Efficacy and Safety of 50% glycolic acid peels in the treatment of melasma in Fitzpatrick’s skin type IV and V

Objective To determine the efficacy and safety of 50% glycolic acid peels in melasma in Fitzpatrick’s skin type IV and V. Methods 50 patients of melasma were included in the study. Type of melasma was identified with the help of Wood’s lamp. Patients were advised a pre-peel program of daily application of tretinoin 0.05% at bedtime for 2-weeks. MASI scoring and colored photographs of each patient were taken before each peel with 50% glycolic acid and at the end of follow-up. Treatment was carried out with an interval of 2-weeks for a total of 6 sessions. Efficacy was assessed 4 weeks after the last session. Side effects, if any, were also recorded. Results The mean age of the patients was 28.88 ± 6.02 years. There were 44 (88%) females and 6 (12%) male patients. 20 (40%) patients had epidermal melasma, 28 (56%) had mixed type and only 2 (4%) patients presented with dermal melasma. Mean baseline MASI score was 15.54 ± 5.76 and the mean MASI score at the end of treatment was 9.6 ± 4.8. The mean percentage of reduction of MASI score was 40.57 ± 11.9%. A significant improvement from baseline to 14 weeks was observed. Only a few side effects were seen in the form of mild erythema and burning sensation. Conclusion This study demonstrates that serial glycolic acid peels are effective and safe in the treatment of melasma in Fitzpatrick’s skin type IV and V