Resumen

Objectives: Share our experience of treating keratosis pilaris (KP) with a novel chemical peel, and describe the cosmetic outcomes, side effects, and patient experience. Introduction: KP is a common, hard-to-treat skin condition that leads to a distinctive rough texture of the affected areas. Chemical peels have previously been used in the management of KP with inconsistent, often unsatisfactory, results. More recently developed chemical peels composed of multiple acids attempt to leverage the synergistic effects of different active ingredients in order to target skin concerns more effectively. This multifaceted approach can result in improved cosmetic outcomes, but also in a reduced number of treatments and downtime. Materials / method: We assessed the efficacy and safety of treatment with a chemical peel of trichloroacetic acid (TCA) 20%, kojic acid, and mandelic acid in the management of adult patients with keratosis pilaris. A total of six fortnightly treatments (2ml for 6-8 minutes) were applied to the affected areas over a period of three months. Medical photographs were obtained pre and post treatment and used for comparison. Pre and post-treatment outcomes were determined using investigator global assessment (IGA), global improvement score (GIS), and patient satisfaction scores. Results: Four patients were treated using the above protocol. All four patients achieved significant improvement in lesion count, lesion size, and overall texture of the treated skin compared to their baseline. Furthermore, moderate improvement was achieved in the reduction of erythema. Patient satisfaction scores showed a significant improvement compared to the baseline. Other than mild, transient irritation, no other side effects were reported or observed. These results were found to be consistent across all four patients without significant interpatient variations in outcomes. Conclusion: Chemical peels containing TCA 20%, kojic acid, and mandelic acid were able to successfully and consistently control the roughness associated with KP, but were less effective in reducing erythema. The lack of side effects allows for immediate resumption of social activities by patients without the need for a downtime. Satisfaction scores suggest that patients put greater weight in improvement of KP-associated roughness compared to erythema. Further studies are required in order to assess long-term outcomes and to establish protocols for maintenance therapy.