Efficacy and Safety of 25% Trichloroacetic Acid Peel Versus 30% Salicylic Acid Peel in Mild-to-Moderate Acne Vulgaris: A Comparative Study

Abstract

Background: Both salicylic acid (SA) and trichloroacetic acid (TCA) have proven efficacy with goodsafety profiles in the treatment of acne vulgaris.
 Objectives: This study compared the clinical efficacy and safety of 25% TCA and 30% SA peels in thetreatment of mild and moderate acne vulgaris.
 Methods: Patients with mild or moderate acne vulgaris were randomized into 2 groups of 25 personseach, and treated with either the TCA peel or the SA peel at 2-week intervals for 12 weeks. Evaluationof active acne was done by individual lesion counts (comedones, papules and pustules) and calculationof the Michaelsson acne score (MAS).
 Results: Both peels led to significant decrease in individual lesion counts and MAS compared to baselinevalues, without significant differences between the treatment groups. Thus, the peels had equivalentefficacy against acne vulgaris. The TCA peel was better in treating non-inflammatory lesions,while the SA peel was better for inflammatory lesions, but the differences were not significant. Noserious adverse effects were recorded, but more patients in the TCA peel group experienced burningand stinging sensations.
 Conclusion: The efficacy of 25% TCA is comparable to that of 30% SA in mild-to-moderate acnevulgaris, but safety and tolerability were better with the SA peel than TCA peel.

Combining superpulse dynamic CO2 laser and supramolecular salicylic acid in the treatment of dense comedones with higher clearance in a shorter time: A prospective, randomized, split‐face clinical trial

“…Compared with 30% SSA, no matter other chemical exfoliators or traditional molecular formation of salicylic acid, the comedone reduction rate was still lower. The reduction rate of 40% pyruvic acid was 38.64% in 24 weeks, that of 25% trichloroacetic acid was 53.91% in 12 weeks, and two lectures reported about the traditional molecular formation of salicylic acid treating AV, whose comedone reduction rate were 56% and 53.71% 24–39 …”

Use of Patient-Reported Outcomes in Acne Vulgaris and Rosacea Clinical Trials From 2011 to 2021

“…Among 2461 potential studies, 206 satisfied the inclusion criteria (eFigure in the Supplement). Among included trials, 163 (79%) were for acne and 43 (21%) were for rosacea. Rosacea RCTs were more likely to include at least 1 PROM (67% [n = 29 of 43]) compared with acne RCTs…”

Expert recommendations on supportive skin care for non‐surgical and surgical procedures

“…58 Mandelic acid (45%) or trichloroacetic acid (25%) peels may have similar efficacy but better safety and tolerability than salicylic acid (30%) peels in mild-to-moderate acne patients. 59,60 In acne patients, isotretinoin treatment should be discontinued for 6 months before the procedure, whilst retinoic acid, adapalene and benzoyl peroxide application should be discontinued for the week beforehand. Other medications such as minocycline and oral contraceptives, frequently used in patients with acne, can cause photosensitivity and predispose to hyperpigmentation.…”