title: Clinical efficacy and safety of 20% glycolic peel, 15% lactic peel, and topical 20% vitamin C in constitutional type of periorbital melanosis: a comparative study.
abstract: BACKGROUND
  Periorbital Melanosis (POM) is a very common esthetic condition, yet there is no definite treatment modality. Topical therapy is the mainstay of treatment which includes chemical peels, vitamin C, and other depigmenting agents.
  
  
  OBJECTIVE
  To compare clinical efficacy, safety, and tolerability of 20% glycolic acid peels, 15% lactic acid peels, and topical 20% vitamin C in treatment of constitutional type of POM in Indian patients.
  
  
  METHODS
  Ninety patients of constitutional POM were enrolled for 12 weeks. The patients were distributed into three groups. One-third of patients underwent 3-weekly GA peel, another one-third underwent 3-weekly lactic peel, and rest applied vitamin C daily. Clinical improvement was assessed objectively using POM grading. Patient's and physicians global assessment along with patient's global tolerance was also evaluated.
  
  
  RESULTS
  More than 50% improvement in POM was observed in 73.34% of patients on GA peel, 56.67% on lactic peel, and 26.67% on vitamin C. On comparing improvement with respect to duration of therapy, GA peel was significantly more effective than lactic peel from 12 weeks onward, while it was more effective than vitamin C from 6 weeks onward. Lactic peel was more effective than vitamin C from 6 weeks onward. Physician and patient global assessment was excellent with glycolic peel followed by lactic peel and vitamin C. The incidence of adverse effect was maximum with GA peel followed by lactic peel and vitamin C.
  
  
  CONCLUSIONS
  Glycolic peel was best among the three modalities, although it was associated with increased rate of side effects.
authors.affiliation: Department of Dermatology, Venereology and Leprology, Pt B D Sharma University of Health Sciences, Rohtak, Haryana, India.
authors.forename: Surabhi
authors.initials: S
authors.lastname: Dayal
authors.affiliation: Department of Dermatology, Venereology and Leprology, Pt B D Sharma University of Health Sciences, Rohtak, Haryana, India.
authors.forename: Priyadarshini
authors.initials: P
authors.lastname: Sahu
authors.affiliation: Department of Dermatology, Venereology and Leprology, Pt B D Sharma University of Health Sciences, Rohtak, Haryana, India.
authors.forename: Vijay Kumar
authors.initials: VK
authors.lastname: Jain
authors.affiliation: Department of Dermatology, Venereology and Leprology, Pt B D Sharma University of Health Sciences, Rohtak, Haryana, India.
authors.forename: Sneh
authors.initials: S
authors.lastname: Khetri
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000975:Antioxidants / Q000008:administration & dosage / Q000009:adverse effects; D001205:Ascorbic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D002615:Chemexfoliation / Q000009:adverse effects / Q000379:methods*; D005123:Eye; D005148:Facial Dermatoses / Q000628:therapy; D005260:Female; D006016:Glycolates / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007641:Keratolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D019344:Lactic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008548:Melanosis / Q000628:therapy*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000975:Antioxidants; D006016:Glycolates; D007641:Keratolytic Agents; C031149:glycolic acid; D019344:Lactic Acid; D001205:Ascorbic Acid
keywords: chemical peeling; glycolic peel; lactic peel; periorbital hyperpigmentation; topical vitamin C