title: Effectiveness, safety, and effect on quality of life of topical salicylic acid peels for treatment of postinflammatory hyperpigmentation in dark skin.
abstract: BACKGROUND
  There are no randomized split-face model studies investigating treatments for postinflammatory hyperpigmentation (PIH) in dark skin.
  
  
  OBJECTIVE
  To assess the efficacy, safety, and effect on quality of life of salicylic acid peels for PIH in dark skin.
  
  
  METHODS
  Ten subjects with Fitzpatrick skin phototypes IV to VI were randomized to receive two 20% salicylic acid peels followed by three 30% salicylic acid peels to half of the face. The contralateral half remained untreated. Response was evaluated by photography reviewed by three blinded dermatologists. The Visual Analog Scale, Dermatology Life Quality Index (DLQI), and treatment quality questionnaire were administered.
  
  
  RESULTS
  Improvement of PIH on the treatment side according to each rater (p=.81, p=.81, p=.42) and according to the raters combined (p=.11) approached but did not reach statistical significance. Subjects' Visual Analog Scale scores indicated significantly greater improvement of PIH on the treatment side than in the control (p=.004). Quality of life measured according to the DLQI improved after treatment but not statistically significantly so (p=.13). Treatment had no significant adverse effects.
  
  
  CONCLUSIONS
  Salicylic acid peels are safe in this population. Although patients rated them as clinically effective, blinded raters found a brief series of peels to have less efficacy. Measured quality of life improved nominally.
authors.affiliation: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
authors.forename: Smita S
authors.initials: SS
authors.lastname: Joshi
authors.forename: Susan L
authors.initials: SL
authors.lastname: Boone
authors.forename: Murad
authors.initials: M
authors.lastname: Alam
authors.forename: Simon
authors.initials: S
authors.lastname: Yoo
authors.forename: Lucile
authors.initials: L
authors.lastname: White
authors.forename: Alfred
authors.initials: A
authors.lastname: Rademaker
authors.forename: Irene
authors.initials: I
authors.lastname: Helenowski
authors.forename: Dennis P
authors.initials: DP
authors.lastname: West
authors.forename: Roopal V
authors.initials: RV
authors.lastname: Kundu
mesh_terms: D000287:Administration, Topical; D000328:Adult; D002615:Chemexfoliation / Q000379:methods*; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000188:drug therapy* / Q000209:etiology; D007249:Inflammation / Q000150:complications; D007641:Keratolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D010781:Photography; D011446:Prospective Studies; D011788:Quality of Life; D020156:Salicylic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D016037:Single-Blind Method; D012880:Skin Pigmentation / Q000187:drug effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007641:Keratolytic Agents; D020156:Salicylic Acid