Abstract
Background: Mostly impacting women with darker Fitzpatrick skin types, especially in sun-exposed regions of the face, melasma is a chronic acquired hyperpigmentation condition. Because of their relapsing character and tolerance to treatment, chemical peels have become complementary or replacement therapies to topical depigmenting agents. The goal of this systematic review was to assess the effectiveness and safety of several chemical peels in melasma therapy.
Methodology: Randomized controlled studies (RCTs), split-face trials, and future comparative investigations examining chemical peels for melasma treatment were found by means of a systematic literature search. Studies were considered if they evaluated clinical results like pigment reduction and treatment tolerance in patients with varied Fitzpatrick skin types. Study design, patient demographics, kind and intensity of chemical peel, comparator treatments, and key outcomes were all data extracted.
Results: Eleven studies met the inclusion criteria, with sample sizes ranging from 10 to 45 participants. Glycolic acid (GA), trichloroacetic acid (TCA), salicylic acid (SA), lactic acid, azelaic acid, and other peeling agents were assessed. GA and TCA were the most often investigated and demonstrated uniform effectiveness across skin types IIIVI. Although many studies showed equal results with peels, some found better clinical results with TCA or GA. Promising new substances include nanosome vitamin C and azelaic acid lotion. Used properly, most chemical peels were well tolerated and had little negative effects. Differences in side effect profiles and onset of improvement were found among treatments.
Conclusion: Chemical peels, especially those based on glycolic and trichloroacetic acid, are effective and generally safe options for melasma management, particularly in darker skin types. Although no single peel emerged as universally superior, the results highlight the importance of individualized treatment selection based on skin type, peel concentration, and patient tolerance. Incorporating chemical peels into multimodal treatment regimens may improve therapeutic outcomes in patients with recalcitrant melasma.

Key words: Melasma, Chemical Peels, Treatment Efficacy, Systematic Review