Melasma darker skin types

Retinoids 2-6 weeks before 2 days before in photoaging 1-2 weeks before in PIH, melasma and in darker skin types... 

In contrast to photodamage, when treating conditions such as melasma and PIH, retinoids should either be discontinued 1 or 2 weeks before peeling or completely eliminated from the peeling preparation to avoid postpeel complications such as excessive erythema, desquamation, and PIH. These conditions are more common in darker racial/ethnic groups, populations at greater risk for postpeel complications. Similar precautions should be taken in acne patients with darker skin types (V and VI). 

There is minimal published data on the use of combination peeling protocols in deeply pigmented skin (Fitzpatrick skin types IV-Vl). The author has reported the efficacy of combination peeling with salicylic acid 20 and 30% in combination with 10% TCA for recalcitrant melasma patients. This peeling regimen was well tolerated with minimal side effects in darker racial ethnic groups (see Salicylic acid/TCA peel section). 

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