@article {193048, title = {Sequential peeling as a monotherapy for treatment of milder forms of acne vulgaris.}, journal = {Journal of cosmetic dermatology}, volume = {19}, year = {2020}, pages = {1381-1387}, abstract = {

BACKGROUND: Glycolic acid (GA) and salicylic acid (SA) peels have been used separately for acne treatment, not as a sequential peel.

AIM: To evaluate the efficacy and safety of sequential peeling with 70\% GA and 20\% SA as a monotherapy and as an adjuvant to systemic doxycycline in treatment of mild to moderate acne and the effect on serum interleukin (IL) 17 and tissue IL-1α.

PATIENTS/METHODS: Forty-five mild to moderate acne vulgaris patients were randomly assigned into three groups. Group [A] underwent sequential application of 70\% GA followed by 20\% SA biweekly for three months. Group [B] underwent sequential peeling and doxycycline PO100~mg BD for 1~month followed by 100 OD for 2~months. Group [C] received oral doxycycline. Acne grading, lesion counting, and patient satisfaction were assessed. Serum samples and perilesional skin biopsies were obtained at onset and 2~weeks after finishing the treatment for assessment of serum IL-17 and tissue IL-1α.

RESULTS: All groups showed statistically significant decrease in acne grading and lesion count, increase in patient satisfaction, and decrease in serum IL-17 and tissue IL-1 α after treatment. There was no significant difference between the 3 groups before or after treatment, except regarding patient satisfaction after treatment, which was significantly higher in groups [A] and [B] than group [C] (P~=~.001).

CONCLUSIONS: This study recommends using sequential GA 70\% and SA 20\% peels in the treatment of mild or moderate acne vulgaris as a new cost-effective mode, with low-down time and potential safety, in noncompliant patients on medical therapy.

}, author = {Zayed, Amira Amin and Sobhi, Rehab Mohamed and El Aguizy, Randa Mohamed Saleh and Dina Sabry and Mahmoud, Sara Bahaa} }