We found no systematic review. We found one randomised and one non-randomised trial. The RCT (10 non-pregnant and non-nursing Asian women with skin phototypes IV or V, suffering moderate-to-severe facial melasma) compared the use of peelings with glycolic acid on one side of the face versus no peelings on the other side.27 All women received concomitant twice-daily applications of a cream containing 10% glycolic acid and 2% hydroquinone, as well as SPF15 sunscreen. An independent evaluator assessed the results using a Munsell colour chart and photographs. Participants also assessed the results. Treatments were randomly allocated to a side of the face, and no placebo was used to conceal the intervention. The physician evaluation found improvement in the side using peeling in all cases, and improvement in control sides in 8/10 cases.
The open non-randomised trial (16 women with skin phototypes II-VI, followed for 6 months) comparing glycolic acid peels against Jessner's solution found no differences in the two groups.28 All women received nightly 0-05% tretinoin (preparation not specified) for 1-2 weeks and daily applications of sunscreen. All women also received three peeling sessions, a month apart. Peelings were done using titrated doses of 70% glycolic acid applied to the right side of the face and Jessner's solution applied to the left side. Follow up was completed by 11 (68%) participants and no differences were found between groups.
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