When 20% trichloroacetic acid peels were paired with 5% ascorbic acid cream, melasma improved significantly more than peels alone over 12 weeks. The combination group saw their melasma severity drop from 23.55 to 9.50 (about 60% improvement), compared to the peel-only group which dropped from 23.61 to 15.10 (about 36% improvement). The ascorbic acid also helped prevent post-inflammatory hyperpigmentation, a common side effect of TCA peels.

Researchers split 60 melasma patients into two groups for 12 weeks: one received TCA peels every two weeks plus daily ascorbic acid cream, the other received peels only. They measured improvement using a standardized melasma severity scale and tracked quality-of-life improvements and side effects.

Funding not disclosed in abstract