Comparison of efficacy of commercially available vs. freshly prepared salicylic acid peel in treatment of acne: a randomized open-label study

Abstract

Background: Chemical peeling is increasingly used in dermatology nowadays. Salicylic acid peels have been widely used in Asian patients since long ago, but very few published literature is there focusing on the efficacy and safety of it in Asian population. This study was planned to compare the efficacy of salicylic acid (SA) peel either commercially available or freshly prepared in treatment of acne. Methods: A prospective, randomized, open-label, parallel-group study was carried out in patients with acne. A total of 126 patients were randomized to receive 30% salicylic acid peel either commercially available (group A, n = 60) or freshly prepared (group B, n = 63). Assessment of acne lesions was done at baseline and at 2, 4, 6, 8, 10, and 12 weeks. Objective assessment was carried out using total acne score and subjective assessment using visual analog scale and were compared. Results: Mean age of patients was 22.4 ± 3.1 years with female predominance. After six sessions with commercially available SA peel, reduction in average number of comedones was 88.45% (P = 0.002), in inflammatory papules 89.16% (P = 0.01), in pustules 31.47% (P = 0.06), and in nodules/cyst 50% (P = 0.5). After six sessions with freshly prepared SA peel, reduction in average number of comedones was 89% (P = 0.0001), in inflammatory papules 90.36% (P = 0.0001), in pustules 28.3% % (P = 0.05), and in nodules 96% (P = 0.05). Significant reduction of both non-inflammatory and inflammatory acne was seen in both groups (P < 0.05). Both of the agents led to a highly significant (P < 0.001) improvement in the total acne score; freshly prepared SA peel showed improvement significantly earlier at 6 weeks onwards. VAS score was significantly high for the freshly prepared SA group (P = 0.05). Conclusion: This study has shown equivalence in therapeutic efficacy of both commercially available and freshly prepared SA peels both in terms of objective and subjective assessments in acne treatment with more patient satisfaction with freshly prepared peel.