Chemical peels for melasma

Peeling agent	Mechanism of action
Glycolic acid	Increased epidermal turnover, anti-inflammatory, epidermolysis, decreased corneocyte adhesion
Jessner's solution*	Tyrosinase inhibition/increased epidermal turnover, decreased intercellular lipids, disrupts hydrogen bonds, decreased corneocyte detachment
Lactic acid	Increased epidermal turnover
Lipohydroxy acid	Similar mechanism to salicylic acid but more lipophilic, exfoliates individual corneosomes (desquamation), increased cell renewal
Mandelic acid	Increased cell turnover
Phytic acid	Inhibits cell growth and generation of reactive oxygen species
Pyruvic acid	Less lipophilic than salicylic acid, partially hydrophilic but same mechanism of action as salicylic acid
Salicylic acid	Increased epidermal turnover, lipophilic beta-hydroxy acid, anti-inflammation, decreased corneocyte adhesion
Tretinoin acid	Downregulation of tyrosinase, increased epidermal turnover
Trichloroacetic acid	Precipitation of epidermal proteins

* Resorcinol, salicylic acid, and lactic acid in 95% ethanol.

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