Clinical trials chemical peel

You'll likely need several follow-up visits soon after your treatment so that your doctor can monitor your healing. Once new skin completely covers the treated area in about two weeks, you can use cosmetics to conceal any redness.

Use sunscreen every day. A light chemical peel improves skin texture and tone and lessens the appearance of fine wrinkles. The results are subtle but increase with repeated treatments. If you have a medium chemical peel, treated skin will be noticeably smoother.

After a deep chemical peel, you'll see a dramatic improvement in the look and feel of treated areas. Results may not be permanent.

Over time, age and new sun damage can lead to new lines and skin color changes. With all peels, the new skin is temporarily more sensitive to the sun. Talk with your doctor about how long to protect your skin from the sun. Chemical peel care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This content does not have an English version.

This content does not have an Arabic version. Overview A chemical peel is a procedure in which a chemical solution is applied to the skin to remove the top layers. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Wound care regimen will consist of dilute acetic acid and either Aquaphor or petroleum jelly.

Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. Try the modernized ClinicalTrials. Learn more about the modernization effort.

Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information. Search for terms. Save this study. Warning You have reached the maximum number of saved studies Listing a study does not mean it has been evaluated by the U.

Federal Government. Read our disclaimer for details. Results First Posted : September 11, The methodological quality of the included RCTs was very low to moderate. Introduction Acne is one of the most common skin disorders and is prevalent in most ethnic populations. View this table: View inline View popup.

Table 1 The abbreviations of commonly used chemical peels for acne vulgaris 4—6 26— Supplemental material [bmjopenSP1. Inclusion and exclusion criteria We included all RCTs addressing any chemical peel compared with placebo or any other treatment for the treatment of acne vulgaris in any study population.

Selection of studies Two authors XC and MY independently reviewed the titles and abstracts identified from the searches and selected possible relevant studies.

Assessment of the risk of bias in included trials Two authors XC and MY independently evaluated the risk of bias in the included trials using the methods recommended by the Cochrane Handbook for Systematic Review of Interventions.

Heterogeneity and data synthesis Significant clinical heterogeneity across the included RCTs was identified. Patient and public involvement Patients and public were not involved. Results Description of studies After removing duplicates, we identified articles during the initial search.

Supplemental material [bmjopenSP2. Table 2 Summary of relevant characteristics of included studies. Risk of bias in included studies The methodological quality of included RCTs was generally low to moderate; however, in some cases, it was very low.

Figure 2 Risk of bias summary for each study. Figure 3 Risk of bias summary graph for all included studies. Effects of interventions Due to significant differences across studies with regard to interventions different chemical peels and regimens , outcomes and follow-up durations, data from the different studies could not be combined to perform a meta-analysis.

Adverse events Initial burning sensations, postpeeling erythema and mild scaling were common symptoms that were comparable for the SA and JS groups. Adverse events All patients reported erythema at least once for both peels during the follow-up period. Adverse events The authors reported that both GA and SA were safe and well tolerated, with no difference in adverse events rates between the two peels.

Adverse events Erythema was common for both peels no data available. Adverse events The authors classified adverse events as follows: none, trace, mild, moderate and severe. Discussion To the best of our knowledge, this is the first systematic review addressing chemical peels for treating acne vulgaris.

Conclusions Implication for practice Commonly used chemical peels appear to be similarly effective for mild-to-moderate acne vulgaris and well tolerated. Implications for research Well-designed and well-reported RCTs are needed to provide high-quality evidence to inform practice, particularly regarding the optimal formulation and regimen for chemical peeling agents.

References 1. Acne and its treatment options: a review. Curr Drug Deliv ; 8 : — 9. OpenUrl PubMed. Bhate K , Williams HC. Epidemiology of acne vulgaris. Br J Dermatol ; : — Kontochristopoulos G , Platsidaki E. Chemical peels in active acne and acne scars. Clin Dermatol ; 35 : — Chemical peeling in ethnic skin: an update. Br J Dermatol ; Suppl 3 : 82 — Jackson A. Chemical peels. Facial Plast Surg ; 30 : — Expert opinion: efficacy of superficial chemical peels in active acne management--what can we learn from the literature today?

Evidence-based recommendations. J Eur Acad Dermatol Venereol ; 25 : — Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol ; 74 : — Glycolic acid peels versus amino fruit acid peels for acne.

J Cosmet Laser Ther ; 12 : — 5. Randomized trial comparing a chemical peel containing a lipophilic hydroxy acid derivative of salicylic acid with a salicylic acid peel in subjects with comedonal acne.

J Cosmet Dermatol ; 10 : — 8. Trichloroacetic acid versus salicylic acid in the treatment of acne vulgaris in dark-skinned patients. Dermatol Surg ; 41 : — Clinical comparison of salicylic acid peel and LED-Laser phototherapy for the treatment of Acne vulgaris in teenagers. Studies that recruited patients with sequelae of acne such as postinflammatory dyschromia or scarring, evaluated the combined effects of chemical agents and other therapies such as laser therapy, were quasi-RCTs and were not published in English were excluded.

Two authors XC and MY independently reviewed the titles and abstracts identified from the searches and selected possible relevant studies. After reviewing the full text of these studies, the two authors independently decided on which studies to include and exclude and documented the reasons for exclusion. Any discrepancy in the selection was resolved through discussion. Two authors XC and MY independently evaluated the risk of bias in the included trials using the methods recommended by the Cochrane Handbook for Systematic Review of Interventions.

The Cochrane risk of bias for each included trial was classified as low, high or unclear. Significant clinical heterogeneity across the included RCTs was identified. Specifically, the skin type of participants, interventions eg, the type, concentration and regimen of chemical peeling agents and outcome measurements were all significantly different across the included RCTs. Therefore, it was not possible to merge data from different trials to perform a meta-analysis.

After removing duplicates, we identified articles during the initial search. Of these, were discarded after screening the titles and abstracts, leaving 19 studies for full review. Another 7 of the 19 studies were excluded after this review. The reasons for exclusion are summarised in online supplementary table 2. Our final analysis included 12 RCTs, providing data from participants.

Relevant characteristics of the included RCTs are summarised in table 2. The methodological quality of included RCTs was generally low to moderate; however, in some cases, it was very low. The risk of bias in each included study is shown in figure 2 , with the percentage of each risk of bias item across studies summarised in figure 3.

Due to significant differences across studies with regard to interventions different chemical peels and regimens , outcomes and follow-up durations, data from the different studies could not be combined to perform a meta-analysis. We identified a total of eight different chemical peels and grouped the data into 11 comparisons.

No adverse event was identified for the SA peel. Both interventions significantly improved acne lesions, with no significant difference between the two interventions in terms of the reduction in the number of comedones MD 2. No information regarding adverse effects was reported.

However, relevant data supporting this conclusion were not clearly described. Furthermore, the authors reported that both SA and JS were effective in reducing inflammatory lesions; however, they did not compare the effects of SA and JS on this outcome. Initial burning sensations, postpeeling erythema and mild scaling were common symptoms that were comparable for the SA and JS groups. All patients reported erythema at least once for both peels during the follow-up period. Of note, all patients reported discomfort that negatively affected daily life with the GA peel.

The achievement of an excellent or good improvement in all lesions was comparable for both SA and PA peels The incidences of scaling, erythema and itching were also reported to be comparable with no data presented.

Hyperpigmentation was rare and comparable for the SA and PA peels The authors reported that both GA and SA were safe and well tolerated, with no difference in adverse events rates between the two peels. The most common adverse events were scaling, peeling and erythema no data available. Self-reported improvements were equivalent for GA and JS Erythema was common for both peels no data available.

The authors classified adverse events as follows: none, trace, mild, moderate and severe. No severe adverse events were reported. Both treatments were considered to be well tolerated. To the best of our knowledge, this is the first systematic review addressing chemical peels for treating acne vulgaris.

Based on our analysis of the data presented in the 12 included RCTs, chemical peeling is an overall positive method of treating acne vulgaris. Furthermore, SA was found to be more effective than JS for the treatment of comedones but less effective than phototherapy in treating pustules. The effectiveness of TCA is comparable with that of pulsed dye laser therapy but the laser provided a longer period of remission. All chemical peels evaluated were well tolerated. The most common adverse events were as follows: transient burning or stinging sensations, postpeeling erythema or scaling, and topical oedema or dryness.

Of note, this RCT did not have sufficient power to identify all adverse events, especially rare adverse events, due to the limited sample size. The information provided in our review may assist dermatologists with selecting the most appropriate chemical peels to treat acne vulgaris.

However, our findings should be considered with caution because the included RCTs were performed in different countries and recruited individuals of different ethnicities. For example, chemical peels, especially medium or deep peels, are unsuitable for those with a Fitzpatrick skin type V or VI because these peels may cause dyspigmentation and scarring in these patients.

In addition, most included studies focused on mild-to-moderate acne. There is currently no consensus regarding the standardised regimen for chemical peeling because the optimal concentration, treatment interval and duration for different chemical peels remain unclear.

In our review, the regimen of chemical peels varied significantly across studies. Studies are warranted to compare different regimens of the same chemical peel in order to determine the optimal regimen for each peeling agent. There is an emerging trend of using a combination of peeling agents because of the belief that better clinical results can be achieved while reducing the risk of adverse events.

In the future, more attention should be focused on these premixed formulations of chemical peels. In this review, we surprisingly found that only one RCT 16 compared a chemical peeling agent GA with placebo for acne vulgaris.

However, more than 10 chemical peeling agents have actually been applied. Further well-designed RCTs are needed to compare other chemical peels with placebo.

A network meta-analysis based on these RCTs should provide more valuable and robust evidence for clinical practice. Additionally, the outcome measurements were significantly different across the included RCTs which made it difficult to compare or merge the results of different studies. Therefore, we suggest that the future version of the guideline of care for the management of acne vulgaris should make recommendations regarding the standard of outcome measurements.

Our review has some limitations. First, all included studies were of very low-to-moderate methodological quality with small sample sizes which might have introduced bias.