title: Chemical peeling with trichloroacetic acid and lactic acid for infraorbital dark circles.
abstract: BACKGROUND
  Periorbital dark circles are relatively common, affecting individuals regardless of age, sex, and race. Available treatment includes bleaching creams, topical retinoid acid, chemical peels, laser therapy, autologous fat transplantation - injectable fillers, surgery (blepharoplasty), and chemical peeling.
  
  
  OBJECTIVE
  To evaluate the efficacy of a combination of trichloroacetic TCA 3.75% and lactic acid 15% on improving the periorbital hyperpigmentation.
  
  
  METHODS
  Thirty patients with periorbital dark circles and skin types II, III, or IV were included in the study. Chemical peeling was performed every week for a series of four treatments. The effect was photo-documented, and a patient's and physician's global assessment was evaluated.
  
  
  RESULTS
  Almost all the patients showed significant esthetic improvement. Physicians assessed a fair, good, or excellent improvement in 93.3% of the patients. Patient's global assessment rated a fair, good, or excellent response in 96.7% of the patients. The procedure itself had only mild and temporary adverse effects, such as erythema, edema, frosting, dryness, and telangiectasias. The effects of treatment remained for at least 4-6 months in the majority of patients with appropriate sun protection.
  
  
  CONCLUSIONS
  The combination of trichloroacetic TCA 3.75% and lactic acid 15% showed encouraging results on improving periorbital hyperpigmentation.
authors.affiliation: 2nd Dermatology Department, Andreas Sygros Hospital, Athens, Greece.
authors.forename: Charitomeni
authors.initials: C
authors.lastname: Vavouli
authors.forename: Andreas
authors.initials: A
authors.lastname: Katsambas
authors.forename: Stamatis
authors.initials: S
authors.lastname: Gregoriou
authors.forename: Anca
authors.initials: A
authors.lastname: Teodor
authors.forename: Carmen
authors.initials: C
authors.lastname: Salavastru
authors.forename: Adina
authors.initials: A
authors.lastname: Alexandru
authors.forename: George
authors.initials: G
authors.lastname: Kontochristopoulos
mesh_terms: D000328:Adult; D000368:Aged; D002424:Caustics / Q000627:therapeutic use*; D002615:Chemexfoliation / Q000009:adverse effects / Q000379:methods*; D004954:Esthetics; D005123:Eye; D005148:Facial Dermatoses / Q000628:therapy*; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000628:therapy*; D019344:Lactic Acid / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D014238:Trichloroacetic Acid / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D002424:Caustics; D019344:Lactic Acid; D014238:Trichloroacetic Acid
keywords: chemical peeling; dark circles; infraorbital hyperpigmentation; lactic acid; trichlo-roacetic acid