Comparison of the Effect of Salicylic Acid Chemical Peel Combined with Topical Modified Kligman Formula and Topical Modified Kligman Formula Alone in the Treatment of Melasma

Abstract

ABSTRACT:BACKGROUND:Many chemicals have been used in the skin peeling for melasma such as trichloacetic acid, Jessner’s solution, glycolic acid, lactic acid and salicylic acid which is beta-hydroxy acid used topically in different dermatoses.OBJECTIVE:To evaluate the efficacy and safety of superficial chemical peel with salicylic acid in combination with topical depigmenting agents in comparison to depigmenting agents alone in treatment of melasma.PATIENTS AND METHODS:Eighty-eight patients with melasma (45 group-1 and 43 group -2) were selected, mostly of skin type III, IV. Most of them were females recruited in this trial, in particular those who attended outpatient’s clinic, Department of Dermatology and Venereology in Sulaimania city from February 2008 to August 2008. Treatment is performed by using a combination of superficial chemical peel with salicylic acid peels of increasing strength from 20% to 30% once every 2 weeks and by application of modified Kligman formula between sessions in group -1, and topical treatment alone in group -2.RESULTS:Most of the patients had showed a good improvement in their melasma with the use of our treatment with adequate sun protection. The clinical response was much better in epidermal than mixed type and very mild in dermal. The MASI scores significantly decrease after treatment especially in epidermal type while no statistical difference was established among final MASI values of patients with mixed and dermal types (p<0.000) with the result being significantly higher in group -1.CONCLUSION:Superficial chemical peel with salicylic acid in combination with topical modified Kligman formula for melasma is more effective than topical modified Kligman formula alone. It is easy and cheap.The results of the epidermal type were better than other types .