Medium-Depth Chemical Peels in the Treatment of Acne Scars in Dark-Skinned Individuals

Al-Waiz, Makram M.; Alsharqi, Ali

doi:10.1046/j.1524-4725.2002.01081.x

Cited by 63 publications

(38 citation statements)

References 14 publications

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“…But we have noticed that from daily clinically practice that postinflammatory hy-perpigmentation is not a complication of dermabrasion or peeling although all our patients have Fitzpatrick's skin types III and IV. In contrary, these patients will have whitening and tightening of their skin [18,19]. This is an agreement with present work as only two patients had postinflammatory hyperpigmentation that resolved over time.…”

Section: Discussionsupporting

confidence: 90%

Treatment of Active Acne Vulgaris by Chemical Peeling Using TCA 35%

Sharquie¹,

Noaimi²,

Al-Janabi³

2013

JCDSA

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Background: The pathogenesis of acne vulgaris is multifactorial, and therapy can be directed at many of these factors, singly or in combination. There are different modalities of treatment of active acne vulgaris but they are often long lasting which could not be accepted by many patients. Objective: To evaluate the effectiveness, long term efficacy and safety of chemical peeling using 35% TCA solution in the treatment of active acne vulgaris. Patients and Methods: This clinical, interventional, therapeutic study was done at the Department of Dermatology-Baghdad Teaching Hospital during the period from January 2012 to March 2013. Eighteen patients with active acne vulgaris were included in this study, 10 (55.6%) females and 8 (44.4%) males. Their ages ranged from 15 to 35 (21.56 ± 5.501) years. Twelve patients were associated with acne scars. History and dermatological examination were performed for all patients regarding all demographic points related to the disease. Chemical peeling with 35% TCA used one session regarding active acne vulgaris and three sessions in patients with associated scarring. Scoring for active acne vulgaris and acne scar was done for each case before and after peeling to evaluate the severity of acne lesions and scarring. All patients were with Fitzpatrick's skin types III and IV. Patients were followed up every two weeks for 12 weeks after starting therapy and every 4 weeks for 12 weeks after stopping the treatment to watch improvement, side effects and relapse. Results: Scoring for active acne vulgaris including papules and pustules showed highly statistically significant reduction after 2 weeks of therapy (p < 0.0001), while in the acne scar scoring reduction ranged from 26% to 50% in 2 patients and 50% to 75% in 2 patients while more than 75% in 8 patients were with statistically significant reduction (p = 0.000002). All patients had full satisfaction with the results of operation. Post inflammatory hyperpigmentation was observed in two patients few weeks after peeling but follow-up showed complete clearance of pigmentation with lightening and tightening of skin. No relapse of active lesion was recorded after twelve weeks follow-up. Conclusions: Chemical peeling by TCA 35% is a cost-effective mode of therapy for active acne vulgaris and acne scar with low down time in patients with dark complexion.

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Section: Discussionsupporting

confidence: 90%

Treatment of Active Acne Vulgaris by Chemical Peeling Using TCA 35%

Sharquie¹,

Noaimi²,

Al-Janabi³

2013

JCDSA

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“…The most commonly studied combination peel is Jessner's solution plus TCA. Work by Al-Waiz and Al-Sharqi 43 has shown a decrease in acne scarring when Jessner's was combined with 35% TCA. Safoury et al 33 reported significantly greater improvement in MASI score with Jessner's plus 15% TCA in comparison with 15% TCA alone.…”

Section: Combination Peelsmentioning

confidence: 99%

Chemical peeling in ethnic skin: an update

2013

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SummaryWith the growth of cosmetic dermatology worldwide, treatments that are effective against skin diseases and augment beauty without prolonged recovery periods, or exposing patients to the risks of surgery, are increasing in popularity. Chemical peels are a commonly used, fast, safe and effective clinic room treatment that may be used for cosmetic purposes, such as for fine lines and photoageing, but also as primary or adjunct therapies for acne, pigmentary disorders and scarring. Clinicians are faced with specific challenges when using peels on ethnic skin (skin of colour). The higher risk of postinflammatory dyschromias and abnormal scarring makes peels potentially disfiguring. Clinicians should therefore have a sound knowledge of the various peels available and their safety in ethnic skin. This article aims to review the background, classification, various preparations, indications, patient assessment and complications of using chemical peels in ethnic skin.What's already known about this topic?• Chemical peels are efficacious therapeutic interventions for many skin disorders.• Many peels exist; however, not all are safe for use in ethnic skin.• Darker skin types have an increased risk of adverse events from chemical peeling such as pigmentary disorders. What does this study add?• This is an up-to-date review of the various peeling agents and their indications for use in ethnic skin.• It provides a summary of newer peeling agents.• It gives practical tips on performing chemical peeling safely and effectively in ethnic skin.

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“…Dermabrasion and peeling by lasers or acids are not well advised in patients with dark complexion as post inflammatory hyperpigmentation might be complication of these therapy but we have noticed from daily clinical practice that postinflammatory hyperpigmentation is not a complications of dermabrasion or peeling although all our patients have Fitzpatrick's skin types III and IV. In contrary these patients have whitening of their skin [18][19][20]. It is difficult to explain the mechanism of action of lactic acid peeling but we can suggest through the following actions: through reduction of microflora of acne lesions mainly Propioni bacterium acnes and other bacteria that causing acne, also might reduce the size of sebaceous glands that is involved in pathogenesis of the acne and thirdly LA might change the immunological reaction present in the acne lesions hence inducing clearance of lesions and reducing the scars.…”

Section: Discussionmentioning

confidence: 93%

“…Most recently one session trichloracetic acid (TCA) peel 35% had been used effectively in treatment of active acne vulgaris with or without scarring and the result were very encouraging as induced both clearance of the lesions and remission of disease, In addition, scarring was reduced tremendously. This stimulated us to conduct the present work using lactic acid 88%in treatment of active acne vulgaris [16][17][18][19][20]. Lactic acid is a member of alpha hydroxy acids (AHA) which has been used in treatment of many skin diseases [21] including: Lactic acid used in treatment of recurrent aphthous ulcer as oral gurgle by increasing spontaneous secretion of endothelial growth factor from keratinocytes and by its antibacterial action [22].…”

Section: Introductionmentioning

confidence: 99%

Treatment of Active Acne Vulgaris by Chemical Peeling Using 88% Lactic Acid

Sharquie¹,

Noaimi²,

Al-Janabi³

2014

Our Dermatol Online

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Introduction: The etiopathogenesis of acne vulgaris is multifactorial, and its therapy is prolonged course that might be not accepted by many patients. Most recently TCA 35% one session peeling gave complete clearance and full remission for active acne vulgaris. Lactic acid has been used effectively as therapeutic topical agents for many skin diseases. Aim: To evaluate the efficacy and safety of chemical peeling using 88% lactic acid solution in the treatment of active acne vulgaris. Material and Methods: This clinical, interventional, therapeutic study was done at the Department of Dermatology, Baghdad Teaching Hospital, during the period from October 2012 to October 2013. Twenty five patients with active acne vulgaris were included, 15 (60%) females and 10 (40%) males and their ages ranged from 16-36 (21.5000± 5.46279) years. Fifteen patients were associated with acne scars. Three chemical peels using 88% lactic acid solution was carried out two weeks apart for patients with active acne vulgaris with or without scarring. Scoring for active acne vulgaris and acne scar was done for each case before and after operation to evaluate the severity of acne and the degree of scar before and after treatment. All patients were with Fitzpatrick's skin types III and IV. Patients were followed up every two weeks during period of therapy and monthly for 3 months after stopping the treatment. Results: Twenty five patients with active acne vulgaris were treated with 3 sessions of lactic acid, fifteen patients had associated acne scar. Scoring for active acne vulgaris including papules and pustules showed highly statistically significant reduction after 2 weeks of therapy (p=0.0001), after 4 weeks (p=0.0001)and after 6 weeks (p=0.0001), with percent reduction 87.2% for papules and 94% for pustules after end of sessions while after 3 months follow up the reduction rate for papules 93.8% and p-value (p=0.001) and for pustules 97.6% and (p=0.0001). While the scarring reduction was moderate in 3 (20%) patients, marked in 3 (20%) patients and excellent in 9 (60%) patients with statistically significant reduction (p=0.002). All patients had full satisfaction about the results of peeling. Post inflammatory hyperpigmentation was observed few weeks after peeling but follow up for 3 months showed complete clearance of pigmentation with lightening and tightening of skin. Conclusions: Chemical peeling using 88% lactic acid is an effective mode of therapy for active acne vulgaris and acne scar in patient with dark complexion.

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Medium-Depth Chemical Peels in the Treatment of Acne Scars in Dark-Skinned Individuals

Abstract: We conclude that medium-depth chemical peel is a safe and effective method of treating acne scars even in patients with dark complexion.

Cited by 63 publications

References 14 publications

Treatment of Active Acne Vulgaris by Chemical Peeling Using TCA 35%

Treatment of Active Acne Vulgaris by Chemical Peeling Using TCA 35%

Chemical peeling in ethnic skin: an update

Treatment of Active Acne Vulgaris by Chemical Peeling Using 88% Lactic Acid

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