Comparative Efficacy of 35 % Glycolic Acid Peel versus 4 % Retinol Peel in Melasma

BACKGROUND: Melasma is an acquired hypermelanosis. Chemical peels have been found efficacious in melasma. However, limited studies have compared the efficacy of various peels in melasma and used dermoscopy to evaluate improvement. OBJECTIVE: To compare the efficacy of 35% glycolic acid peel and 4% retinol peel in melasma using clinical, dermoscopic, and quality of life assessments. MATERIALS AND METHODS: A randomized controlled study included 60 adults (18-60 years) with clinically diagnosed melasma. Participants were randomized into Group A (glycolic acid) and Group B (retinol), receiving 6 sessions of peels at two-week intervals. Pretreatment and post-treatment assessments included modified Melasma Area Severity Index (mMASI), dermoscopic scoring, and Hindi Melasma Quality of Life Index (HI-MELASQOL). Statistical analysis used p -values <0.05 for significance. RESULTS: Both groups showed significant improvements in mMASI, dermoscopic features, and HI-MELASQOL ( p < .001) with no significant difference between groups. Mild, self-limiting adverse effects were more common in the retinol group (13.3%) than the glycolic acid (3.3%). CONCLUSION: Both 35% glycolic acid and 4% retinol peels are effective in treating melasma, with significant improvements in pigmentation, dermoscopic features, and quality of life. No significant difference was observed between the 2 treatments. Dermoscopy is useful to assess response.