420 JOURNAL OF COSMETIC SCIENCE Method of study: All the eligible cases attending skin VD OPD, S.S.G. Hospital, Med- ical College Baroda during the study period (September 1, 2016, to June 30, 2017) was included for the study with a written consent. • Detailed history including age, sex, duration of the disease, number of the lesions, history of medication, and so on, was taken. • Clinical examination included both general and dermatological examinations. • MASI* score calculation was done. • All cases was given standardized treatment. • Photographic and clinical assessment was carried out at 0, 2, 6, 10, 14 weeks. • Treatment was given according to protocol.* • Patient with odd sr no. (1, 3, 5, …) was given 35% GA peel. • Patient with even sr no. (2, 4, 6, . . …) was given JP (14% salicylic acid, 14% lactic acid, and 14% resorcinol in 95% ethanol). Cutaneous and systemic examination were done and documented in preset proforma. Morning—sunscreen cream (SPF sunscreen (Octyl Methoxycinnamate 7.5+ Vitamin E Acetate 0.5% W/W+Overa-Spf Aloe Vera Extract 10) • At night—Triple combination (2% hydroquinone, 0.025% tretinoin, 0.01% fluoci- nolone acetonide) • Peeling—Intermittent peeling either 35% GA peel or JP as per protocol Pretreatment MASI score noted and pretreatment photograph were taken. RESULTS AND DISCUSSION Sixty cases of Melasma attending Skin-VD OPD, Baroda Medical College from Septem- ber 1, 2016, to June 30, 2017, were enrolled. Out of 60 cases, 50 cases had completed the treatment as per protocol (14 weeks) while 10 cases had left the study after 6 weeks of enrolment. The data has been analyzed and the results produced are as follows. a. In the present study, the youngest case enrolled was 26 years old and eldest was 46 years old. (Table I) b. Highest number (total 19) of cases were found in the age group of 36–40 years. c. 60% cases were in 31–40 year age group. In a large global survey with 324 melasma women, the mean age of melasma cases was 34 years (range 14–65 years) (5). Table I Melasma in Female: Age at Presentation Age Group (in years) Total (n = 60) Percentage (100%) 26–30 13 21 31–35 17 28 36–40 19 32 41–45 10 17 46–50 01 2

421 COMPARATIVE EFFICACY OF 35% GLYCOLIC ACID PEEL In Brazil, it was found that most of the female cases ( 50%) developed melasma between the second and fourth decades of life (20–35 years of age) (6). In India and Singapore, the average ages of disease onset were higher: 30 and 38 years, respectively (7,8). In the present study, 45% of cases had history of melasma for the duration ranging from 1 to 5 years at the time of enrollment. Only 3% cases presented within 6 months of onset. (Table II) Table II Melasma in Female: Duration at Time of Enrollment Duration Number of Cases (n = 60) Percentage Cases (%) 6 months 2 3 6 month to 1 year 17 28 1–5 year 27 45 5 year 14 23 Table III Melasma: Triggering Factors Triggering Factors Number of Cases (n = 60) Percentage Cases (%) Past history of OC pill 3 5 History of cosmetic product application 4 7 History of sun exposure (Outdoor work) 6 10 History of thyroid abnormality 2 3 History of menstrual irregularity 7 12 OC: oral contraceptive. Table IV Melasma in Female: Clinical Types Type of Melisma Cases (n = 60) No. % Centrofacial (Cf) 32 53% Malar (M) 27 45% Mandibular (Mn) 1 2% Table V Baseline MASI Score (n = 50) MASI Score GA Peel (n = 25) Jessner peel (n = 25) Total (50 cases) ≤5 — — — 5–10 5 5 10 10–15 8 7 15 15–20 7 7 14 20 5 6 11 GA: glycolic acid MASI Melasma Area and Severity Index.