Combined trichloroacetic acid peel and topical ascorbic acid versus trichloroacetic acid peel alone in the treatment of melasma: a comparative study.

Abstract

BACKGROUND:

Melasma is a common acquired hypermelanosis that is difficult to treat. Several chemical peeling agents were used in treatment of melasma. Topical vitamin C was also used with minimal side effects.

AIM:

To compare the effect of 20% trichloroacetic acid (TCA) peel alone vs. 20% TCA peel combined with topical 5% ascorbic acid in cases of epidermal melasma.

PATIENTS AND METHODS:

Thirty women with bilateral epidermal melasma (Fitzpatrick skin types III and IV) were divided into two groups (A and B, 15 patients each). Before therapy, digital photography and a melasma area and severity index (MASI) score were done for each patient. Groups A and B were primed for 2 weeks before TCA peel. Group B also applied 5% ascorbic acid topically once daily; 20% TCA peel was done for all patients weekly until clearance of melasma or for a maximum of six peels. Group B continued to use 5% ascorbic acid topically in between peels and during the 16-week follow-up period. Patients were assessed at the end of peeling sessions and at the end of follow-up by photography, MASI score, and a global evaluation by the patient.

RESULTS:

Group B compared with group A showed a significant decrease in MASI score at the end of TCA peels (P < 0.001) and at the end of the 16-week follow-up period (P < 0.003). Global evaluation showed that 13 patients (87%) in group B improved or maintained their improvement compared with only 10 patients (67%) in group A.

CONCLUSION:

Topical ascorbic acid combined with 20% TCA peel in melasma improves the results and helps in maintaining the response to therapy.

• Authors: Mohsen Mohamed Soliman, Shahira Abdel-Rahman Ramadan, Dalia Ahmed Bassiouny, Marwa Abdelmalek
• Journal: Journal of cosmetic dermatology (J Cosmet Dermatol) Vol. 6 Issue 2 Pg. 89-94 (Jun 2007) ISSN: 1473-2165 [Electronic] England
• PMID: 17524124 (Publication Type: Clinical Trial, Comparative Study, Journal Article)

Chemical References

• Dermatologic Agents
• Tretinoin
• Trichloroacetic Acid
• Ascorbic Acid

Topics

• Administration, Cutaneous
• Adult
• Ascorbic Acid (administration & dosage, adverse effects)
• Chemexfoliation (adverse effects, methods)
• Dermatologic Agents (administration & dosage, adverse effects)
• Drug Administration Schedule
• Drug Therapy, Combination
• Facial Dermatoses (therapy)
• Female
• Humans
• Melanosis (therapy)
• Middle Aged
• Severity of Illness Index
• Treatment Outcome
• Tretinoin (administration & dosage)
• Trichloroacetic Acid (administration & dosage, adverse effects)