Bari A U, Zafar Iqbal, Majid Sohail, Simeen Ber Rahman.
Skin priming and efficacy of Glycolic Acid and Salicylic Acid in the treatment of Melasma.
J Coll Physicians Surg Pak Jan ;12(8):461-4.

Objective: To assess the effects of priming of facial skin with topical tretinoin prior to peeling and to see the comparative efficacy of two different peeling agents for the treatment of melasma. Design: A prospective and experimental study. Place and Duration of Study : Military Hospital, Rawalpindi, Pakistan between November, 2000 and May 2001. Patients and Methods: Forty patients of either sex and in the age group between 18-48 years, having melasma of all types and of variable duration, were included in the study. Group-I (n=20) patients were pre-treated with tretinoin cream for two weeks while no such treatment was offered to group-II (n=20) patients. Six fortnightly peeling sessions with glycolic acid(40%-60%) on right side and salicylic acid (20%-30%) on left side of the face were performed. Avoidance of sun exposure and regular use of sunscreen was emphasized. Evaluation was done before and after treatment based on MASI scoring, measurement of lesional area and photographs. Results: Moderate to excellent response was observed in all patients regarding reduction in melasma (p < 0.05). But the results were not statistically better in patients of group-I when compared with group-II (p > 0.05). Mild and transient adverse reactions like burning, stinging and erythema were seen in most of the patients. Conclusion: Salicylic acid and glycolic acid have almost equal efficacy and pre-peel priming of skin with topical tretinoin may not be an essential component of chemical peeling.

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