Combining Modified Jessner's Solution (MJs) with Trichloroacetic Acid (TCA) has been shown to be 20% is more efficacious than Glycolic Acid 70% Combined With Trichloroacetic Acid 20% in Melasma treatment, suggests a recent study. The study findings have been published in Dermatologic Surgery.
Melasma  is an acquired challenging pigmentary skin problem, which commonly affects the  face. A wide range of therapeutic modalities is available, yet none is  satisfactory. Melasma is a symmetric progressive hyperpigmentation  of the facial skin that occurs in all races but has a predilection for darker  skin phenotypes. Melasma has been associated with hormonal imbalance, sun  damage, and genetic predisposition. Clinically, melasma can be divided into  centrofacial, malar, and mandibular, according to the pigment distribution on  the skin. By Wood's light examination, melasma can be classified into epidermal,  dermal or mixed type.
     
    Many  depigmenting agents and other therapies such as chemical peeling are used for  treating melasma, in the form of monotherapy or combined therapy.  The most commonly used peeling agents are  alpha-hydroxy-acids, resorcinol, Jessner's solution, and trichloroacetic acid.  TCA is the most popular peeling agent used in  different concentrations. It has the broadest spectrum of indications. 
    The  Jessner's-trichloroacetic acid peel is a procedure developed by Dr. Gray  Monheit (USA) to produce a safe, effective medium-depth chemical peel for the  treatment of photoaged skin, actinic keratoses, and superficial acne scars.
    To  gain a deeper knowledge into the matter,researchers undertook the study to  compare  the efficacy and safety of  trichloroacetic acid (TCA) 20% peeling with either modified Jessner's solution  (MJs) or with glycolic acid (GA) 70% peeling in the treatment of melasma.
     
    Ths  study design consisted of Thirty adult Egyptian women with melasma who were  recruited in the study. After cleansing the face, MJs was applied on one side  of the face and GA 70% on the other side. Then, TCA 20% was applied in one  uniform coat on both sides of the face. Assessment of the clinical response was  guided by calculating the melasma area, severity index (MASI), modified MASI,  and hemi-MASI scores before and after the end of treatment.
     
    Key  points highlighted in the results were –
    - Both combinations showed significant  reduction in MASI, modified MASI, and hemi-MASI scores (p value = .000, for  each). 
- Moreover, the hemi-MASI score after MJs  and TCA20% showed a significant decrease compared with GA70% and TCA20% (p  value = .013).
For  the full article follow the link: Modified Jessner's Solution Combined With Trichloroacetic Acid 20%  Versus Glycolic Acid 70% Combined With Trichloroacetic Acid 20% in the  Treatment of Melasma Dermatol  Surg 2021 Feb 22;[EPub Ahead of Print], EM Abdel-Majid, ER Helmy, AA Abdel  Motaleb
    Primary  source: Dermatologic Surgery
 
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