66%) with laser toning in comparison to glycolic acid peel (26.6% patients).

Conclusions: Glycolic acid peel and laser toning were comparable in terms of outcome with laser toning showing slightly better results. In comparison to peels recurrence rate and complications like hypopigmentation in Asian patients were higher with laser toning.


Keywords


Hyperpigmentation, Chemical peeling, Nd-YAG laser

Full Text:

PDF

References


Sarkar R, Arora P, Garg VK, Sonthalia S, Gokhale N. Melasma update. Indian Dermatol Online J. 2014;5(4):426-35.

Chandrashekar BS, Shenoy C, Madura C. Complications of laser and light-based devices therapy in patients with skin of color. Indian J Dermatol Venereol Leprol. 2019;85:24-31.

Shah SD, Aurangabadkar SJ. Laser toning in melasma. J Cutan Aesthet Surg. 2019;12:76-84.

Sarkar R, Gokhale N, Godse K, Ailawadi P, Arya L, Sarma N, et al. Medical management of melasma: A review with consensus recommendations by Indian pigmentary expert group. Indian J Dermatol. 2017;62:558-77.

Soleymani T, Lanoue J, Rahman Z. A Practical Approach to Chemical Peels: A Review of Fundamentals and Step-by-step Algorithmic Protocol for Treatment. J Clin Aesthet Dermatol. 2018;11(8):21-28.

Sarkar R, Kaur C, Bhalla M, Kanwar AJ. The combination of glycolic acid peels with a topical regimen in the treatment of melasma in dark-skinned patients: A comparative study. Dermatol Surg. 2002;28:828-32.

Suh KS, Sung JY, Roh HJ, Jeon YS, Kim YC, Kim ST. Efficacy of the 1064-nm Q-switched Nd: YAG laser in melasma. J Dermatolog Treat. 2011;22:233-8.

Kumar S, Mahajan BB, Kamra N. Melasma in North Indians: A clinical, epidemiological, and etiological study. Pigment Int. 2014;1:95-9.

Bansal C, Naik H, Kar HK, Chauhan A. A comparison of low-fluence 1064-nm Q-switched Nd: YAG laser with topical 20% azelaic acid cream and their combination in melasma in Indian patients. J Cutan Aesthet Surg. 2012;5:266-72.

Manjunath KG, Raghu MT, Yogendra M, Harish G. A clinical and therapeutic study of efficacy of 40% glycolic acid facial peels in melasma. Int J Res Dermatol. 2018;4(2):136-41.

Kar HK, Gupta L, Chauhan A. A comparative study on efficacy of high and low fluence Q-switched Nd: YAG laser and glycolic acid peel in melasma. Indian J Dermatol Venereol Leprol. 2012;78:165-71.

Divya KG, Murali N, Rajagopalan V, Parveen B. Efficacy and safety of 70% glycolic acid versus Q Switched Nd: YAG laser in the treatment of melasma: a comparative study. Int J Res Dermatol. 2017;3(1):1-6.

Zhou X, Gold MH, Lu Z, Li Y. Efficacy and safety of Q Switched 1064 Neodymium doped Yttrium Aluminium Garnet laser treatment of Melasma. Dermatol Surg. 2011;37:962-70.

Parra HCA, Careta MF, Valente NY, Osorio SNE, Torezan LA. Clinical and histopathologic assessment of facial melasma after low-fluence Q-switched neodymium-doped yttrium aluminium garnet laser. Dermatol Surg. 2016;42:507-12.

Wattanakrai P, Mornchan R, Eimpunth S. Low fluence Q Switched Neodymium Doped Yttrium Aluminium Garnet 1064 nm laser for treatment offacial melasma in Asians. Dermatol Surg. 2010;36:76-87.

Ho SG, Chan HH. The Asian dermatologic patient: Review of common pigmentary disorders and cutaneous diseases. Am J Clin Dermatol. 2009;10:153-68.