Trichloroacetic acid and Jessner’s solution most effective for melasma in dark skins

In a meta-analysis of 13 studies, trichloroacetic acid and Jessner’s solution emerged as the most efficacious single-agent chemical peels for melasma in patients with dark skin.

In a study published in the Journal of Cosmetic Dermatology, single-agent peels were investigated for their efficacy and safety when treating melasma in dark skins, where the increased risk of post-inflammatory hyperpigmentation is considered.  

The meta-analysis included data from 10 randomised controlled trials and three prospective comparative studies, gathered from the databases of The Medline, SCOPUS, Web of Science, Google Scholar, and Cochrane.

The studies included patients with Fitzpatick skin types III-VI and investigated the relative efficacy and safety of two or more of: alpha-hydroxy acids, beta-hydroxy acids, Jessner’s solution, retinoic acid, or trichloroacetic acid.

Melasma area and severity index score (MASI) and incidence of adverse events were looked at as outcomes of interest.

The overall effect estimate favoured glycolic acid over trichloroacetic acid peel in terms of MASI. On the other hand, the overall effect estimates did not favour glycolic over tretinoin, vitamin C iontophoresis and amino fruit acid in terms of MASI. The overall effect estimates favoured trichloroacetic acid peel and Jessner's solution over topical hydroquinone in terms of MASI.

Results from the meta-analysis identified trichloroacetic acid and Jessner’s solution as particularly effective modalities for melasma treatment in dark skin. Though side effects were found to be mild in nature, trichloroacetic acid was associated with higher risk for erythema compared with glycolic acid. 

 

Last month, an analysis of Google search data found that searches for chemical peels were at an all-time high.