title: Different therapeutic modalities for treatment of melasma.
abstract: BACKGROUND
  Chemical peels and topical depigmenting agents have become a popular modality in the treatment of melasma.
  
  
  OBJECTIVE
  To compare the clinical efficacy of trichloroacetic acid peel 20%vs. Jessner's solution peel vs. the topical mixture of hydroquinone 2% and kojic acid.
  
  
  METHODS
  Forty five patients with melasma were randomly assigned into three groups of fifteen patients each. Group A received Jessner's solution peel, group B received trichloroacetic acid peel 20%, and group C received topical hydroquinone 2% and kojic acid. All patients were seen in follow-up period after 16 weeks; clinical evaluation using Melasma Area and Severity Index (MASI) score and photography were recorded before and after treatment and after 16 weeks.
  
  
  RESULTS
  There was a decrease in MASI score in all three groups after treatment and after follow-up period but after treatment MASI score was statistically significantly lower in group A than group C (P = 0.01), and it was also statistically significantly lower in group B than group C (P < 0.001) but there was no statistically significant difference between groups A and B. After the follow-up period, MASI score was statistically significantly lower in group A than group C (P < 0.001), statistically significantly lower in group B than group C (P < 0.001), and statistically significantly lower in group B than group A (P = 0.035). The statistical analysis was done through one-way anova followed by least significant difference (LSD).
  
  
  CONCLUSIONS
  Trichloroacetic acid 20% showed better results than Jessner's solution as peeling agent and hydroquinone 2% with kojic acid as a topical agent in the treatment of melasma.
authors: Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors: Omar A
authors: OA
authors: Azzam
authors: Tahra M
authors: TM
authors: Leheta
authors: Noha A
authors: NA
authors: Nagui
authors: Eman
authors: E
authors: Shaarawy
authors: Rania M Abdel
authors: RM
authors: Hay
authors: Rana F
authors: RF
authors: Hilal
mesh_terms: D000287:Administration, Topical; D000328:Adult; D004338:Drug Combinations; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006873:Hydroquinones / Q000008:administration & dosage*; D007641:Keratolytic Agents / Q000008:administration & dosage*; D019344:Lactic Acid / Q000008:administration & dosage*; D008548:Melanosis / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D011753:Pyrones / Q000008:administration & dosage*; D012118:Resorcinols / Q000008:administration & dosage*; D012459:Salicylates / Q000008:administration & dosage*; D016037:Single-Blind Method; D014238:Trichloroacetic Acid / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D004338:Drug Combinations; D006873:Hydroquinones; C061170:Jessner's solution; D007641:Keratolytic Agents; D011753:Pyrones; D012118:Resorcinols; D012459:Salicylates; D019344:Lactic Acid; D000431:Ethanol; D014238:Trichloroacetic Acid; C011890:kojic acid