Combined peel with 25% salicylic acid solution and 10% trichloroacetic acid gel for melasma

Aim. The aim of the study is to evaluate the efficacy and tolerability of a new kind of combined peeling for melasma. Methods. This new combined peel consists in using salicylic acid 25% in alcoholic solution and trichloroacetic acid 10% in gel, subsequently in the same session. We used this technique to treat 15 female patients, aged from 18 to 45 years, with phototype from II to IV according to Fitzpatrick scale; they were affected by epidermic (S patients), dermal (4 patients) or mixed-depht (3 patients) melasma. For the evaluation of the type and the severity of melasma we used MASI score and Wood's lamp. Results. We obtained an excellent esthetic results, in 3-4 settings at 3-4 weeks interval: in fact, we observed complete resolution in patients with epidermic melasma, significant regression of the hyperpigmentation in mixed-depth melasma (more than 50% decrease in MASI score) and a mild regression in dermal melasma (more than 25% decrease in MASI score). No side effects were observed. In patients with total resolution no relapses were observed after 6 months from the end of the treatment. Conclusion. In this study we have evaluated the efficacy and tolerability of the combined peel, proving that it is useful, reliable and safe in the treatment of the melasma, in all skin types.