Comparative study of 15% trichloroacetic acid peel combined with 70% glycolic acid and 35% trichloroacetic acid peel for the treatment of photodamaged facial skin in aging women.

BACKGROUND: Photoaging (extrinsic aging) is caused by environmental exposure to ultraviolet radiation. Superficial and medium-depth chemical peels with trichloroacetic acid (TCA) are performed to reduce wrinkles, hyperpigmentation, dryness, and erythema caused by photoaging process. AIM: The aim of this study was to compare the efficacy and tolerability of 15% TCA peel against the combined 70% glycolic acid and 35% TCA for the treatment of photodamaged facial skin. PATIENTS/METHODS: Forty female patients with types II and III of Glogau photoaging scale were divided into two groups of twenty subjects (GA/TCA and 35% TCA). The GA/TCA group was treated with combination peeling of 70% GA and 15% TCA, whereas the 35% TCA group was treated with monopeeling of 35% trichloroacetic acid. Each patient was submitted to five sessions of these peels, with an interval of 14 days between each session. The following skin aging parameters were examined before treatments, before each session, and 3 months after the last application: hydration, elasticity, melanin index, and erythema index (MPA-5; Courage-Khazaka, Germany); and depth and volume of wrinkles (PRIMOS; GFMesstechnik GmbH, Germany). RESULTS: Both peel methods achieved significant improvement in all skin parameters: elasticity, hydration, melanin index, and erythema index. Significant differences between the GA/TCA and 35% TCA groups were found only for hydration and melanin index. GA/TCA was characterized by significantly higher values of the hydration parameter and lower values of melanin index compared with 35% TCA. Combination peel GA/TCA did not cause dryness, edema, or intensive lysis of the epidermis, and the frequency of peel-induced erythema did not increase with the addition of glycolic acid, but with higher concentration of the TCA solution. However, subject-perceived improvements of the 35% TCA peel did not differ significantly from subject-perceived improvements of combination peel treatment. Adverse events requiring intervention or discontinuing treatment were not observed in either group. CONCLUSION: The addition of glycolic acid before 15% TCA chemical peel application significantly enhanced TCA-induced improvement in photoaging parameters (increase in skin elasticity and hydration; reduction in melanin index and erythema index), and subject-perceived improvements. However, 35% TCA peel is more effective in reducing wrinkles, despite a lower tolerability. Both medium-depth chemical peels including 15% TCA in combination with 70% GA and 35% TCA alone proved to be useful for the removal of epidermal or superficial lesions and to improve the texture of photodamaged facial skin (grade II-III Glogau photoaged skin).

Evaluation of 70% glycolic peels versus 15% trichloroacetic peels for the treatment of photodamaged facial skin in aging women.

BACKGROUND: Chronic solar irradiation results in both morphological and functional changes in affected skin. Superficial peels have been shown to improve all symptoms of photodamaged skin. OBJECTIVE: This study was designed to compare the efficacy and tolerability of glycolic acid (GA, 70%) with trichloroacetic acid (TCA, 15%) for the treatment of photoaging. MATERIALS AND METHODS: Twenty female patients affected by photodamage were treated with graded concentrations of 70% GA and 15% TCA peel. Each patient was submitted to 5 sessions of these peels, with an interval of 14 days between each session. Four clinical parameters of surface evaluation of the living skin (hydration, elasticity, melanin, and erythema) were measured. The records were made before each treatment and 3 months after the last application. RESULTS: The statistical significance in each group of patients was observed with elasticity and hydration. Decrease in melanin content in the skin occurred significantly after the application of a series of treatments with GA. Increase in severity of erythema showed statistical significance after the treatment with TCA. CONCLUSION: Superficial peels, such as 70% GA and 15% TCA, proved to be an effective treatment modality for photodamaged facial skin. Both acids contribute to improvement of the photodamaged skin's parameters. Glycolic acid increases skin's hydration faster.

Influence of azelaic and mandelic acid peels on sebum secretion in ageing women.

INTRODUCTION: Azelaic acid and mandelic acid are superficial peels commonly applied in people of various age groups. As they are mild and do not cause any side effects, they are also often used in elderly people. AIM: To compare the influence of azelaic and mandelic acid peels on facial sebum secretion in mature women aged 49-71 years. MATERIAL AND METHODS: The level of secreted sebum was measured in 28 women. Eleven women were treated with azelaic acid peel and 17 with mandelic acid peel. Each of the peels was applied five times with 2-week intervals. The measurements were made on the cheeks and chin with the use of Sebumeter SM 15 (Courage & Khazaka, Germany). The last measurement, i.e. the sixth one, was made 2 weeks after the treatment. RESULTS: We observed a significant increase in sebum secretion in the U-zone after the application of 20% azelaic peel and 40% mandelic peel. Neither peel significantly affected sebum secretion in the T-zone. CONCLUSIONS: Peels with 20% azelaic acid and 40% mandelic acid might be considered treatments which contribute to an increase in sebum secretion in ageing women.