From the Guidelines
Chemical peels can be considered a treatment for acne, particularly for patients with comedonal acne, as they help unclog pores and reduce inflammation, with salicylic acid peels being a commonly used option. The use of chemical peels in acne treatment is supported by recent guidelines, which conditionally recommend salicylic acid for acne treatment based on moderate certainty evidence 1. Salicylic acid peels, with concentrations ranging from 20-30%, are specifically discussed in the context of physical modalities for acne management 1.
When considering chemical peels for acne, it's essential to note the recommended concentrations and application times. For instance, salicylic acid peels can be used at concentrations of 20-30%, with application times varying depending on the intensity of the clinical response 1. The potential benefits of chemical peels in acne treatment include unclogging pores, reducing sebum production, killing acne-causing bacteria, and decreasing inflammation.
However, it's crucial to weigh these benefits against potential adverse effects, such as mild stinging, burning, erythema, and exfoliation 1. Pre-treatment preparation and post-treatment care, including discontinuing retinoids and using sunscreen, are vital to minimize risks and optimize outcomes. Chemical peels are particularly beneficial for treating both active acne and post-inflammatory hyperpigmentation but may not be suitable for severe nodular or cystic acne, which typically requires oral medications like isotretinoin.
The most recent guidelines emphasize the importance of combining topical therapies with multiple mechanisms of action and limiting systemic antibiotic use, which can inform the decision to use chemical peels as part of a comprehensive acne treatment plan 1. Overall, chemical peels, including those with salicylic acid, can be a valuable treatment option for acne, especially when used judiciously and as part of a broader treatment strategy.
From the FDA Drug Label
Uses For the treatment of acne Reduces the number of acne pimples and blackheads Allows skin to heal Helps prevent new acne pimples from forming Chemical peel, specifically glycolic acid, can be considered a treatment for acne as it reduces the number of acne pimples and blackheads, allows the skin to heal, and helps prevent new acne pimples from forming 2.
- Key benefits of using glycolic acid for acne treatment include:
- Reduces acne pimples and blackheads
- Allows skin to heal
- Prevents new acne pimples from forming
From the Research
Chemical Peels as a Treatment for Acne
- Chemical peels can be considered a treatment for acne, as they cause controlled destruction of the epidermis, leading to exfoliation and removal of superficial lesions, followed by regeneration of new epidermal and dermal tissues 3.
- The most frequently used peeling agents for acne treatment are salicylic acid, glycolic acid, pyruvic acid, lactic acid, mandelic acid, Jessner solution, trichloroacetic acid, and phenol 3.
- A combination of chemical peels and topical salicylic acid-based gel can be an effective treatment for mild and moderate acne, leading to significant improvement in skin lesions and quality of life 4.
Efficacy and Safety of Chemical Peels for Acne
- Chemical peels have been shown to be effective in improving acne severity and quality of life, with all patients showing improvement in skin lesions after 4 sessions of chemical peel 4.
- The use of isotretinoin in combination with chemical peels does not result in significant complications, and may even lead to faster and better improvement in acne treatment 5.
- Superficial chemical peels can be safely performed in patients on oral isotretinoin for acne and acne-induced pigmentation, with no significant difference in complications between patients on isotretinoin and those not on isotretinoin 5.
Patient Selection and Perspectives
- Patient selection is crucial when using chemical peels for acne treatment, with factors such as skin type, acne severity, and medical history taken into consideration 6.
- The Fitzpatrick skin type scale can be used to classify patients based on skin color and ability to tan, and to evaluate preoperative risk of postpeel response and complications 6.
- Dark-skinned patients are at higher risk of postinflammatory/postpeel hyperpigmentation, and deep chemical peels should be avoided in these patients 6.
Comparison of Chemical Peels for Acne
- A systematic review of randomized controlled trials found that commonly used chemical peels appear to be similarly effective for mild-to-moderate acne vulgaris and well tolerated 7.
- However, the methodological quality of the included trials was very low to moderate, and meta-analysis was not possible due to significant clinical heterogeneity across studies 7.
- Well-designed randomized controlled trials are needed to identify optimal regimens for chemical peels in acne treatment 7.