Abstract

Objectives: Chemical peels are gaining popularity due to their effectiveness and affordability. The objective of this case report is to evaluate the effectiveness of a specific combination of acids in the treatment of hyperpigmentation. This combination includes Trichloroacetic Acid (12%), Kojic Acid (5-7%), and Mandelic Acid (5-7%). The aim is to assess the efficacy of this acid blend in reducing hyperpigmented areas while minimizing side effects such as irritation and peeling, thereby providing a balanced approach that prioritizes both treatment efficacy and patient comfort. Introduction: Hyperpigmentation and melasma are prevalent pigmentation disorders primarily affecting women living in regions with high sun exposure. In this Case report a 38-year-old European female patient, classified as Fitzpatrick skin type III from a Mediterranean country, presented with forehead hyperpigmentation. Clinical examination revealed multiple pigmented brown macules and patches diffusely distributed on the forehead. Intensity confirmed with Lifeviz Quantificare camera. The treatment aimed to provide an effective chemical peel and to keep the patient comfortable without a recovery period. Materials / method: Three treatment sessions were conducted 14 days apart, utilizing a combination of Trichloroacetic Acid (12%), Kojic Acid (5-7%), and Mandelic Acid (5-7%) at a pH of 0.2-1. After completing the treatment protocol, the patient was followed up from March to May 2024. Following each session, the patient experienced mild erythema that appeared immediately but resolved within the same hour. To ensure optimal results the patient was advised to avoid sun exposure and to apply sunscreen regularly. Any strenuous physical activity wasn't recommended for two days following treatment. Results: By the conclusion of the treatment plan, the clinical assessment indicated significant improvement, characterized by a visibly noticeable reduction in both the size and color intensity of the hyperpigmented lesions on the forehead. This positive outcome was corroborated by measurements taken with the Lifeviz Quantificare camera, further validating the effectiveness of the treatment while ensuring patient comfort and safety. Results were stable and confirmed after three months follow-up. Conclusion: The combination of Trichloroacetic Acid (12%), Kojic Acid (5-7%), and Mandelic Acid (5-7%) at a pH of 0.2-1 provides a highly safe and convenient treatment option for patients. This blend significantly addresses hyperpigmentation and melasma without causing pain or excessive exfoliation. The synergistic effects of these acids make this combination an effective and reliable choice for clinicians, enhancing patient satisfaction and outcomes. Thus, it represents a valuable addition to clinical practice for managing pigmentation disorders.