Combined chemical peels beneficial in hand aging treatment

Key takeaways:

• Glycolic acid and a combination of glycolic acid and trichloroacetic acid both showed improvements in hand aging.
• The combination treatment was slightly more efficacious in reducing pigmentation intensity.

Using a combination of chemical peeling is beneficial in reversing aging on the hands, according to a study.

“All body organs, including the skin, gradually lose reserve capacity and function as people age,” Satya Wydya Yenny, MD, PhD, of the department of dermatology and venereology at Dr. M. Djamil Hospital in Padang, Indonesia, and colleagues wrote. “The natural degeneration of skin function can be accelerated and worsened by long-term exposure to environmental variables, such as ultraviolet and infrared radiation and environmental carcinogens in polluted air. ... Wrinkles, pigmentation changes, tissue, dermal atrophy, profound intermetacarpal gaps, protruding bones and tendons, and enlarged reticular veins indicate hand aging in the dermis layer.”

This study enrolled 69 patients aged 20 to 69 years who were each treated with 20% glycolic acid (GA) on one hand and a combination or 20% GA and 15% trichloroacetic acid (TCA) on the second hand.

Prior to treatment, as well at weeks 2, 5, 8 and 11, the hands were photographed in a pronated position and evaluated with a dermoscope (Illuco ids-1000, Illuco USA). Patients were also asked to rate treatment tolerance, satisfaction in treatment procedure and satisfaction in post-chemical peeling.

Both hands showed a statistically significant improvement in dermoscopic evaluation of dorsal hand wrinkles, pigmentation density, hand pigmentation intensity and the Merz Hand Grading Scale (MHGS), which measures the appearance of the hand’s dorsum.

A statistically significant improvement in dorsal hand pigmentation intensity was found after 14 weeks and four treatments in hands treated with the combination therapy compared with the hands treated with GA alone.

Tolerance and satisfaction were similar for both treatments, with a linear increase shown throughout the treatment duration.

“The combination of 20% GA and 15% TCA is slightly superior to 20% GA peel, especially in reducing skin pigmentation, indicating that the combined method is a more effective treatment strategy than using a single type of peel,” the authors wrote. “Further study is needed to expand the clinical utility of our methods for other parts of the skin that are affected by aging.”