Background: Chemical facial peels are common cosmetic procedures that have gained in popularity over the last decade.
Objective: The aim of this study was to compare the efficacy and morbidity of a series of superficial glycolic acid (GA) peels with those of a midlevel trichloroacetic acid (TCA) peel.
Methods: We conducted a split-face study of 7 female patients, comparing the benefits of a single 35% TCA peel with those of a series of 5 30% GA peels performed at monthly intervals. Throughout the study, we performed noninvasive biophysical measurements, optical imaging, and expert and naïve image evaluations and conducted subject-group discussions so that we might objectively quantify and compare the treatments over time. An additional objective of the research was to use quantitative objective measurements of skin condition and actinic damage to establish these techniques as biologically based standards for treatment evaluation.
Results: Skin elasticity and hydration increased during the course of the study but were not significantly different between the 2 treatment modes. Overall improvement with both treatments was relatively small as judged by expert evaluations of digital images taken at baseline and 3 months after treatment. No important differences were perceived when naïve judges were asked to evaluate the images. Digital-image analysis of wrinkles in the cheek region revealed significantly greater improvement in wrinkles with the TCA peel. In patient-group discussions, TCA peels were associated with greater improvement but also with more discomfort; GA peels were associated with a high degree of satisfaction, although their effect on quantitative technical measures of actinic damage was not dramatic.
Conclusions: Although a single TCA peel produced more improvement than a series of superficial peels, the differences were small, and the TCA peel was associated with significantly greater discomfort.