Salicylic–mandelic acid versus glycolic acid peels in Egyptian patients with acne vulgaris

Background: Many studies have evaluated the glycolic acid peel (GAP) in acne vulgaris; however, there is little in the literature about the use of a salicylic–mandelic acid peel (SMP). Objective: To evaluate the efficacy and the tolerability of a combination of 20% salicylic–10% mandelic acid peel (SMP) against a 35% GAP in the treatment of active acne vulgaris, postacne scarring, and associated hyperpigmentation in Egyptian acne patients. Patients and methods: This clinical trial was conducted on 40 patients with facial acne vulgaris divided randomly into group A (n = 20), which was treated with SMP, and group B (n = 20), which was treated with GAP for seven sessions every 2 weeks and followed up for 2 months (week 20). An objective assessment of the treatment outcomes was performed by the treating physicians, whereas a subjective assessment was performed by two independent dermatologists. Patient satisfaction scores and side effects were also assessed. Results: Percentages of improvement in groups A and B from weeks 0 to 20 were 90.2 and 35.87% in comedones, 81.72 and 77.78% in papules, 85.38 and 75.65% in pustules, 85.29 and 68.50% in the total acne score, 66.13 and 46.88% in postacne hyperpigmentation, 17.85 and 11.9% in icepick scars, and 29.3 and 25.8% in boxcar scars, respectively. Both peeling agents were associated with a burning sensation, dryness, desquamation, and acne flare. Conclusion: Both peeling agents were effective in the treatment of inflammatory acne, noninflammatory acne, and postacne hyperpigmentation. However, SMP proved to have a higher efficacy than the more commonly used GAP.