Abstract
Photoaging can significantly contribute to lower quality of life. Medium-deep peeling using trichloroacetic acid allows controlled keratocoagulation through the dermis and into the dermal papillary layer that is effective for skin rejuvenation. The purpose of this article is to give updates regarding the efficacy, possible adverse events, and patient satisfaction of trichloroacetic acid (TCA) peeling for skin rejuvenation by assessing various photoaging parameters. A systematic review of prospective trial articles collected from PubMed, MEDLINE, EMBASE, Cochrane, and Scopus databases was conducted on November 2, 2020. Treatment efficacy was assessed based on the photoaging parameters used by each study. Adverse events and patient satisfaction as the secondary outcome were assessed based on patients-perceived improvements. Five studies included three randomized comparison studies and two prospective cohort studies. These studies show that TCA peeling significantly improve the cosmesis of photoaged facial skin. Low concentration is effective for superficial sun damage. Medium-depth peels using a higher concentration of TCA or as combination therapy are effective as skin resurfacing agents to reduce wrinkles. Some adverse effects may occur but usually resolve within weeks. Overall patients were satisfied with the treatment result. An equivalent basic skin preparation such as topical retinoic acid skin priming prior to intervention is necessary for more objective comparison. Further research studies with a larger sample size and longer follow-up period are required. This evidence suggests that TCA peeling is effective in photoaging treatment, either as monotherapy or as combination therapy with other modalities.
Highlights
Photoaging is a series of changes in the skin caused by exposure to ultraviolet rays over time. is process overlaps the aging process chronologically, making the aging process happen prematurely
Improvements in the skin imperfections and overall skin condition pretreatment and posttreatment scores were found in all four groups. e group of patients who showed the most preferable results using the global aesthetic improvement scale (GAIS) at six months after the last treatment evaluation was the group who received fractional radiofrequency (FRF) treatment followed immediately by 20% TCA2, especially in laxity and wrinkling, as well as pigmentation and dyschromia (p < 0.001)
Unlike the case of topical therapy, Arty et al [13] showed longer downtimes where the patients experienced reduced activity due to discomfort and severity of the erythema, edema, crusting, and blistering was significantly reported in FRF therapy followed by trichloroacetic acid (TCA) peeling this combination showed the best result on skin rejuvenation. is combination resulted in deeper TCA penetration. e histological examination demonstrates signs of burn such as thinned, detached, and epidermal necrosis with foci of ulceration in all groups that received FRF treatment
Summary
Medium-deep peeling using trichloroacetic acid allows controlled keratocoagulation through the dermis and into the dermal papillary layer that is effective for skin rejuvenation. E purpose of this article is to give updates regarding the efficacy, possible adverse events, and patient satisfaction of trichloroacetic acid (TCA) peeling for skin rejuvenation by assessing various photoaging parameters. Treatment efficacy was assessed based on the photoaging parameters used by each study. Adverse events and patient satisfaction as the secondary outcome were assessed based on patients-perceived improvements. Ese studies show that TCA peeling significantly improve the cosmesis of photoaged facial skin. Medium-depth peels using a higher concentration of TCA or as combination therapy are effective as skin resurfacing agents to reduce wrinkles. Is evidence suggests that TCA peeling is effective in photoaging treatment, either as monotherapy or as combination therapy with other modalities Further research studies with a larger sample size and longer follow-up period are required. is evidence suggests that TCA peeling is effective in photoaging treatment, either as monotherapy or as combination therapy with other modalities
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