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Combined trichloroacetic acid peel and topical ascorbic acid versus trichloroacetic acid peel alone in the treatment of melasma: a comparative study
Author(s) -
Soliman Mohsen Mohamed,
Ramadan Shahira AbdelRahman,
Bassiouny Dalia Ahmed,
Abdelmalek, MSc Marwa
Publication year - 2007
Publication title -
journal of cosmetic dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.626
H-Index - 44
eISSN - 1473-2165
pISSN - 1473-2130
DOI - 10.1111/j.1473-2165.2007.00302.x
Subject(s) - melasma , trichloroacetic acid , ascorbic acid , dermatology , chemistry , medicine , food science , chromatography
Summary Background Melasma is a common acquired hypermelanosis that is difficult to treat. Several chemical peeling agents were used in treatment of melasma. Topical vitamin C was also used with minimal side effects. Aim To compare the effect of 20% trichloroacetic acid (TCA) peel alone vs. 20% TCA peel combined with topical 5% ascorbic acid in cases of epidermal melasma. Patients and methods Thirty women with bilateral epidermal melasma (Fitzpatrick skin types III and IV) were divided into two groups (A and B, 15 patients each). Before therapy, digital photography and a melasma area and severity index (MASI) score were done for each patient. Groups A and B were primed for 2 weeks before TCA peel. Group B also applied 5% ascorbic acid topically once daily; 20% TCA peel was done for all patients weekly until clearance of melasma or for a maximum of six peels. Group B continued to use 5% ascorbic acid topically in between peels and during the 16‐week follow‐up period. Patients were assessed at the end of peeling sessions and at the end of follow‐up by photography, MASI score, and a global evaluation by the patient. Results Group B compared with group A showed a significant decrease in MASI score at the end of TCA peels ( P < 0.001) and at the end of the 16‐week follow‐up period ( P < 0.003). Global evaluation showed that 13 patients (87%) in group B improved or maintained their improvement compared with only 10 patients (67%) in group A. Conclusion Topical ascorbic acid combined with 20% TCA peel in melasma improves the results and helps in maintaining the response to therapy.