30% supramolecular salicylic acid peels effectively treats acne vulgaris and reduces facial sebum

Abstract Background Acne is a chronic inflammatory skin disease with high incidence and recurrence. Aim To study the efficacy of 30% supramolecular salicylic acid (SSA) in the treatment of acne, especially its effect on facial sebum secretion and the skin barrier. Methods Chemical peeling treatment with SSA using self‐contrast was performed every 2 weeks for a total of four treatments in 25 patients. VISIA photographs and skin parameter measurements were recorded at every treatment, with a 2‐week follow‐up after the last treatment. We performed skin biopsy and immunohistochemical staining to detect sterol response element‐binding proteins (SREBPs), fatty acid synthase (FAS), and cyclooxygenase 2 (COX2), which are important factors involved in the regulation of sebum metabolism. Results The global acne‐grading system (GAGS) score of patients with acne decreased with 30% SSA treatment. The sebum level in the nose ( p < 0.001), chin ( p < 0.001), left cheek ( p < 0.05), and right cheek ( p < 0.05) improved significantly with increasing number of treatments. The T‐zone sebum level ( p < 0.001) improved more than the U‐zone ( p < 0.01). The VISIA index porphyrin score also reduced ( p < 0.001). Skin hydration ( p < 0.001), transepidermal water loss (TEWL) ( p < 0.05), and pH value ( p < 0.01)—reflecting the skin barrier—were also improved. Immunohistochemistry showed decreased expression of SREBPs, FAS, and COX2. Conclusion Peels with 30%SSA effectively treated acne and reduced facial sebum secretion without damaging the skin barrier. Reduction of sebum showed cumulative effect, which suggests that multiple 30%SSA chemical peels are beneficial to acne patients.