Introduction: Pyruvic acid in concentration between 40% and 70% is currently been used as a superficial to medium peeling agent for various dermatological indications including acne. However, there is a paucity of its efficacy studies on acne in Asians, particularly in Indian skin.Aim: Our study was aimed at determining the efficacy and tolerability of 40% pyruvic acid on acne, post-acne hyperpigmentation, and scarring. Materials and Methods:A total of 30 patients with active acne, post-acne scarring, and hyperpigmentation were included. Patients already on oral antibiotic or topical antiacne medication for the last 4 weeks, a history of hypertrophic scarring, keloids, active or recurrent herpes were excluded. Chemical peeling was done at 2 weekly interval from 0 to 12 weeks. An objective assessment of active acne lesions, postacne scarring, and hyperpigmentation was made at each visit that is at 0, 4,8,12, and 24 weeks. Patients were followed up 2 weeks after the last peel and again at 24 weeks. Permission from the ethical committee was also obtained. Results:There was significant decrease in the number of comedones at 12 weeks compared with 0 week (p = 0.001). Similarly, the number of papules decreased from o weeks to 12 weeks (p value 0.004). Acne score improved from 0 weeks to 12 weeks (p < 0.0001); from 0 weeks to 24 weeks (p = 0.011). and hyperpigmentation improved from 0 weeks to 12 weeks (p = 0.008); from 0 weeks to 24 weeks (p = 0.021). Conclusion:Our study showed a significant decrease in comedones, papules, acne score, and hyperpigmentation, though acne scar did not improve significantly.However, a study with larger sample is needed due to the limited number of patient population in our study.

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