Comparative Study of 15% TCA Peel Versus 35% Glycolic Acid Peel for the Treatment of Melasma: A Randomised Controlled Trial

Background: Melasma is a common acquired hypermelanosis with significant cosmetic and psychosocial impact. Chemical peels are widely used as adjunctive treatment modalities. The aim is to evaluate the safety and effectiveness of 35% glycolic acid (GA) and 15% trichloroacetic acid (TCA) peels for melasma patients. Material and Methods: Settings and Design: Single-centre, randomized controlled trial conducted in the Department of Dermatology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad. A total of 108 patients with melasma refractory to first-line therapy were randomized into two groups: Group B (n = 54) received 35% glycolic acid peel, while Group A received 15% TCA peel. Patients underwent three peeling sessions at four-week intervals following a two-week priming period with 4% hydroquinone. The Melasma Area and Severity Index (MASI) and dermoscopic examination were used for clinical evaluation at baseline, four, and eight weeks. Statistical Analysis Used: The Chi-square test, Student's t-test, and descriptive statistics were used. Statistical significance was defined as a p-value of less than 0.05. Results: The MASI scores for both groups significantly decreased from baseline to eight weeks. The mean MASI dropped from 23.90±6.16 to 16.35±5.59 in the GA group and from 23.85±6.01 to 16.20±5.05 in the TCA group. The differences between the groups were not statistically significant (p=0.885). Adverse effects and improvements in dermoscopy were similar in both groups. Conclusion: There is no discernible difference in the safety and effectiveness of 15% TCA peel and 35% glycolic acid peel as melasma treatments.

Keywords: Melasma, Trichloroacetic Acid, Glycolic Acid, Chemical Peel, MASI, Dermoscopy, Randomised Controlled Trial.