Jessner Peel or TCA Peel for Melasma?

I am an Asian from India. I have light melasma on both of my cheeks, little bit on forehead and upper lip. I have used 14% jessener peel three times. first time up to 3-4 layers 2nd and third time 5-6 layers I have seen little bit improvement in my skin. My skin looks more even but not fully even or cleared tone. How many treatments usually one needs to treat if it is epidermal melasma. Can I use TCA peel? if yes, then what percentage or should I stick to jessener peel. thank you

Doctor Answers 1

Jessner's or TCA can help melasma

Both Jessner's and TCA peels can be used to treat epidermal melasma.  With darker skin, it is always wise to start conservatively by using the Jessner's.  The depth and effect of the peel depends on many factors including how the skin was prepared in the weeks prior to peeling, how the skin was prepared before peeling, and how the peel was applied.  I prepare skin in the weeks before peeling by using a retinoid, like tretinoin, and hydroquinone.  In general, I have found that 5 - 6 Jessner's peels are often needed.  TCA can be used in darker skin types, and if Jessner's fails, one can consider peeling with TCA 15 - 20%.  Lastly, it is ESSENTIAL to strictly protect the skin affected by melasma from the sun by avoiding direct exposure and wearing a broad spectrum sunscreen of SPF 30 or higher daily.

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