EFFICACY OF 3O% SALICYLIC ACID AND JESSNER SOLUTION CHEMICAL PEELING IN PATIENTS WITH EPIDERMAL MELASMA

Abstract

Background; Melasma has a significant impact on appearance, causing psychosocial and emotional distress, and reducing the quality of life of the affected patients. In this context, it has a negative impact on the quality of life of patients, affecting their psychological and emotional well-being, which often motivates them to search for a dermatologist. Objective; To compare mean MASI score of in patients with epidermal melasma treated with 30 % salicylic acid versus Jessner solution chemical peeling. Material and methods; A total of 396 patients were taken in our study. Patients was randomly allocated in to two groups by lottery method. Group A, having 198 patients, were treated with 30 % salicylic acid while group B, having 198 patients, with Jessner solution chemical peeling in patients. After two weeks of priming, which was comprised of nightly application of 0.05% tretinoin and daytime sunscreen with a sun protection factor of 60, treatment according to the group was started. Night-time use of moisturizer was applied in all patients and asked for follow up visits after 2 weeks till 12 weeks to document final outcome. Baseline and post-treatment MASI scores was calculated and patients were followed weekly till 12 weeks from the beginning of therapy to document efficacy. Results; Of these 396 study cases, 126 (31.8 %) were male patients while 270 (68.2 %) were female patients. Mean age of our study cases was 27.20 ± 5.08 years.  Mean body mass index of our study cases was 24.82 ± 2.51 kg/m² and obesity was present in 28 (7.1 %) of our study cases. Fitzpatrick Skin type III was noted in 270 (68.2%) and skin type III was noted in 126 (31.8%) of our study cases. Mean disease duration was 10.62 ± 5.92 months and 293 (74 %) had duration of illness up to 1 year. Mean post treatment MASI score in our study was noted to 9.31 ±2.93 while mean MASI in group A was 7.59 ± 3.02 while in group B mean MASI was 11.03 ± 1.48 (p = 0.000). Conclusion; Our study results have indicated that 30 % salicylic acid is more effective in treatment of epidermal melasma as compared with Jessner solution as there was significant reduction of mean MASI score in our patients and it provides rapid and sustained clinical improvement in the treatment of melasma. The results of this study support use of 30 % salicylic acid among targeted population which had significant impact on the improvement of quality of life of these patients and relieved them from psychological stress of this disease. Proper management of melasma helps improve productivity of the patients as it hits main working force of the society, hence plays important role in the national productivity and health economy.

Keywords; Melasma, Salicylic acid, Jessner Solution, MASI.