The Effectivity of 15% TCA Superficial Chemical Peeling to Treat Comedos and Papulo-Pustules Acne Vulgaris

Background: Acne vulgaris was very common self limitting disease, affected approximately 85% of adolesence, that was defined as a chronic inflammation of pilosebaceous units. It was characterized by the formation of comedones (as primarily acne lession), erythemathous papules and pustules, less frequently nodules and pseudocyst, and was accompanied by scarring in some cases that caused psychosocial problems. TCA 15% was superficial chemical peeling, involved an application of exfoliating agents to the skin, resulting in controlling wound and destructing the portion of the epidermis with subsequent regeneration and reepithelialization within 3-5 days.TCA was the first line therapy for acne scar and skin rejuvenation. Objective/Aim Study: To know the effectivity of 15% TCA superficial chemical peeling to treat comedos and papulepustules in acne vulgaris. Research Design & Statistical Analysis: Cohort experimental Study - Wilcoxon Sign Rank Sum Test statistical analysis methods. Material & Methods: One layer of 15% TCA superficial chemical peelings was applied. Clinical improvements were judged by counting acne lessions and classified the acne severity according to Global Acne grading System before and after treatment. Result: There was statistically significant difference in clinical improvement of all type acne lessions before after therapy with 15% of TCA chemical peeling. The mean of difference of papulepustules before-after peelings was 5,14 (81,66%), comedos was 83,92 (85,23%) and the total acne lessions was 77,07 (86,79%). The mean of difference of GAGS acne score before-after peeling was 13,07 (74,75%). Discussion: This research proved that one layer of 15% TCA superficial chemical peeling was statistically and clinically effective and good to treat all type of acne vulgaris. It was the best comedolytic activity and good to treat inflammatory/papulepustules acne lession. The goal therapy of acne vulgaris: removed plugging of the pilar drainage, reduced sebum production, treated bacterial and fungal colonization, and prevented from scarring could be solved by 15% TCA superficial chemical peeling. It improved the depth contour and caused softening associated scars by their action on collagen remodelling and stimulation of new collagen activity, reepithelialization, regenerated compact epidermis that improved light reflection, eliminated dermal melanin and prevented transfer melanin to keratinocytes that improved skin textural and fine line, glowed, rejuvenated, lightened and minimized PIH. It decreased skin pH and TEWL and improved skin barrier permeability. 15% TCA superficial chemical peeling was good and well tolerated methods for acne therapy, now considered as the single main acne therapy or could be combined with other therapy to treat acne chronicity and solved resistance problems to antibiotics and antifungi.