Efficacy of glycolic acid peels in combination with topical therapy in common facial melanosis in skin of color: A randomized clinico-dermoscopic study

Objectives: The objective of the study is to compare the efficacy of topical therapy versus its combination with glycolic acid (GA) peels in common facial melanosis including melasma, acquired dermal macular hyperpigmentation (ADMH), and post-inflammatory hyperpigmentation (PIH), using clinical and dermoscopy scores. Material and Methods: A total of 120 patients (melasma-67, ADMH-42, PIH-11) were included and divided into 2 groups in this randomized controlled study. Group 1 received topical therapy alone- 4% hydroquinone in melasma ( n = 34), 0.1% tacrolimus cream in ADMH ( n = 21), and 0.025% tretinoin cream in PIH ( n = 5). Group 2 patients (including 33 melasma, 21 ADMH, and 6 PIH) received topical therapy (as group 1) along with 4 sessions of 35 % GA peel at 3 weekly intervals. Evaluation was done using clinical and dermoscopic scores specific to diagnosis. Results: A significant decrease in clinical and dermoscopy scores was observed in melasma and ADMH between both groups at 12 weeks ( p < 0.05). In PIH, clinical scores showed significant improvement; however, dermoscopy did not reveal any significant results. Conclusion: GA peels combined with topical therapy provide an additional benefit in facial melanosis, with dermoscopy aiding in diagnosis and treatment as well.