Comparison between 1% Tretinoin Peeling Versus 70% Glycolic Acid Peeling in the Treatment of Female Patients with Melasma

Document Type : Original Article(s)

Authors

1 Associate professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan,Iran

3 Assistant professor, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan,Iran

Abstract

Background: Melasma is an irregular brownish pigmentation that appears on the face of young to middle-aged women, especially of Asian races, which may contribute to various emotional disturbances. Although no favorable treatment option has been approved yet, one appropriate approach is peeling with glycolic acid 70% (GA 70%). Considering the efficiency of tretinoin in lower concentrations as an over-the-counter lightening agent, peeling with higher concentrations may effectively diminish the pigmentation of melasma. Our main purpose was to compare the efficiency and safety of GA 70% with tretinoin 1% peelingin the treatment of melasma.Methods: The present study was arandomized, double-blind clinical trial performed on 63 female patients with bilateral melasma. One facial side was treated with drug A (GA 70%) and the opposite side with agent B (Tretinoin 1%) for four sessions with two-week intervals. Changes in Melasma Area and Severity Index (MASI) scores, patients' discomfort and untoward complications following peeling during the study period were evaluated and compared.Findings: The efficiency of tretinoin 1% peelings in reducing the MASI score and the rate of unwanted complications were similar to GA 70%. However, the patients' discomfort following the procedures was significantly lower in the tretinoin 1% group compared with the GA 70% group. Patients' satisfaction with each intervention was statistically similar. Furthermore, participants of both groups experienced comparable times of onset of the therapeutic responses. Conclusion: Compared to GA 70%, tretinoin 1% may cause more comfort and satisfaction in treatment of melasma.

Keywords

References

  1. 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(6): 698-710.
  2. Breathnach AS. Melanin hyperpigmentation of skin: melasma, topical treatment with azelaic acid, and other therapies. Cutis 1996; 57(1 Suppl): 36-45.
  3. Grimes PE, Yamada N, Bhawan J. Light microscopic, immunohistochemical, and ultrastructural alterations in patients with melasma. Am J Dermatopathol 2005; 27(2): 96-101.
  4. 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(2): 228-37.
  5. Nikolaou V, Stratigos AJ, Katsambas AD. Established treatments of skin hypermelanoses. J Cosmet Dermatol 2006; 5(4): 303-8.
  6. Guevara IL, Pandya AG. Melasma treated with hydroquinone, tretinoin, and a fluorinated steroid. Int J Dermatol 2001; 40(3): 212-5.
  7. Lee JH, Park JG, Lim SH, Kim JY, Ahn KY, Kim MY, et al. Localized intradermal microinjection of tranexamic acid for treatment of melasma in Asian patients: a preliminary clinical trial. Dermatol Surg 2006; 32(5): 626-31.
  8. Rubin M. Chemical peels. Philadelphia, PA: Saunders; 2005.
  9. Clark CP, III. Office-based skin care and superficial peels: the scientific rationale. Plast Reconstr Surg 1999; 104(3): 854-64.
  10. Slavin JW. Considerations in alpha hydroxy acid peels. Clin Plast Surg 1998; 25(1): 45-52.
  11. Cuce LC, Bertino MC, Scattone L, Birkenhauer MC. Tretinoin peeling. Dermatol Surg 2001; 27(1): 12-4.
  12. Khunger N, Sarkar R, Jain RK. Tretinoin peels versus glycolic acid peels in the treatment of Melasma in dark-skinned patients. Dermatol Surg 2004; 30(5): 756-60.
Journal of Isfahan Medical School
Volume 29, Issue 173 - Serial Number 173
November and December 2012
Pages 2996-3002

Files

History

  • Receive Date: 12 March 2012
  • Revise Date: 30 April 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics