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Trichloroacetic acid peel safe, efficient for different skin types

Trichloroacetic acid peels are safe and efficient for light and dark skin, according to study results published in JAMA Facial Plastic Surgery.

Nabil Fanous, MD, FRCSC, and Shadi Zari, MD, FRPC, both from McGill University in Montreal, reviewed 923 patients (mean age, 42 years; 803 women) whom they had performed trichloroacetic acid peels on from 1996 to 2015. The researchers’ methods for safely performing the technique include a prepeel skin classification, including genetico-racial skin categories, predicting the skin’s response to a peel, choice of peel depth, prepeel preparation, control of the peel depth and “strip” technique, finalized with postpeel care.

The researchers defined their skin classifications based on skin color and facial features rather than skin color alone. Their recommendations by classification include: medium or light to medium peel for northern Europeans; medium to deep peel for mid-Europeans; medium or medium to deep peel for southern Europeans; light peel for southern Caucasians; very light peel for Africans; medium peel for northern and central Asians; and light to medium peel for southern Asians.

The researchers said physicians who are novices with the technique should restrict their trichloroacetic acid peel practice to superficial peels (light or light to medium depth) until they have gained substantial experience.

Complications included 54 patients (5.9%) with persistent hyperpigmentation, mostly Asians and Indo Pakistanis, which required one or more “spot peels.” Three northern European patients had mild telangiectasia. Two patients developed acute herpesvirus early in the case series, two others developed Staphylococcus, and one developed hypopigmentation. There was no occurrence of scarring.

“When properly performed, the universal trichloroacetic acid peel technique improves the condition and quality of the skin in light- and dark-skinned patients,” the researchers wrote. “It can be an easily implementable addition to a physician’s cosmetic practice.” – by Talitha Bennett

Disclosure : The researchers report no relevant financial disclosures.