80% Lactic Acid Peel Versus 50% Glycolic Acid Peel for Melasma: A Randomised Clinical Trial

Peels are simple, inexpensive office procedures with acceptable side effect profiles and make a good treatment modality for patients with melasma. Glycolic acid peels have been used widely for the treatment of melasma. Due to their tendency to cause undesirable side effects such as post-inflammatory hyperpigmentation, other modalities need to be studied. To compare the efficacy of 80% lactic acid and 50% glycolic acid peel for the treatment of melasma. This was a prospective, single-blinded (study subjects), randomised study. Forty patients with melasma between the ages of 18-50 years from the dermatology outpatient department of a tertiary care hospital in Central India were included in the study and randomised to receive either 80% lactic acid peel or 50% glycolic acid peel (20 in the lactic acid group and 20 in the glycolic acid group) for four sessions at 2-week intervals. The efficacy was assessed using Melasma Area and Severity Index (MASI) scores calculated at the baseline and at the end of the treatment (10 weeks). The pre- and post-treatment MASI scores were calculated for each treatment, and their difference was compared using the Mann-Whitney test. Thirty-four patients completed the study over 6 months and were included in the final analysis. Six patients were lost to follow-up. The median (25^th-75^th percentile) decrease in MASI with glycolic acid 50% peel was 2.85 (1.875-3), which was significantly higher as compared to lactic acid 80% peel, which was 1.8 (1.125-2.4) (P value = 0.009). No significant difference was seen in the side effect profile (P value = 0.105). 50% glycolic acid peel is more efficacious than 80% lactic acid peel for the treatment of melasma.