Clinical Efficacy and Safety of 20% Glycolic Acid Versus 30% Lactic Acid Peel in Constitutional Type of Periorbital Melanosis: A Comparative Study

Abstract

Background: Periorbital melanosis (POM) is a common aesthetic condition with significant impact. Chemical peeling is a frequently used treatment; yet, an ideal peeling agent is however to find. The aim of the study was to compare the clinical efficacy and safety of 20% glycolic acid (GA) and 30% lactic acid (LA) peels in POM.

Methods: With approval and consent, the study was conducted from September 2016-August 2017. Patients aged 18-60 years of both sexes, having a constitutional POM were enrolled. Patients known to be allergic to the peeling agents were excluded. Alternate patients were enrolled into Gr-G (20% GA) and Gr-L (30% LA) and were treated every 3 weeks, for 3 sessions and evaluated till 9 weeks. Clinical improvement using POM grading, patients’ global assessment, satisfaction, and physician's global satisfaction were noted. Data are presented in number, percentages and mean±standard deviation. INSTAT software was used for statistical analysis; p<0.05 was considered significant.

Results: Fifty-six (27 in Gr-G, 29 in Gr-L) were enrolled; 70.37% and 68.97% completed the study. Demographic variables, baseline POM grade, and skin types were similar. Compared to baseline, both Gr-G and Gr-L showed significant improvement (p<0.0001). Patient-reported significantly higher improvement in Gr-L (p=0.008) and higher satisfaction. Both the peeling agents were tolerated well with statistically indifferent adverse effects.

Conclusions: Both GA and LA are useful in the aesthetic treatment of the constitutional type of POM. Three sessions of 30% LA peel appears to be better than 20% GA peeling used at 3 weeks apart.

Keywords: Periorbital hyperpigmentation, Infraorbital dark circles, Chemical peeling, Alfa hydroxyl acids, Therapy, Effectiveness, Adverse effects,