A comparative study of 70% glycolic acid and 30% trichloroacetic acid peel in the treatment of facial atrophic acne scars: A split-face study

Objectives: Medium-depth peels are dynamic tools when used as part of office procedures for the treatment of acne scars. Most of the available literature on chemical peels focuses on their role in skin rejuvenation and hyperpigmentation. There is a paucity of well-conducted studies that have compared peels in the treatment of acne scars in Asian patients. Material and Methods: The study aimed to compare the efficacy of 70% glycolic acid (GA) and 30% trichloroacetic acid (TCA) chemical peels in the treatment of facial atrophic acne scars. A longitudinal, right-left study was conducted to assess the effectiveness and side effects of 70% GA and 30% TCA in 30 patients with acne scars. A total of four peeling sessions were performed every 4 weeks. Evaluation of the response was done using Goodman and Baron’s quantitative global acne scarring grading system (GBASG), physician visual analog scale (VAS), and patient VAS at baseline and 4, 8, 12, and 16 weeks. Relevant statistical tests were employed to study the effectiveness of both TCA and GA peels. Results: Significant reduction was noted in mean GBASG scores on both sides at 8, 12, and 16 compared to baseline score ( P = 0.000). Mean GBASG scores decreased from 12.67 ± 3.19 to 8.97 ± 2.73 on the 70% GA side while that on the 30% TCA side reduced from 13.20 ± 3.56 to 6.83 ± 2.60 ( P = 0.003). The results were much better on the TCA peel side as compared to GA peel as per physician VAS ( P = 0.000) and patient VAS ( P = 0.000). Side effects such as post-inflammatory hyperpigmentation and acne were seen on both sides while dryness and crusting were more common on the TCA peel side. Conclusion: A 30% TCA peel is efficacious and well-tolerated for mild-to-moderate acne scars. About 70% GA peel is an effective alternative to TCA peel, especially for patients not tolerating TCA or requiring lesser downtime.