A Clinical Study to Compare the Efficacy of Trichloroacetic Acid Peel Versus Tretinoin Peel in the Treatment of Melasma

Abstract

BACKGROUND Melasma is the most common facial pigmentary disorder causing cosmetic disfigurement. Treatment options are numerous with varied results. The aim of this study is to compare the therapeutic response of melasma in south Indian patients when treated by 20% trichloroacetic acid peel and 1% tretinoin yellow peel in a split-face study. MATERIALS AND METHODSAn experimental study was done on hundred patients over a period of 1 year between December 2014 and November 2015. Patients were selected as per the inclusion and exclusion criteria. The face was arbitrarily divided into right and left halves. Right half was treated with Obagi blue peel containing trichloroacetic acid 20% and left half with yellow peel containing tretinoin 0.1%. A total of 4 sittings of peel at an interval of four weeks was done for all the patients. Clinical colour photographs were taken before the start of each sitting of peel and at followup. RESULTSThere were 100 patients included in the study, 78 were females and 22 were males. Epidermal melasma accounts for 75% and mixed melasma 25%. Duration of melasma ranged from 1 month to 60 months with mean duration of 34 months. The percentage reduction of MASI score in mixed melasma was 34.6% in TCA group and 33.7% in Tretinoin group. The percentage reduction of MASI score in epidermal melasma was 72.9% and 70.2% in TCA group and Tretinoin group. CONCLUSIONThe therapeutic response of melasma to TCA peel and Tretinoin peel is similar in our study. The response to treatment was significantly better in the epidermal melasma patients when compared to mixed melasma patients with either of the peel agents.