Trichloroacetic Acid Versus Salicylic Acid in the Treatment of Acne Vulgaris in Dark-Skinned Patients

Dermatol Surg. 2015 Dec;41(12):1398-404. doi: 10.1097/DSS.0000000000000522.


Background: Treatment options for acne include chemical peeling. Trichloroacetic acid (TCA) has been used for treating acne. The ability of TCA to diminish corneocyte cohesion and keratinocyte plugging addresses this mode of treatment. Salicylic acid is an excellent keratolytic agent. It is believed to function through solubilization of intercellular cement, thereby reducing corneocyte adhesion.

Objective: Comparing the therapeutic efficacy of TCA 25% peels with those of salicylic acid 30% in patients with acne vulgaris.

Materials and methods: Twenty patients, Fitzpatrick skin Types III to V with facial acne, were enrolled. Twenty-five percent of TCA was applied to the right half of the face and 30% salicylic acid to the left half at 2-week interval for 2 months.

Results: Total improvement was more frequent with salicylic acid peeling (95%) versus (85%) with TCA. Total comedones improvement was more frequent with TCA peeling (80%) versus (70%) with salicylic acid. Improvement of inflammatory lesions was more frequent among the side treated with salicylic acid (85%) versus (80%) with TCA peeling. However, the results did not reach the statistical significance level.

Conclusions: Trichloroacetic acid is more superior in treating comedonal lesions, whereas salicylic is more superior in treating inflammatory lesions, without significant different between their results.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acne Vulgaris / therapy*
  • Chemexfoliation / methods*
  • Dermatitis, Exfoliative / chemically induced
  • Double-Blind Method
  • Erythema / chemically induced
  • Female
  • Humans
  • Hyperpigmentation / chemically induced
  • Keratolytic Agents / therapeutic use*
  • Male
  • Prospective Studies
  • Salicylic Acid / therapeutic use*
  • Skin Pigmentation*
  • Treatment Outcome
  • Trichloroacetic Acid / adverse effects
  • Trichloroacetic Acid / therapeutic use*


  • Keratolytic Agents
  • Trichloroacetic Acid
  • Salicylic Acid