A CLINICAL AND HISTOLOGIC EVALUATION OF 2 MEDIUM-DEPTH PEELS - GLYCOLIC ACID VERSUS JESSNERS TRICHLOROACETIC-ACID

BACKGROUND. Chemical peels using alpha hydroxy acids have become one o f the most frequently requested dermatologic procedures. The use of gl ycolic acid in superficial chemical peels is now well established. How ever, the role of glycolic acid in medium-depth chemical peels has yet to be elucidated. OBJECTIVE. We performed a clinical and histologic c omparison of 70% glycolic acid versus Jessner's solution as part of a medium-depth chemical peel using 35% trichloroacetic acid (TCA). METHO DS. Thirteen patients with actinic keratoses, solar lentigines, and fi ne wrinkling were evaluated prospectively. Each patient was treated wi th 70% glycolic acid plus 35% TCA (GA-TCA) to the right face and Jessn er's solution plus 35% TCA (JS-TCA) to the left face. Clinical and his tologic changes were evaluated at 7, 30, and 60 days postoperatively. RESULTS. Clinically, the GA-TCA peel was effective in treating photoda maged skin. The GA-TCA peel was slightly more efficacious in removing actinic keratoses (clinical response score = 1.5) than the JS-TCA peel (clinical response score = 1.0). Histologically, the GA-TCA peel caus ed the formation of a slightly thicker Grenz zone (mean = 0.053 mm) 60 days postpeel than the JS-TCA peel (mean = 0.048 mm) (not statistical ly significant). The GA-TCA peel caused more neoelastogenesis than the IS-TCA peel, while the JS-TCA peel resulted in move papillary dermal fibrosis and neovascularization than the GA-TCA peel. CONCLUSION. The GA-TCA peel is a new medium-depth chemical peel that is effective in t reating photodamaged skin.