Treatment of Melasma With 88% Lactic Acid versus 30% Salicylic Acid Peels, a Split Face Study


ABSTRACT:BACKGROUND:Melasma is a common pigmentation disorder where there is increase in melanin stores in theepidermis, dermis or both. There are many topical therapies for these disorders, salicylic acid andlactic acid had been used for treatment of melasma as peeling agents.OBJECTIVE:To evaluate the efficacy and safety of 30% salicylic acid in comparison with 88% lactic acid intreatment of melasma in a split face study.PATIENTS AND METHODS:Twenty six patients with melasma participated. 24 (93.3%) were women, and 2 (7.7%) were men.All patients had therapy-resistant melasma for 1 year. Full clinical examination including Wood’slight examination was done to all patients. The severity of melasma was assessed by MASI(Melasma Area Severity Index). 88% lactic acid was used on the left half of the face while 30%salicylic acid was applied to the right half. The peeling sessions were done every 2 weeks for 3months. Follow-up was carried out for 3 months after the last session.RESULTS:Eighteen patients completed the study, their ages ranged from 24 to 47 years with a mean ± SD of38.22±5.36 years. According to Fitzpatrick’s classification 14 (77.7%) patients had skin type IV; 3(16.6%) patients had skin type III and one (5.5%) patients had skin type V. After 3 months, thepercent reduction to lactic acid and salicylic acid were 50% and 44.7% respectively with staticallysignificant value (P value = 0.0001). Mild stinging sensation and transient erythema were reported.Most patients maintained improvement 3 months after cessation of therapy. However, there were nostatically significant differences (P value = 0.4106) between the two modalities.CONCLUSION:Both peeling agents were effective in treating melasma with no important side effects.