Adjuvant alternative treatment with chemical peeling and subsequent iontophoresis for postinflammatory hyperpigmentation, erosion with inflamed red papules and non-inflamed atrophic scars in acne vulgaris

J Dermatol. 2017 Apr;44(4):401-405. doi: 10.1111/1346-8138.13634. Epub 2016 Oct 15.


The standard management of acne vulgaris in Japan includes a combination of topical treatment with benzoyl peroxide (BPO) and BPO/clindamycin (CLDM), topical adapalene and systemic antimicrobials. However, the treatment of therapy-resistant complications such as postinflammatory hyperpigmentation (PIH), erosions with inflamed red papules and atrophic scars has not been established. We performed chemical peeling with glycolic acid and iontophoresis with ascorbyl 2-phosphate 6-palmitate and DL-α-tocopherol phosphate for the treatment of PIH, erosions with inflamed red papules and non-inflamed atrophic scars in 31 patients with acne vulgaris (mild to severe severity), and evaluated the efficacy and safety of these interventions. In most of cases, there was remarkable improvement in PIH and erosions with inflamed red papules after treatment. There was also some improvement in non-inflamed atrophic scars without erythema. Mild redness and irritation was observed in four cases as adverse reactions. Early initial treatment of PIH and erosions with red papules by chemical peeling and iontophoresis is an effective and safe method to prevent the formation of atrophic scars in patients with acne vulgaris.

Keywords: acne; atrophic scar; chemical peeling; iontophoresis; postinflammatory hyperpigmentation.

MeSH terms

  • Acne Vulgaris / complications*
  • Acne Vulgaris / therapy*
  • Adapalene / therapeutic use
  • Adolescent
  • Adult
  • Anti-Infective Agents / therapeutic use
  • Ascorbic Acid / administration & dosage
  • Ascorbic Acid / adverse effects
  • Ascorbic Acid / analogs & derivatives
  • Ascorbic Acid / therapeutic use
  • Atrophy
  • Benzoyl Peroxide / therapeutic use
  • Chemexfoliation / adverse effects*
  • Cicatrix / pathology
  • Cicatrix / therapy*
  • Clindamycin / therapeutic use
  • Combined Modality Therapy
  • Erythema / therapy*
  • Female
  • Glycolates / administration & dosage
  • Glycolates / adverse effects
  • Glycolates / therapeutic use
  • Humans
  • Hyperpigmentation / therapy*
  • Iontophoresis / adverse effects*
  • Japan
  • Male
  • Severity of Illness Index
  • Treatment Outcome
  • Young Adult
  • alpha-Tocopherol / administration & dosage
  • alpha-Tocopherol / adverse effects
  • alpha-Tocopherol / analogs & derivatives
  • alpha-Tocopherol / therapeutic use


  • 6-O-palmitol-ascorbate-2-O-phosphate
  • Anti-Infective Agents
  • Glycolates
  • glycolic acid
  • Adapalene
  • alpha-tocopherol phosphate
  • Clindamycin
  • alpha-Tocopherol
  • Ascorbic Acid
  • Benzoyl Peroxide