Efficacy and tolerability of chemical peeling as a single agent for melasma in dark‐skinned patients: A systematic review and meta‐analysis of comparative trials

Dorgham, Nevine A.; Hegazy, Rehab A.; Sharobim, A; Dorgham, Dina A.

doi:10.1111/jocd.13725

Cited by 14 publications

(6 citation statements)

References 43 publications

(70 reference statements)

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“…Also, a strong correlation between MASI and Sun Exposure, R = 0.663 (Table 6) was noted in our study. Jointly, studies provide evidence that excessive sun exposure contributes to melasma and therefore impacts the severity of melasma [59][60][61]. The excessive sun exposure from our study may have resulted from the participation in outdoor sports as well as insufficient sun protection application, as indicated by the study respondents.…”

Section: The Use Of Sunscreenmentioning

confidence: 71%

The Effect of Melasma on the Quality of Life in People with Darker Skin Types Living in Durban, South Africa

Mpofana,

Paulse,

Gqaleni

et al. 2023

IJERPH

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Melasma is a common skin disorder of acquired hyperpigmentation that appears commonly on the face. Although asymptomatic, melasma causes psychosocial and emotional distress. This study aimed to assess melasma’s severity on people with darker skin types, evaluate the effects of melasma on the quality of life (QoL), and establish QoL predictors in affected individuals. This was a cross-sectional analytic study that enrolled 150 patients from three private dermatology clinics in Durban, South Africa who were diagnosed with melasma. The severity of melasma alongside QoL were measured using a melasma area and severity index (MASI) score and melasma quality of life scale (MELASQoL), respectively. The associations among factors and QoL were explored using multivariable methods and stepwise regression analysis. p-values less than 0.05 were considered significant. Enrolled patients were predominantly females (95%), of which 76% were of black African ethnicity, 9% were of Indian ethnicity, and 15% had mixed ancestry, with an average age of 47.30 years. Family history revealed that 61% had no prior melasma cases, while 39% had affected relatives, most commonly mothers (41%). The cheeks were the most common site for melasma. MASI score of Masi (β = 0.209, t = 2.628, p < 0.001), the involvement of cheeks (β = −0.268, t = −3.405, p < 0.001), level of education (β = −0.159, t = −2.029, p = 0.044), and being menopausal (β = −0.161, t = −2.027, p = 0.045) were found to be predictors of QoL. A regression model was created to forecast MELASQoL using these four predictors. This equation’s significance lies in its ability to enable the remote assessment of MELASQoL based on these four variables. It offers a valuable tool for researchers and medical professionals to quantitatively and objectively evaluate the impact of melasma on an individual’s quality of life.

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Section: The Use Of Sunscreenmentioning

confidence: 71%

The Effect of Melasma on the Quality of Life in People with Darker Skin Types Living in Durban, South Africa

Mpofana,

Paulse,

Gqaleni

et al. 2023

IJERPH

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“…Te systematic review and metaanalysis of comparative trials by Dorgham et al reported satisfactory results of glycolic acid (GA) and trichloroacetic acid peel as a melasma treatment in dark skin patients, with better efects and safety profle of GA. Undoubtedly, there is a need to perform research evaluating the efectiveness of retinol peel in the population with Fitzpatrick IV-VI skin type [24].…”

Section: Discussionmentioning

confidence: 99%

Unique Retinol Therapy with Antioxidant and Anti‐Inflammaging Complex for Naturally Reborn Skin: The Clinical Case Series Study

Sołdacka,

Podgórska,

Barańska-Rybak

2023

Dermatologic Therapy

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One of the methods used to prevent symptoms of skin aging are chemical peels. Among retinoids, retinol is much less described in the literature than tretinoin as a substance used in the peel procedure. The aim of our study was to determine the efficacy of using a 4% retinol solution product containing novel TGF-β activators and antioxidants in improving the condition of the skin in patients with facial skin issues caused by aging and skin disorders. Each of 15 patients went through three peel treatment series, with a 30-day gap between each session and was examined using Multi Skin Test MC 1000 Courage + Khazaka, evaluating hydration, elasticity, and skin pigmentation and Observ 520x. All patients reported overall improvement after the peeling procedure, and most of them reported subjective improvement in the reduction of the facial skin: tone, skin pigmentation, dehydration, dryness, structure, and sebaceous gland activity. An objective evaluation revealed significant clinical improvement in pigmentation in study groups. Elasticity parameters were shown to increase during treatment, with a greater effect occurring in patients with mature skin with first signs of aging and patients with postinflammatory hyperpigmentation, atrophic acne scars, and enlarged pores. Concluding, combined peel therapy of 4% retinol serum product containing novel TGF-β activators and antioxidants showed good efficacy in reducing facial pigmentation of the skin high patients’ satisfaction with the procedure. The study revealed that the described method is simple to use, has low cost, is with rare adverse events, and has well tolerability.

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“…Chemical peeling is the recommended second-line treatment for melasma, and it can accelerate epidermal renewal and collagen regeneration to remove epidermal melanin and suspend the transfer of melanosomes ( 48 ). A systematic review and meta-analysis showed that GA peeling had no obvious advantage over tretinoin (MD 0.00, 95% CI [0.99, 0.99], P = 0.3) and VC (MD 1.50, 95% CI [0.50, 3.50], P = 0.14), while TCA peeling (MD 5.30, 95% CI [6.41, 173 4.19], P < 0.001) and Jessner solution (MD 3.20, 95% CI [5.35, 1.05], P = 0.004) were better than HQ in treating melasma ( 49 ). Chemical peeling in this study included GA, TCA, SA, and Jessen solution.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Efficacy of Melasma Treatments: A Network Meta-Analysis of Randomized Controlled Trials

Liu

et al. 2021

Front. Med.

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Background: Melasma is an acquired pigmentation disorder with challenges in treatment because of its refractory nature and high risk of recurrence.Objectives: This study aimed to compare the efficacy and side effects of 14 common therapies for melasma using a systematic review and network meta-analysis (NMA).Methods: The PubMed, Embase, and Cochrane Library databases were searched till December 2020 using the melasma area and severity index as a therapeutic index. A total of 59 randomized controlled trials (RCTs) met the inclusion criteria and were selected.Results: The ranking of relative efficacy compared with placebo in descending order was Q-switched Nd:Yag 1,064-nm laser (QSND), intense pulsed light, ablative fractional laser (AFL), triple combined cream (TCC), topical vitamin C, oral tranexamic acid (oTA), peeling, azelaic acid, microneedles (MNs), topical tranexamic acid (tTA), tretinoin, picosecond laser, hydroquinone (HQ), and non-AFL. Moreover, QSND was more effective than HQ and tTA against melasma. The ranking of percentage (%) of side effects in ascending order for each of 14 therapies with more than 80 participants was tretinoin (10.1%), oTA (17.6%), HQ (18.2%), AFL (20.0%), QSND (21.5%), TCC (25.7%), tTA (36.75%), peeling (38.0%), and MN (52.3%). Taking both efficacy and safety into consideration, TCC was found to be the most favorable selection among the topical drugs for melasma. QSND and AFL were still the best ways to treat melasma among photoelectric devices. oTA as system administration was a promising way recommended for melasma. Among 31 studies, 87% (27/31) studies showed that the efficacy of combination therapies is superior to that of single therapy. The quality of evidence in this study was generally high because of nearly 50% of split-face RCTs.Conclusions: Based on the published studies, this NMA indicated that QSND, AFL, TCC, and oTA would be the preferred ways to treat melasma for dermatologists. However, more attention should be paid to the efficacy and safety simultaneously during the clinical application. Most of the results were in line with those of the previous studies, but a large number of RCTs should be included for validation or update.Systematic Review Registration: identifier: CRD42021239203.

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Efficacy and tolerability of chemical peeling as a single agent for melasma in dark‐skinned patients: A systematic review and meta‐analysis of comparative trials

Cited by 14 publications

References 43 publications

The Effect of Melasma on the Quality of Life in People with Darker Skin Types Living in Durban, South Africa

The Effect of Melasma on the Quality of Life in People with Darker Skin Types Living in Durban, South Africa

Unique Retinol Therapy with Antioxidant and Anti‐Inflammaging Complex for Naturally Reborn Skin: The Clinical Case Series Study

Comparison of the Efficacy of Melasma Treatments: A Network Meta-Analysis of Randomized Controlled Trials

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