1Department of Dermatology, Saveetha Medical College and Hospital (SMCH), Saveetha Institute of Medical and Technical Sciences (SIMATS), Thandalam, Chennai-602105, Tamil Nadu, India; medasaishivaram@gmail.com (S.S.R.M) and nehajoe93@gmail.com (N.M.J).
2Department of Research, Saveetha College of Nursing (SCON), Saveetha Institute of Medical and Technical Sciences (SIMATS), Thandalam, Chennai-602105, Tamil Nadu, India; mythileeswari@gmail.com (M.L) and anbubot373@gmail.com (T.A).
3*Natural Biomedicine Laboratory, Department of Dermatology, Saveetha Medical College and Hospital (SMCH), Saveetha Institute of Medical and Technical Sciences (SIMATS), Thandalam, Chennai-602105, Tamil Nadu, India; saktthivel@gmail.com (S.M).
Background: Periorbital melanosis (dark circles under the eyes) is a common cosmetic concern that can negatively affect appearance and psychological well-being. Various therapeutic approaches have been explored in cosmetic dermatology for its management. Mandelic acid, an alpha-hydroxy acid derived from bitter almonds, promotes gentle exfoliation and inhibits melanin synthesis, while kojic acid primarily acts as a tyrosinase inhibitor that reduces melanogenesis. Although both agents are widely used in treating hyperpigmentation disorders, comparative clinical evidence regarding their effectiveness in periorbital melanosis remains limited.
Objectives: This study aimed to compare the clinical efficacy, safety, and patient satisfaction of a 40% mandelic acid chemical peel with 2% topical kojic acid cream in patients with periorbital melanosis. The study also evaluated changes in pigmentation severity, lesion color characteristics, and overall improvement using standardized clinical grading and a visual analogue scale (VAS) over a 12-week treatment period.
Methods: This single-center randomized parallel clinical trial included 20 adult patients with periorbital melanosis recruited from the outpatient dermatology department of Saveetha University Medical College and Hospital. Participants were randomly assigned to two groups. The intervention group received 40% mandelic acid peel applied to the periorbital area every two weeks for six sessions, while the comparator group applied 2% kojic acid cream twice daily for 12 weeks. Pigmentation was evaluated at baseline and week 12 using a 10-point VAS, standardized pigmentation grading (Grades I–IV), and color classification. Safety and tolerability were also monitored.
Results: Both groups showed significant improvement in pigmentation after treatment. However, the mandelic acid peel group demonstrated greater clinical improvement, with 40% of patients achieving Grade I reduction and a greater shift toward lighter pigmentation compared with the kojic acid group. VAS scores were significantly higher in the mandelic acid group (p < 0.05). Both treatments were well tolerated, with only mild transient erythema reported and no serious adverse events.
Conclusion: Both 40% mandelic acid peel and 2% topical kojic acid are safe and effective for treating periorbital melanosis; however, the mandelic acid peel demonstrated superior efficacy. Its combined exfoliative and anti-melanogenic effects may contribute to faster and more noticeable improvement.
Keywords: Periorbital Melanosis, Mandelic Acid Peel, Kojic Acid, Hyperpigmentation Treatment, Chemical Peeling.
How to cite this article: Meda SSR, Joseph NM, Lakshmikanthan M, Ayyadurai T, Muthu S. Comparative Efficacy of Mandelic Acid Peel versus Topical Kojic Acid 2% in the Treatment of Periorbital Melanosis. Int J Drug Deliv Technol. 2026;16(15s): 118-123. DOI: 10.25258/ijddt.16.15s.14
Source of support: Nil.
Conflict of interest: None