Efficacy of 15% Trichloroacetic Acid and 50% Glycolic Acid Peel in the Treatment of Frictional Melanosis: A Comparative Study

BACKGROUND: Frictional dermal melanosis is aesthetically displeasing. Various modalities ranging from depigmenting agents to lasers have been tried but it continues to be a difficult problem to treat. OBJECTIVE: To study and compare the efficacy of 15% trichloroacetic acid (TCA) and 50% glycolic acid in the treatment of frictional melanosis of the forearm. MATERIALS AND METHODS: 40 patients of frictional melanosis of the forearm were included in the study. Patients were randomly divided into two equal groups A and B. Pre-peel priming was carried out with 12% glycolic acid and sunscreen for 2 weeks. Group A was treated with trichloroacetic acid (TCA-15%) peel and Group B with glycolic acid (GA-50%) peel. Four peels were done one every 15 days. Clinical photographs were taken to assess the response. Response to therapy was evaluated by both objective and subjective methods. The patients were followed up for 3 months after the last peel to note any relapse. RESULTS: Both TCA and glycolic acid peels were effective in frictional melanosis. TCA showed better response compared to glycolic acid at the end of the treatment, both by subjective and objective methods. However, this difference was not statistically significant (P > 0.05). No permanent side effects were seen in any of the treated patients and the improvement was sustained without any relapse at 3 months. CONCLUSION: Chemical peeling with both tricholoroacetic acid (15%) and glycolic acid (50%) is safe and effective for the treatment of frictional dermal melanosis. Tricholoroacetic acid was found to be marginally superior to glycolic acid.