Glycolic acid, Lactic acid and Trichloroacetic acid (TCA) peels have been used in various combinations for treating melasma patients, but none of the studies have compared their therapeutic efficacy and improvement in QOL index with these three peeling agents in Melasma.

A new study published in Dermatologic Therapy compared the clinical efficacy, safety, tolerability and improvement in QOL index between 30% glycolic, 92% lactic and 15% TCA peeling in epidermal melasma.

In this study, 90 patients were divided into three groups with 30 subjects in each. First group was treated with 30% Glycolic acid peel, second with 92% lactic peel and third with 15% TCA peel – at every 2 weeks interval for 12 weeks. Melasma area severity index (MASI) and QOL index (Melasma quality of life and Health related quality of life index) were used for clinical evaluation. Patients were observed for side effects and tolerability.

It was noted that the mean MASI score after therapy was significantly lower in patients treated with Glycolic acid and TCA peels as compared to the group receiving lactic peel. However, there was no significant difference in the mean MASI scoring at 12 weeks between Glycolic acid peel and TCA peel groups. The improvement in QOL index was higher among patients undergoing glycolic peel followed by TCA and Lactic peel. Adverse effects were noted mostly with TCA peels followed by glycolic and lactic peel.

Therefore, it was inferred that glycolic acid and TCA peels proved equally efficacious and more effective than lactic peels. Lactic peel had minimum side effects and better tolerability than GA and TCA peels.

Source: Dermatologic Therapy. 2020 Dec 28;e14693. doi: 10.1111/dth.14693.