In the article "Efficacy of Glycolic Acid Peels in the Treatment of Melasma,"¹ the authors conclude that the addition of 4 glycolic "peels" did not enhance the hypopigmenting effect of hydroquinone treatment. A chemical peel is a procedure in which the skin peels after treatment with a chemical solution. In this case, the authors reported the application of 20% and 30% glycolic acid pads did not result in epidermolysis and indeed only produced erythema.

In our experience, glycolic acid is a weak peeling agent and requires the use of concentrations of 50% to 70% to achieve peeling. We have clinically observed improvement in melasma when concentrated glycolic acid solutions were used in a repeated fashion (monthly) in the absence of hydroquinone. Paradoxical hyperpigmentation is rare in darker-skinned patients.