A 15% Trichloroacetic Acid + 3% Glycolic Acid Chemical Peel Series Improves Appearance of Hand Lentigines: An Evaluator-Blinded, Split-Hand Prospective Trial

Overview

Journal Dermatol Surg

Date 2024 Mar 9

PMID 38460193

Authors

Ali Alajmi

Ghassan Niaz

Christine Chen

Kachiu Lee

Affiliations

Soon will be listed here.

Abstract

Background: Improving the appearance of lentigines on the hands is a key component to hand rejuvenation. Soft tissue fillers revolumize hands, but do not address pigmentary changes. OBJECTIVE: This study investigated the effiacy of a 15% trichloroacetic acid (TCA) + 3% glycolic acid (GA) combination peel in improvement of appearance of hand lentigines.

Methods: A prospective evaluator-blinded, split-hand study was performed using a 15% TCA + 3% GA peel to treat patients with hand lentigines. Subjects received a total of 3 treatments at 4-week intervals on 1 hand, with the other hand serving as an untreated control. Final photographs were taken 12 weeks after the last treatment. Two blinded board-certified dermatologists graded improvement in hand lentigines using a 5-point scale.

Results: Eighteen of 20 patients completed the study (90%). The mean age was 64.4 years (SE 1.6, range 51-71). The mean pain scores were 3.8 (SE 0.4) on a 10-point scale (1 = no pain, 10 = extremely painful). Blinded evaluators correctly identified the after-treatment photographs in 16 patients (88%). Physician and patient-graded mean improvement of lentigines was significant for treated versus control hands ( p < .01). No adverse events were noted.

Conclusion: A series of three 15% TCA + 3% GA peels are effective and safe in the treatment of hand lentigines.

References

Goldie K, Peeters W, Alghoul M, Butterwick K, Casabona G, Yu Chao Y . Global Consensus Guidelines for the Injection of Diluted and Hyperdiluted Calcium Hydroxylapatite for Skin Tightening. Dermatol Surg. 2018; 44 Suppl 1:S32-S41. DOI: 10.1097/DSS.0000000000001685. View

Chandan N, Puyana C, Haber R . Combination Approaches to Hand Rejuvenation: A Review of the Literature and Discussion. Dermatol Surg. 2023; 49(2):164-170. DOI: 10.1097/DSS.0000000000003673. View

Seirafi H, Fateh S, Farnaghi F, Ehsani A, Noormohammadpour P . Efficacy and safety of long-pulse pulsed dye laser delivered with compression versus cryotherapy for treatment of solar lentigines. Indian J Dermatol. 2011; 56(1):48-51. PMC: 3088935. DOI: 10.4103/0019-5154.77552. View

Brodland D, Cullimore K, Roenigk R, Gibson L . Depths of chemexfoliation induced by various concentrations and application techniques of trichloroacetic acid in a porcine model. J Dermatol Surg Oncol. 1989; 15(9):967-71. DOI: 10.1111/j.1524-4725.1989.tb03183.x. View

Schoenewolf N, Hafner J, Dummer R, Bogdan Allemann I . Laser treatment of solar lentigines on dorsum of hands: QS Ruby laser versus ablative CO2 fractional laser - a randomized controlled trial. Eur J Dermatol. 2015; 25(2):122-6. DOI: 10.1684/ejd.2014.2513. View

Fulton J, Porumb S . Chemical peels: their place within the range of resurfacing techniques. Am J Clin Dermatol. 2004; 5(3):179-87. DOI: 10.2165/00128071-200405030-00006. View

Mukovozov I, Roesler J, Kashetsky N, Gregory A . Treatment of Lentigines: A Systematic Review. Dermatol Surg. 2022; 49(1):17-24. DOI: 10.1097/DSS.0000000000003630. View

Kim T, Choi E, Kang Y, Lee S, Ahn S . The effects of topical alpha-hydroxyacids on the normal skin barrier of hairless mice. Br J Dermatol. 2001; 144(2):267-73. DOI: 10.1046/j.1365-2133.2001.04011.x. View

Horibe E, Ferreira L, Horibe E, Lima A, Cruz N . Er:YAG laser versus Blue Peel in the treatment of photoaging hands. J Clin Laser Med Surg. 2002; 20(4):207-13. DOI: 10.1089/104454702760230537. View

10.

Imhof L, Dummer R, Dreier J, Kolm I, Barysch M . A Prospective Trial Comparing Q-Switched Ruby Laser and a Triple Combination Skin-Lightening Cream in the Treatment of Solar Lentigines. Dermatol Surg. 2016; 42(7):853-7. DOI: 10.1097/DSS.0000000000000793. View

11.

Pavicic T . Calcium hydroxylapatite filler: an overview of safety and tolerability. J Drugs Dermatol. 2013; 12(9):996-1002. View

12.

Sharad J . Glycolic acid peel therapy - a current review. Clin Cosmet Investig Dermatol. 2014; 6:281-8. PMC: 3875240. DOI: 10.2147/CCID.S34029. View

13.

Butterwick K . Rejuvenation of the aging hand. Dermatol Clin. 2005; 23(3):515-27, vii. DOI: 10.1016/j.det.2005.04.007. View

14.

Vachiramon V, Panmanee W, Techapichetvanich T, Chanprapaph K . Comparison of Q-switched Nd: YAG laser and fractional carbon dioxide laser for the treatment of solar lentigines in Asians. Lasers Surg Med. 2016; 48(4):354-9. DOI: 10.1002/lsm.22472. View

15.

Trevidic P, Kaufman-Janette J, Weinkle S, Wu R, Dhillon B, Antunes S . Injection Guidelines for Treating Midface Volume Deficiency With Hyaluronic Acid Fillers: The ATP Approach (Anatomy, Techniques, Products). Aesthet Surg J. 2022; 42(8):920-934. PMC: 9373948. DOI: 10.1093/asj/sjac007. View

16.

Fartasch M, Teal J, Menon G . Mode of action of glycolic acid on human stratum corneum: ultrastructural and functional evaluation of the epidermal barrier. Arch Dermatol Res. 1997; 289(7):404-9. DOI: 10.1007/s004030050212. View

17.

Raziee M, Balighi K, Shabanzadeh-Dehkordi H, Robati R . Efficacy and safety of cryotherapy vs. trichloroacetic acid in the treatment of solar lentigo. J Eur Acad Dermatol Venereol. 2007; 22(3):316-9. DOI: 10.1111/j.1468-3083.2007.02409.x. View

18.

Lugo-Janer A, Lugo-Somolinos A, Sanchez J . Comparison of trichloroacetic acid solution and cryosurgery in the treatment of solar lentigines. Int J Dermatol. 2003; 42(10):829-31. DOI: 10.1046/j.1365-4362.2003.01951.x. View

19.

Sezer E, Erbil H, Kurumlu Z, Tastan H, Etikan I . A comparative study of focal medium-depth chemical peel versus cryosurgery for the treatment of solar lentigo. Eur J Dermatol. 2007; 17(1):26-9. DOI: 10.1684/ejd.2007.0104. View

20.

Lee K, Wambier C, Soon S, Sterling J, Landau M, Rullan P . Basic chemical peeling: Superficial and medium-depth peels. J Am Acad Dermatol. 2018; 81(2):313-324. DOI: 10.1016/j.jaad.2018.10.079. View