Efficacy, safety, and cost-effectiveness of glycolic acid vs. azelaic acid in melasma.

Abstract

To compare efficacy, safety, and cost of the treatment among topical glycolic acid (GA) and azelaic acid (AA) in melasma patients. A total of 80 patients with melasma were randomized into two groups of 40 each and received either topical GA (12%) or AA (20%). Their demographic data, detailed clinical history, and systemic and complete local skin examination were carried out. MASI scoring and adverse events were recorded at baseline, 2, 4, 6, and 8 weeks after treatment and compared. The total cost of therapy was calculated and compared. Most patients belong to 24-35 years with a female preponderance. No statistically significant difference was found for risk factors like exposure to sunlight, hormonal contraceptives, Fitzpatrick skin type, and affected site among both groups (<i>P</i> > 0.05). The mean MASI score in the AA and GA groups, respectively, was 5.13 and 4.84 at the baseline (<i>P</i> = 0.48) which reduced to 4.57 and 4.86 in the AA and GA groups correspondingly (<i>P</i> > 0.05) in the first week. In the 8^th week, the mean MASI score was 2.82 and 2.88 in the AA and GA groups (<i>P</i> > 0.05). There was no statistically considerable difference in the prevalence of side effects between the two groups (<i>P</i> > 0.05). The total cost of treatment was Rs. 1410 and Rs. 430 per patient for the AA and GA groups, respectively (<i>P</i> < 0.05). There is no noticeable difference between AA and GA in terms of their effectiveness and safety profiles while treating melasma but the cost of treatment was significantly higher with azelaic acid.