Glycolic acid peels side effects

The safety and efficacy of a series of glycolic acid facial peels were investigated in 25 Indian women with melasma [16]. Patients were treated with 50% glycolic acid peels monthly for 3 months. Improvement was noted in 91% of patients with maximal clearing occurring in patients classified with epidermal melasma. Side effects were observed in one patient who developed brow hyperpigmentation. 

Tretinoin was compared with glycolic acid in ten Indian women with melasma, an acquired symmetrical hypermelanosis characterized by irregular light to gray-brown macules on sun-exposed skin that is more frequently seen in women and is more prevalent in darker complexioned individuals [308]. In this study, a 1 % tretinoin peel was applied on one side of the face weekly for 12 weeks, and 70 % glycolic add was appUed similarly to the other side. The tretinoin solution contained 1 % tretinoin in a 95 % isopropyl alcohol base and 5 % chloroform with antioxidant butylated hydroxy-toluene. There was a significant decrease in the melasma score from 6 to 12 weeks, with no difference between the tretinoin- and glycolic-acid-treated sides. Side effects were minimal and tretinoin was well tolerated [308]. 

Percic S, Bubanj M, Bubanj S, Janiic S. Side effect in glycolic acid peelings in patients with acne type I. Bosn J Basic Med Sci. 2011 11 52-7. 

In general, glycolic acid peels are well tolerated in darker skinned people. Side effects are substantially minimized when peel concentrations are gradually titrated from the lower concentrations of 20-35% to the full-strength 70%. Glycolic acid peels are most advantageous when treating darker skin types with sensitive skin. 

When compared to 70% glycolic acid peels, no difference was found with respect to the frequency of side effects in patients of skin types IV-Vl. However, the phenolic compound, resorcinol, may cause some depigmentation jjroblems in skin types V and VI. 

Side effects, such as temporary hyperpigmentation or irritation, are not very common with superficial glycolic acid peels. Some studies demonstrate that the level of skin damage with glycolic acid peel increases in a dose- and time-dependent manner. Lower doses (1 and 3 mg/cm ) of glycolic acid caused erythema and eschars, whereas higher doses (5 and 7 mg/cm ) caused redness, edema and necrotic ulceration. Systemic effects are rare. 

Jessner s solution contains 14% resorcinol, 14% salicylic acid and 14% lactic acid. Jessner s solution has been used alone for superficial peeling, or in combination with TCA 35% to achieve a medium-depth peel. Increasing the number of coats applied to the treated area increases the depth and reaction induced by the Jessner s peel. These peels are well tolerated with minimal side effects in the author s practice. As with glycolic acid and salicylic acid peels, Jessner s peels are most commonly used as adjimctive therapy for moderate to severe facial dyschromias, acne, oily skin, texturally rough skin, fine wrinkles, and pseudofolliculitis barbae. 

Superficial chemical peels, including salicylic and glycolic acids, and Jessner s peels target the stratum corneum to the papillary dermis. These agents can be safely used to facilitate the resolution of PIH (Figs. 16.2,16.3,16.4 and 16.5). To assess for variability in response and limit further PIH, when possible, chemical peels should be initiated at the lower concentrations and titrated to higher concentrations if necessary to increase efficacy while minimizing side effects (see Darker Skin Section). 

Side effects, such as temporary hyperpigmentation or irritation, are not very significant. Finally, glycolic acid is a member of the alpha-hydroxy acid family, which provides an important adjunctive therapy in a variety of skin disorders. It is widely used in chemical peels in a variety of concentrations, ranging from 20% to 70%. People of almost any skin type and color are candidates and almost any area of the body can be peeled. Glycolic acid can be applied simultaneously with TCA, which represents another technique for a... 

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