The combination of glycolic acid and hydroquinone or kojic acid for the treatment of melasma and related conditions

Dermatol Surg. 1996 May;22(5):443-7. doi: 10.1111/j.1524-4725.1996.tb00345.x.


Background: Melasma continues to be a difficult problem. Although the cause is genetic, the condition is aggravated with sunlight, birth control pills, and pregnancy. Although hydroquinone is effective and has been available for years, a new product, kojic acid, has the advantage of being pharmaceutically more stable and, also, a tyrosinase inhibitor.

Objective: To evaluate on melasma and related conditions two similar formulations of glycolic acid/hydroquinone and glycolic acid/kojic acid. The therapeutic index of the two formulations is examined.

Methods: Thirty-nine patients were treated with kojic acid on one side of the face and hydroquinone in a similar vehicle on the other side of the face. The results were documented by a clinical investigator and with Wood's light examination combined with ultraviolet light photography.

Results: Fifty-one percent of the patients responded equally to hydroquinone and kojic acid. Twenty-eight percent had a more dramatic reduction in pigment on the kojic acid side; whereas 21% had a more dramatic improvement with the hydroquinone formulation. These results were not statistically different. The kojic acid preparation was more irritating.

Conclusion: Both glycolic acid/kojic acid and glycolic acid/hydroquinone topical skin care products are highly effective in reducing the pigment in melasma patients. Both formulations should be available to the dermatologist to satisfy the patient's preferences.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Drug Evaluation
  • Drug Therapy, Combination
  • Female
  • Glycolates / administration & dosage*
  • Humans
  • Hydroquinones / administration & dosage*
  • Male
  • Melanosis / diagnosis
  • Melanosis / drug therapy*
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications / drug therapy
  • Pyrones / administration & dosage*
  • Radiation-Protective Agents / administration & dosage*
  • Time Factors


  • Glycolates
  • Hydroquinones
  • Pyrones
  • Radiation-Protective Agents
  • glycolic acid
  • kojic acid
  • hydroquinone