A Comparative Study of Glycolic Acid Versus Mixture of Trichloroacetic Acid and Glycolic Acid Peeling for Treatment of Three Benign Epidermal Lesions

Demystifying the mechanism of action of professional facial peeling: In‐vivo visualization and quantification of changes in inflammation, melanin and collagen using Vivascope® and ConfoScan ®

“…Collagen remodeling was noticed in two subjects with lighter skin tone, showing a more fibrous network of long collagen fibers on day 9 post‐peel versus pre‐peel. The increase in fibrous network of collagen after chemical peeling corroborates with previous studies that analyzed punch biopsies after chemical peeling 7,9 . On the basis of depth of injury by the chemical peel, melanin redistribution in DEJ and collagen remodeling in papillary dermis, 1 and our previous findings on synergistic action of two exfoliating agents in the peel (TCA and lactic acid), 4 we can infer that the professional peel used in this study performed like a medium depth peel but at lower concentration of acids (10% TCA and 20% lactic acid).…”

“…Similar collagen remodeling profile was observed in subject 4 (data not shown). Increase in collagen and other components of dermal extracellular matrix like elastin and glycosaminoglycans have been reported 7,9 …”

“…Subjects were provided with post‐procedure care kits (sunscreen, cleanser, moisturizer, and skin procedure ointment). Unlike other peel clinical studies 7 , 8 , 10 there was a 14 days washout period before peeling, and subjects were restricted to use only the supplied post‐peel care products to make sure the changes are due to peeling and not pre‐ or post‐peel care products that can increase peeling efficacy against pigmentation and collagen. Facial peeling was done on four subjects ( Chart 1 ) and confocal microscopy images were obtained post‐peel after 5 min, 48 h, and day 9 using FDA‐approved skin imaging instrument, Vivascope 1500.…”

“…There are some studies showing the effect of chemical peeling on melanin, collagen, elastin, epidermal and dermis thickness 4 . However, these studies either used human skin explants for the chemical peel treatment 4 or used the classical invasive punch biopsy and histological staining approach to observe changes 6,7 . One study has demonstrated use of Vivascope to clinically capture the reduction in melanin after peeling 8 .…”

“… 4 However, these studies either used human skin explants for the chemical peel treatment 4 or used the classical invasive punch biopsy and histological staining approach to observe changes. 6 , 7 One study has demonstrated use of Vivascope to clinically capture the reduction in melanin after peeling. 8 However, it was not certain that reduction in melanin was due to chemical peel or the daily use of skin brightener after 1 week of peeling.…”