Chemical Peels for Melasma: A Systematic Review

BACKGROUND Melasma is a common chronic, relapsing pigmentary disorder that causes psychological impact. Chemical peels are a well-known therapeutic modality used for accelerating the treatment of melasma. OBJECTIVE To review the published evidence on the efficacy and safety of chemical peels in the treatment of melasma. METHODS A systematic review was done. A meta-analysis could not be done due to the heterogeneity of data. RESULT The authors conducted a PubMed search and included prospective case series of more than 10 cases and randomized controlled trials (RCTs) that have studied the safety and/or efficacy of chemical peel in melasma. Out of 24 studies, 9 were clinical/comparative trials and 15 were RCTs. The total sample size was 1,075. The duration of the study varied from 8 to 36 weeks. Only 8 studies were split face. All studies used self-assessment, physician global assessment, and Melasma Area and Severity Index (MASI) for quantifying the results. Glycolic acid was found to be the most safe and effective in melasma. CONCLUSION Chemical peels were found to be safe and effective in the management of melasma.