Comparison of efficacy and safety of low-fluence neodymium-doped yttrium aluminium garnet laser versus glycolic acid peeling in patients of melasma: A split-face study

Objectives To compare the efficacy and safety of low-fluence neodymium-doped yttrium aluminium (Nd:YAG) laser and glycolic acid peeling in Melasma Material and Methods 80 patients of clinically diagnosed melasma were treated with 3 sessions of low-fluence Nd: YAG laser on the right side of the face. For the left side, initial 2 sessions of GA 35% and later 3 sessions of GA 70% were done. Outcome was measured as percentage reduction in melasma area and severity index (MASI) score. Results Statistically significant reduction in mean MASI score was recorded with both the modalities, though the total reduction with Nd: YAG laser was found to be significantly more compared to the reduction with GA peeling ( P = 0.003). Erythema was the most common side effect observed with both treatments. Delayed side effects were not seen with GA peeling but one patient developed hyperpigmentation after Nd: YAG laser treatment. Conclusion Laser sessions have the added advantage over GA peeling requiring comparatively fewer sessions while being equally or more efficacious. Immediate side effects are more common with GA peeling, while delayed side effects are more common with laser therapy.