Combination of glycolic acid peel and topical 20% azelaic acid cream in melasma patients: efficacy and improvement in quality of life

Dayal, Surabhi; Sahu, Priyadarshini; Dua, Ruchika

doi:10.1111/jocd.12260

Cited by 30 publications

(19 citation statements)

References 11 publications

(16 reference statements)

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“…Amongst the various peels, glycolic acid (GA) has been most extensively studied in the treatment of melasma. A small open-label study found that 30–50% GA peels at 3-week intervals for 6 months in addition to AA 20% twice-daily regimen resulted in superior MASI scores when compared to AA 20% alone [ 45 ]. However, a small split-face study found no difference in decreased pigmentation when using HQ 4% with GA 20–30% compared to HQ alone [ 85 ].…”

Section: Introductionmentioning

confidence: 99%

Melasma: an Up-to-Date Comprehensive Review

Ogbechie-Godec

Elbuluk

2017

Dermatol Ther (Heidelb)

239

210

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Melasma is a common acquired condition of symmetric hyperpigmentation, typically occurring on the face, with higher prevalence in females and darker skin types. Multiple etiologies, including light exposure, hormonal influences, and family history, have been implicated in the pathogenesis of this disorder. Overall prevalence ranges widely at 1–50%, since values are typically calculated within a specific ethnic population within a geographic region. Histologically, melasma can display increased epidermal and/or dermal pigmentation, enlarged melanocytes, increased melanosomes, solar elastosis, dermal blood vessels, and, occasionally, perivascular lymphohistiocytic infiltrates. Various topical, oral, and procedural therapies have been successfully used to treat melasma. Traditional topical therapies including hydroquinone, tretinoin, corticosteroids, and triple combination creams; however, other synthetic and natural topical compounds have also shown varying efficacies. Promising oral therapies for melasma include tranexamic acid, Polypodium leucotomos, and glutathione. Procedures, including chemical peels, microneedling, radiofrequency, and lasers, are also often used as primary or adjunctive treatments for melasma. Notably, combination therapies within or across treatment modalities generally result in better efficacies than monotherapies. This review serves as a comprehensive update on the current understanding of the epidemiology, pathogenesis, clinical and histologic features of melasma, as well as treatments for this common, yet therapeutically challenging, condition.

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Section: Introductionmentioning

confidence: 99%

Melasma: an Up-to-Date Comprehensive Review

Ogbechie-Godec

Elbuluk

2017

Dermatol Ther (Heidelb)

239

210

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“…Incluyó Los peelings superficiales con AG, AS y TCA deberían considerarse tratamientos de segunda línea. Los peelings con AG al 35% pueden ser útiles en el tratamiento del melasma [28]; Sarkar et al [29] mostraron que los peelings de AG 35% y salicílico-mandélico 20% pueden mejorar el melasma en pieles oscuras, y Dayal et al [30] alcanzaron resultados prometedores combinando AG (30-50%) y AA. Las exfoliaciones con TCA combinadas con solución de Jessner podrían ser una alternativa prometedora en el tratamiento del melasma recalcitrante, pero se necesitan estudios de mayor tamaño muestral [31].…”

Section: Discussionunclassified

Actualización en el tratamiento del melasma. Revisión sistemática

López¹,

Egea²

2021

Medicina Estética

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"Introducción. El melasma es una alteración en la melanogénesis de predominio facial que produce manchas de coloración marrón. Suele afectar a las mujeres. Su origen es multifactorial y está íntimamente relacionado con el estado hormonal y la exposición solar. Estas lesiones tienen un gran impacto sobre la calidad de vida de los pacientes, por lo que se han realizado múltiples estudios para dilucidar qué tratamientos son los más adecuados. El objetivo principal es evaluar la eficacia de los diferentes tratamientos en el melasma. Material y método. Revisión sistemática de artículos completos de enero de 2019 a junio de 2020, basados en estudios clínicos originales obtenidos de las bases de datos PubMed (Medline) y Cercabib. Se revisaron ensayos clínicos de enero de 2016 a diciembre de 2018 para encontrar publicaciones que, aun siendo menos actualizadas, pudieran aportar un conocimiento adicional. También se consultaron los resúmenes de estudios clínicos y metaanálisis de los últimos 5 años para desarrollar los apartados de introducción y discusión del estudio. Resultados. Se incluyeron 19 ensayos clínicos y 2 metaanálisis: 4 de tratamientos tópicos, 6 sobre ácido tranexámico, 4 de exfoliaciones, 6 de tratamiento con láseres y 1 sobre fotoprotección. Conclusiones. La hidroquinona sigue siendo el gold standard para el tratamiento del melasma. En los últimos años se ha evidenciado la efectividad del ácido tranexámico como opción terapéutica. La fotoprotección es fundamental en el control de esta patología. El empleo de peelings superficiales y dispositivos láser debe valorarse cuidadosamente."

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“…However, clinical experience of combination of GA peel with azelaic acid in melasma is very limited [12]. Azelaic acid is a depigmenting agent which acts by inhibition of DNA synthesis and mitochondrial enzymes, thereby inducing direct cytotoxic effects on melanocytes.…”

Section: Discussionmentioning

confidence: 99%

“…This might be due to the reason that in our case, we used only AA cream with serial GA peel, while in Erbil et al's study, they have used AA cream with 0.1% adapalene gel in combination with serial GA peel [2]. Thus, the use of additional topical agent, that is, adapalene 0.1% gel which acts in lightening of melasma by accelerating skin turnover and enhancing the efficacy of bleaching agents, may be responsible not only for higher percentage decrease in MASI score but also in side effects like erythema, pruritus, and post inflammatory hyperpigmentation (PIH) [7,12].…”

Section: Discussionmentioning

confidence: 99%

Combination Therapy in Melasma with Lentigo Solaris

2020

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Background: Melasma and lentigo solaris are common, recurrent, and refractory acquired hyperpigmentation disorder. In spite of variety of therapeutic options available for this cosmetically disfiguring condition, the treatment of this condition remains a challenge. Azelaic acid (AA) is a depigmenting agent which acts by inhibition of DNA synthesis and mitochondrial enzymes, thereby inducing direct cytotoxic effects on melanocytes. Glycolic acid (GA) peel is one of the most versatile agents in the treatment of melasma and lentigo solaris. GA peels alone or in combination with topical hypopigmenting agents has shown encouraging results. However, there is paucity of controlled trial demonstrating the efficacy of GA peels in conjunction with topical AA. Case: A 42-years-old female, works as a street vendor, came with dark brown spots on both cheeks, nose, chin and forehead that spreads to whole face since one year ago. She had a history of using contraceptives. From the dermatological examination, there were multiple well-circumscribed, irregular hyperpigmented macules that asymmetrical, with size ranging from lenticular to plaque on the maxillary, left buccalis, mentalis and frontalis region. We also found a numular dark brown hyperpigmented macules on right zygoma. She was diagnosed with melasma and lentigo solaris. The Melasma Area Severity Index (MASI) score was 25.6, which classified as moderate melasma. She was treated with 20% azaleic acid cream twice a day, broadspectrum sunscreen with SPF 50 and GA 20% peeling. Result: After 6 weeks of treatment, there were significant improvement in both melasma and lentigo solaris.

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Combination of glycolic acid peel and topical 20% azelaic acid cream in melasma patients: efficacy and improvement in quality of life

Abstract: GA peel enhances therapeutic efficacy of topical AA cream for treatment of melasma, with improvement in quality of life without serious side effects.

Cited by 30 publications

References 11 publications

Melasma: an Up-to-Date Comprehensive Review

Melasma: an Up-to-Date Comprehensive Review

Actualización en el tratamiento del melasma. Revisión sistemática

Combination Therapy in Melasma with Lentigo Solaris

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