Effectiveness of Fortnightly 35 percent Glycolic Acid Peel Versus Daily 12 percent Glycolic Acid Cream in the Treatment of Melasma: A Prospective, Comparative, Two-arm, Double-blind, Randomised Controlled Study at a Tertiary Care Centre in Mandya

This study is a prospective hospital-based, double-blind, randomized controlled trial designed to compare the efficacy of fortnightly 35% glycolic acid peel with daily 12% glycolic acid cream in the treatment of melasma. A total of 60 patients aged 18–65 years will be randomized into two groups of 30 each: Group A will receive 35% glycolic acid peels every two weeks along with a placebo cream, while Group B will receive daily 12% glycolic acid cream with a placebo peel. Both patients and investigators will remain blinded to the treatment allocation, with placebos used to maintain blinding. All participants will be advised regular use of sunscreen. The primary objective is to evaluate and compare the reduction in pigmentation using the Melasma Area and Severity Index (MASI) score at baseline, 4, 8, and 12 weeks. Secondary objectives include assessing the impact of treatment on quality of life, recording adverse events, and comparing efficacy across different melasma types (epidermal, dermal, mixed). By directly comparing peel versus cream therapy, this study aims to provide valuable evidence on which modality offers better clinical outcomes, safety, and cost-effectiveness, thereby guiding dermatologists in optimizing melasma management.