title: Efficacy of glycolic acid peels in the treatment of melasma.
abstract: BACKGROUND
  Melasma is an acquired hypermelanosis that is often recalcitrant to treatment with hypopigmenting agents.
  
  
  OBJECTIVE
  To assess the efficacy of 4% hydroquinone cream vs 4% hydroquinone cream combined with glycolic acid peels as treatment for melasma.
  
  
  METHODS
  Twenty-one Hispanic women with bilateral epidermal and mixed melasma were enrolled in a split-faced prospective trial lasting 8 weeks. Patients underwent 20% to 30% glycolic acid peels every 2 weeks to one side of the face only in addition to twice-daily full-face application of 4% hydroquinone cream and sun protective factor 25 UV-B sunscreen each morning. Pigmentation was measured objectively using a mexameter and the Melasma Area and Severity Index and subjectively using a linear analog scale and physician and patient global evaluation.
  
  
  RESULTS
  Hydroquinone treatment alone and treatment with the combination of hydroquinone and glycolic acid had a significant effect in reducing skin pigmentation compared with baseline (P<.001). However, no significant difference was found using combination therapy compared with hydroquinone alone (P =.75).
  
  
  CONCLUSIONS
  Use of 4% hydroquinone and a daily sunscreen is effective in the treatment of melasma; however, the addition of 4 glycolic acid peels did not enhance the hypopigmenting effect of hydroquinone treatment alone.
authors.affiliation: Department of Dermatology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9190, USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Hurley
authors.forename: Ian L
authors.initials: IL
authors.lastname: Guevara
authors.forename: Rose Mary
authors.initials: RM
authors.lastname: Gonzales
authors.forename: Amit G
authors.initials: AG
authors.lastname: Pandya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002615:Chemexfoliation / Q000379:methods*; D004954:Esthetics; D005148:Facial Dermatoses / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006016:Glycolates / Q000627:therapeutic use*; D006801:Humans; D007641:Keratolytic Agents / Q000627:therapeutic use*; D008548:Melanosis / Q000175:diagnosis / Q000188:drug therapy*; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D006016:Glycolates; D007641:Keratolytic Agents; C031149:glycolic acid