Safety and efficacy of modified Jessner’s solution versus 70% glycolic acid for the treatment of melasma in different skin types: a split-face study

Background The treatment of melasma has been challenging; numerous approaches have been used with variable results. Chemical peeling is an established technique for the treatment of pigmentary imperfections. Objective The aim of the study was to compare the efficacy and safety of glycolic acid (GA) 70% and a modified Jessner’s solution in the treatment of melasma in different skin types among a sample of Egyptian women. Patients and methods Thirty women with a clinical diagnosis of melasma were selected. Modified Jessner’s solution and GA 70% were applied on a split-face basis at a 2-week interval for a maximum of eight sessions. Evaluation of the results was carried out by the Melasma Area and Severity Index (MASI) score at baseline, at the end of sessions, and after the followup period of 16 weeks. Patient satisfaction score and Global Aesthetic Improvement Scale were evaluated by a blinded clinical investigator. Side effects were recorded. Results There was a significant reduction in the total MASI score in the modified Jessner’s solutiontreated side than in the GA 70%-treated side after the last session (P 0.001). In patients with skin type III, there was a significant reduction in the MASI score in the modified Jessner’s-treated side compared with the GA-treated side (P=0.012). In patients with skin type II and V, the reduction in the MASI score between both sides of the face was not significant (P=0.673 and 0.317 respectively). Pigmentation was the common complication, especially in skin types IV and V, with a nonsignificant difference between both sides of the face. Recurrence of increased pigmentation occurred on follow-up. Conclusion Modified Jessner’s solution is more effective for the treatment of melasma in different skin types, especially skin type III, with high patient satisfaction compared with 70% GA.