Expert Opinion: Efficacy of Superficial Chemical Peels in Active Acne Management--what Can We Learn from the Literature Today? Evidence-based Recommendations

Background: Superficial chemical peels offer therapeutic results in a convenient, affordable treatment. Many clinicians use these peels in the treatment of acne and acne-prone oily skin.

Objectives: This article examines the evidence base that supports the widespread use of superficial peels in this setting.

Methods: A search of the English language medical literature was performed to identify clinical trials that formally evaluated the use of chemical peeling in active acne.

Results: Search of the literature revealed very few clinical trials of peels in acne (N=13); a majority of these trials included small numbers of patients, were not controlled and were open label. The evidence that is available does support the use of chemical peels in acne as all trials had generally favourable results despite differences in assessments, treatment regimens and patient populations. Notably, no studies of chemical peels have used an acne medication as a comparator. As not every publication specified whether or not concomitant acne medications were allowed, it is hard to evaluate clearly how many of the studies evaluated the effect of peeling alone. This may be appropriate, however, given that few clinicians would use superficial chemical peels as the sole treatment for acne except in rare instances where a patient could not tolerate other treatment modalities.

Conclusions: In the future, further study is needed to determine the best use of chemical peels in this indication.