Comparison of 35% and 20% glycolic acid peel in the treatment of periorbital hyperpigmentation

Objectives: The objective of the study is to compare the clinical efficacy and safety of 35% and 20% GA (glycolic acid) peels in the treatment of POH (periorbital hyperpigmentation) in Indian patients. Material and Methods: A single-blinded, split-face study. Thirty patients of POH were enrolled. Patients were applied 35% GA peel on the right eyelid and 20% GA peel applied on the left eyelid. Peeling sessions were performed at 3 weekly intervals for 4 sessions at 0, 3, 6, and 9 weeks and followed up at 12 weeks. Clinical efficacy was assessed using the physician’s and patient’s global assessment and POH grading. Results: By the physician’s global assessment, 20% GA peel showed good response in 43.3% and excellent response 33.3% of patients, while 35% GA peel showed good response in 13.3% and excellent response in 70% of patients ( p = 0.0002). By the patient’s global assessment, 20% GA peel showed good response in 43.3% and excellent response in 26.7% of patients while 35% GA peel showed good response in 36.7% and excellent response in 56.7% patients ( p = 0007). Significant improvement in POH grade was also noted in both groups ( p = 0.049). Both 20% and 35% GA peels demonstrated efficacy in the treatment of POH, though 35% GA peel exhibited a better response. Among side effects, itching and burning sensations were most common in both the groups which did not necessitate cessation of therapy. Conclusion: Both 20% and 35% GA peels demonstrate good to excellent responses in the treatment of POH in most of the patients. However, 35% GA peel exhibits a significantly better response compared to the 20% GA peel. Adverse effects do not differ significantly between the two groups.