Chen X, et al. - Using Standard Cochrane methodological procedures, researchers contemplated the effectiveness of chemical peeling for treating acne vulgaris. Findings demonstrated the similar effectiveness of commonly used chemical peels for mild-to-moderate acne vulgaris. These appeared to be well tolerated. It was determined that combined salicylic acid (SA) and mandelic acid peeling was superior to glycolic acid (GA) peeling.

Methods

• Experts used standard Cochrane methodological procedures.
• A search was carried out of MEDLINE, Cochrane Central Register of Controlled Trials and EMBASE via OvidSP through April 2017.
• Reviewers independently analyzed the eligibility, risk of bias and extracted data.

Results

• This study included 12 RCTs (387 participants).
• It was noted that effectiveness was not significantly different: Trichloroacetic acid vs salicylic acid (SA) (percentage of total improvement: risk ratio (RR) 0.89; 95% CI 0.73 to 1.10), glycolic acid (GA) vs amino fruit acid (the reduction of inflammatory lesions: mean difference (MD), 0.20; 95% CI -3.03 to 3.43), SA vs pyruvic acid (excellent or good improvement: RR 1.11; 95% CI 0.73 to 1.69), GA vs SA (good or fair improvement: RR 1.00; 95% CI 0.85 to 1.18), GA vs Jessner’s solution (JS) (self-reported improvements: RR 1.00; 95% CI 0.44 to 2.26), and lipohydroxy acid vs SA (reduction of non-inflammatory lesions: 55.6%vs48.5%, p=0.878).
• Findings was demonstrated that combined SA and mandelic acid peeling was superior to GA peeling (percentage of improvement in total acne score: 85.3% vs 68.5%, p < 0.001).
• Data exhibited the superiority pf GA peeling to placebo (excellent or good improvement: RR 2.30; 95% CI 1.40 to 3.77).
• It was found to be probable that SA peeling was superior to JS peeling for comedones (reduction of comedones: 53.4% vs 26.3%, p=0.001) but less effective compared to phototherapy for pustules (number of pustules: MD -7.00; 95% CI -10.84 to -3.16).