title: Medium-depth chemical peels in the treatment of acne scars in dark-skinned individuals.
abstract: BACKGROUND
  Multiple modalities are available for treating acne scars, one of which is chemical peeling.
  
  
  OBJECTIVE
  To evaluate the efficacy of medium-depth peels in the treatment of acne scars.
  
  
  METHODS
  A total of 15 patients (14 women and 1 man) were seen between November 1998 and March 2000. A medium-depth chemical peel was performed. The peel was performed using a combination of Jessner's solution followed by the application of 35% trichloroacetic acid (TCA). The mean age of patients who entered the study was 28 years. A total of 42 peeling sessions were performed: 13 patients had the full three-session regiment, 1 patient had two sessions, and 1 had only one session.
  
  
  RESULTS
  Patients in our study had two forms of acne scars, the atrophic saucer or crater-like form and the pitted (ice-pick) form. Improvement occurred in all except one of our patients. Significant improvement (greater than 75% clearance of lesions) occurred in 1 patient (6.6%), moderate improvement (51-75% clearance) in 8 patients (53.3%), mild improvement (26-50% clearance) in 4 patients (26.6%), minimal improvement (1-25% clearance) in 1 patient (6.6%), and no response in 1 patient (6.6%). All patients had different combinations of the above two forms. Four patients (26.6%) had mainly pitted scars and deep atrophic scars. The clinical response in those patients was moderate, mild, minimal, and no response, respectively. The remainder of our patients had mainly atrophic scars of moderate depth. Nine patients (73.4%) suffered from transient postinflammatory hyperpigmentation. In two of them it was preceded by erythema that lasted for more than 1 month. All patients were free of noticeable pigmentation 3 months after the final peel. Patients in whom hyperpigmentation did not develop were of light brown complexion.
  
  
  CONCLUSIONS
  We conclude that medium-depth chemical peel is a safe and effective method of treating acne scars even in patients with dark complexion.
authors.affiliation: Department of Dermatology, Baghdad University, Bab Al-Mua'dhem, Baghdad, Iraq.
authors.forename: Makram M
authors.initials: MM
authors.lastname: Al-Waiz
authors.forename: Ali I
authors.initials: AI
authors.lastname: Al-Sharqi
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D002424:Caustics / Q000008:administration & dosage; D002615:Chemexfoliation / Q000379:methods*; D002921:Cicatrix / Q000188:drug therapy*; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007493:Iraq; D019344:Lactic Acid / Q000008:administration & dosage; D008297:Male; D012118:Resorcinols / Q000008:administration & dosage; D012459:Salicylates; D012880:Skin Pigmentation; D014238:Trichloroacetic Acid / Q000008:administration & dosage
chemical_list: D002424:Caustics; D004338:Drug Combinations; C061170:Jessner's solution; D012118:Resorcinols; D012459:Salicylates; D019344:Lactic Acid; D000431:Ethanol; D014238:Trichloroacetic Acid