Comparative Study of Efficacy of Glycolic Acid Peel and Intense Pulsed Light in the Treatment of Melasma


  • Dr. Vasantrao Pawar Medical College Hospital and Research Center, Department of Dermatology, Venerology and Leprology, Nashik, 422003, India


Background: Melasma, one of the common aesthetically displeasing entities, continues to be a difficult problem to treat. Chemical peeling is one new weapon in the therapeutic armamentarium of melasma. Intense Pulsed Light (IPL) is a noncoherent, broad-spectrum light, ranging from 500 to 1200 nm. Intense Pulsed Light (IPL) treatment is a good option for patients with melasma. Aims and Objective: To compare the efficacy of glycolic acid peel and intense pulsed light in the treatment of melasma. Setting: Outpatient department of Dermatology, Venerology Leprology of a tertiary health care centre with an attached medical college. Material and Methods: 60 patients of melasma were recruited in the study. Patients were randomly allocated into two groups: one group (glycolic acid 50%) and another group (IPL) with 30 patients in each group. All the participants were subjected to undergo pre-peel programme of daily application of sunscreens (day time) and 0.025% retinoic acid at bed time for two weeks in GA peel group. 4 peels were carried out at 2 weekly intervals. Four sessions of IPL were done at 3 weeks interval. MASI scoring and coloured photographs (without reavealing identity) of each patient were taken before each peel and at the end of the follow-up period i.e. 2 weeks after 4th sitting in GA peel group and 3 weeks after 4th sitting in IPL group. Side effects, if any, were also recorded. Statistical Analysis Used: SYSTAT version-12. Results: In both the groups there was constant decrease in MASI scores after each sitting as compared to pre-peel scores. However, the comparison of mean MASI scores i.e. both pre-peel and after each peel, between the two groups showed statistically significant difference (p<0.05). Local reactions, such as burning sensation and erythema during the peel were not significant with both the groups. Conclusions: Glycolic Acid (GA) peel (50%) is more efficacious&safe treatment modality in melasma compared to IPL.


Glycolic Peel, Intense Pulse Light, Melasma.

Subject Discipline


Full Text:


Khunger N, Sarkar R, Jain RK. Tretinoin peels versus glycolic acid peels in the treatment of Melasma in dark-skinned patients. Dermatol Surg. 2004 May; 30(5):756-60.

Valkova S. Treatment of melasma with glycolic versus trichloroacetic acid peel: comparison of clinical efficacy. Annual proceedings IMAB. 2004; 10(1):42-4.

Kumari R, Thappa DM. Comparative study of trichloroacetic acid versus glycolic acid chemical peels in treatment of melasma. Indian J Dermatol Venereol Leprol. 2010; 76:447.

Li YH, Chen JZ, Wei HC, Wu Y, Liu M, Xu YY, Dong GH, Chen HD. Efficacy and safety of intense pulsed light in treatment of melasma in Chinese patient. Dermatol Surg. 2008 May; 34(5):693-700.

Wang CC, Hui CY, Sue YM, Wong WR, Hong HS Intense pulsed light for the treatment of refractory melasma in Asian persons. Dermatol Surg. 2004 Sep; 30(9):1196-200.

Balkrishnan R, McMichael AJ, Hu JY, Camacho FT, Shew KR, Bouloc A, Rapp SR, Feldman SR: Correlates of healthrelated quality of life in women with severe facial blemishes. Int J Dermatol. 2006; 45:111-5.

Engasser PG, Maibach HI. Cosmetics and dermatology: bleaching creams. J Am Acad Dermatol. 1981; 5:143-7.

Garcia A, Fulton JE. The combination of glycolic acid and hydroquinone or kojic acid for the treatment of melasma and related conditions. Dermatol Surg.1996; 22:443-7.

Murad H, Shambar AT, Moy LS. Polka-dot syndrome. Cosmet Dermatol. 1993; 4:57-8.

Van Scott EJ, Yu RJ. Alpha hydroxy acids: procedures for use in clinical practice. Cutis. 1989; 43:222-9.

Griffiths CEM, Finkel LJ, Ditre CM, Hamilton TA, Ellis CN, Voorhees JJ. Topical tretinoin (retinoic acid) improves melasma: a vehicle-controlled, clinical trial. Br J Dermatol. 1993; 129:415-21.

Lim JTE, Tham SN. Glycolic acid peels in the treatment of melasma among Asian women. Dermatol Surg. 1997; 23:177-9.

Gupta AK, Gover MD, Nouri K, Taylor S. The treatment of melasma: a review of clinical trials. J Am Acad Dermatol. 2006; 55:1048-65.

Achar A, Rathi SK. Melasma: a clinicoepidemiological study of 312 cases. Indian J Dermatol. 2011 Jul-Aug; 56(4):380-2.

Goh CL, Dlova CN. A retrospective study on the clinical presentation and treatment outcome of melasma in a tertiary dermatological referral centre in Singapore. Singapore Med J. 1999; 40:455-8.

Katasambas A, Antoniou Ch. Melasma Classification and treatment. J Eur Acad Dermatol Venereol. 1995; 4:217-23.

Jang YH, Sim JH, Kang HY, Kim YC, Lee E-S. The histopathological characteristics of male melasma: Comparison with female melasma and lentigo. J AM ACAD Dermatol. 2012 Apr; 66:642-9.

Hall G, Phillips TJ. Estrogen and skin: the effects of estrogen, menopause, and hormone replacement therapy on the skin. J Am Acad Dermatol. 2005; 53:555-68.

Lieberman R, Moy L. Estrogen receptor expression in melasma: results from facial skin of affected patients. J Drugs Dermatol. 2008; 7:463-5.

Jee SH, Lee SY, Chiu HC, Chang CC, Chen TJ. Effects of estrogen and estrogen receptor in normal human melanocytes. Biochem Biophys Res Commun. 1994; 199:1407-12.

Verdier-Sevrain S, Bonte F, Gilchrest B. Biology of estrogens in skin: implications for skin aging. Exp Dermatol. 2006; 15:83-94.

Schmidt AN, Nanney LB, Boyd AS, King LE Jr, Ellis DL. Estrogen receptor-beta expression in melanocytic lesions. Exp Dermatol. 2006; 15:971-8.

Kang WH, Yoon KH, Lee ES, Kim J, Lee KB, Yim H, et al. Melasma: histopathological characteristics in 56 Korean patients. Br J Dermatol. 2002; 146:228-37.

Kippenberger S, Loitsch S, Solano F, Bernd A, Kaufmann R. Quantification of tyrosinase, TRP-1, and Trp-2 transcripts in human melanocytes by reverse transcriptase-competitive multiplex PCReregulation by steroid hormones. J Invest Dermatol. 1998; 110:364-7.

Passeron T. Melasma pathogenesis and influencing factors - an overview of the latest research. JEADV. 2013; 27(suppl. 1):5-6.

Vazquez M, Maldonado H, Benmaman C, Sanchez JL: Melasma in men. A clinical and histologic study. Int J Dermatol. 1988; 27:25-7.

Sarkar R, Jain RK, Puri P. Melasma in Indian males. Dermatol Surg. 2003; 29:204.

Adalatkhah H, Sadeghi-bazargani H, Aminisani N, Zeynizadeh S. Melasma and its association with different types of nevi in women: A case-control study. BMC Dermatology. 2008; 8:3.

Pathak MA. Clinical and Therapeutic aspects of melasma: an overview. In: Fitz Patrick TB, Wick MM, Toda K, editors. Brown melanoderma. Tokyo: University of Tokyo press; 1986. p. 161-72.

Moin A, Jabery Z, Fallah N. Prevalence and awareness of melasma during pregnancy. Int J Dermatol. 2006; 45:285-8.

Sanchez NP, Pathak MA, Sato S, Fitzpatrick TB, Sanchez JL, Mihm MC Jr. Melasma: a clinical, light microscopic, ultrastructural, and immunofluorescence study. J Am Acad Dermatol. 1981; 4:698-710.

Adalatkhah H, Melasma prevalence in Ardabil. Dermatology quarterly. 2004; 7:72-7.

Goh CL, Dlova CN: A retrospective study on the clinical presentation and treatment outcome of melasma in a tertiary dermatological referral centre in Singapore. Singapore Med J. 1999; 40:455-8.

Hughes BR. Melasma occurring in twin sisters. J Am Acad Dermatol. 1987; 17:841.

Fitzpatric TB, Eisen AZ, Wolff K, et al. Dermatology in general medicine New York: McGraw- Hill; 1997:996-7.

Gupta RR, Mahajan BB, Garg G. Chemical peeling: evaluation of glycolic acid in varying concentrations and time intervals. Indian J Dermatol Venereol Leprol. 2001; 67:28-9.

Dogra A, Sunil Gupta, Surpriya Gupta. Comparative efficacy of 20% trichloroacetic acid and 50% glycolic acid peels in treatment of recalcitrant melasma. Journal of Pakistan Association of Dermatologists. 2006; 16:79-85.

Hurley ME, Guevara IL, Gonzales RM, et al. Efficacy of glycolic acid peel in the treatment of melasma. Arch Dermatol. 2002; 138:1578-82.

Javaheri SM, Handa S, Kaur I, Kumar B. Safety and efficacy of glycolic acid facial peel in Indian women with melasma. Int journal of dermatol. 2001; 40:354-7.

Kalla G, Garg A, Kachhawa D. Chemical peeling: glycolic versus Trichloroacetic acid in melasma. Indian J dermatol venerol leprol. 2001; 67:82-4.

Grover C, Reddu BS. The therapeutic value of glycolic acid peels in dermatology. Indian J dermatol venerol leprol. 2003; 69:148-50.

Sarkar R, Kaur C, Bhalla M, Kanwar AJ. The combination of glycolic acid peel with a topical regimen in the treatment of melasma in dark skinned patients: a comparative study. Dermatol Surg. 2002; 28:828-32.

Zoccali G, Piccolo D, Allegra P, Gialiani M. Melasma treated with intense pulsed light. Asthetic plast surg. 2010 Aug; 34(4):486-93. Epub 2010 Mar 12.


  • There are currently no refbacks.