Topical Treatment of Melasma with Lactic Acid Cream: a Comparative Study with Glycolic Acid Cream
Iraqi Postgraduate Medical Journal,
2017, Volume 16, Issue 3, Pages 229-234
Melasma is a major cosmetic problem affecting young people mainly females. There are many modalities of topical therapy but usually end with relapse.
To evaluate the efficacy and safety of 6% lactic acid cream in comparison with glycolic acid cream 6% and 12% in the treatment of melasma.
PATIENTS & METHODS:
This is a COHORT comparative therapeutic trial conducted in the Department of Dermatology-Baghdad Teaching Hospital.
Sixty patients with melasma were included in this study. They were divided into three groups; each one consisted of twenty patients. Group one treated with 6% lactic acid cream, group two with 6% glycolic acid cream, group three with 12% glycolic acid cream. Patients were evaluated clinically using wood’s light & melasma area severity index score before and after therapy. Follow up was done regularly every two weeks for two months to assess the improvement and side effects. Also patients were seen monthly for 3 months after the end of treatment to see any relapse. All patients were instructed to apply the cream once at night for two months with broad spectrum sun block SPF > 30 before sun exposure.
In group one of the study using lactic acid cream 6%, 14 patients completed the study; their ages ranged from 26-42 years, with a mean 31.9 SD 4.1 years, twelve patients (86%) were females and 2 (14%) males. The result showed that the average score before treatment was 11.45 2.9 while after treatment score changed to 5.312.71; so the improvement was 6.14, this represented a (54%) decrease and was statistically significant (p value<0.0005). No important side effects were recorded during the treatment or follow up. In group two of the study using 6% glycolic acid cream, 13 patients completed the treatment; their ages ranged from 17- 40 years with a mean 27.5 SD 6.8 years, all patients (100%) were females. The result revealed the mean of score before treatment was 10.56 2.77 while after treatment score became 8.36 2.85. So the average decrease was2.2 which represented (21%) decrease and it was statistically significant (p value<0.0005). No important side effects were recorded during the treatment or follow up. While In group 3 of the study using 12% glycolic acid cream,15 patients completed the study; their ages 22 to 40 years with a mean of 31.8 SD 5.3 years. Thirteen (87%) patients were females and 2 (13%) males. The result showed that the mean before treatment was 12.54 3, 4 while after treatment score changed to 6.06 2.38. So the average decrease was 6.48; this represented 52% decrease and was statistically significant (p value <0.0005). No important side effects were recorded during the treatment or follow up. The three agents were statistically significant for the treatment of melasma and there were no significant difference between 6% lactic acid cream and 12% glycolic acid cream (p value= 0.654). But there were significant difference between 6% glycolic acid cream and the others.
Lactic acid cream 6% is a new, non costly, alternative effective, safe agent and as effective as 12% glycolic acid cream for the treatment of melasma.
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