The effects of trichloroacetic acid in the treatment of post-acne atrophic scars

Abstract

Introduction: The atrophic scar treatment lasts for several months. The therapy should prevent or reduce scarring. The pathogenesis is the result of sebum hyperproduction, follicular epidermal hyperkeratinisation, the activity of Cutibacterium (Propionibacterium) acnes, and immune response. The TCA peeling stimulates tissue regeneration causing protein deposition, coagulation necrosis and exfoliation of photo-damaged cells. Goal: To demonstrate the effects of TCA peels and the significance of skin care in the treatment of atrophic scars. Methodology: The prepared skin was TCA solution-treated, in circular motions, in five steps. The eyes were covered and protected. The next peeling layers were applied in 3 steps. Case study: subject, skin phototype 3, with post-acne atrophic scars. The therapy: the treatment of TCA - 50% to atrophic regions, follow up on the frosting (coagulation of epidermal and dermal proteins) under the physician supervision. Results and Discussion: The first treatment decreased the number of active acne lesions and inflammation, atrophic scars were less visible. The skin was smooth and gentle. There were no postinflammatory hyperpigmentation. The chemical peels are simple to perform at the histological level, have a low complication rate, low costs. Skin care after surface chemical peeling involves gentle cleansing. Moisturizing, pH neutral creams are recommended for skin care. Sun protection is mandatory. Conclusion: TCA is stable, inexpensive, does not cause systemic toxicity. Peeling is easy to perform, the depth of peeling correlates with the intensity of frosting. There is no need to neutralize TCA. If performed correctly, TCA peels achieve histological and clinical improvement of the skin.