The glycolic acid trichloroacetic acid peel.

Background: Chemical peeling has become increasingly popular. Technique is more critical in medium depth peeling than with deeper peels because of variable penetration of the trichloroacetic acid.

Objective: This article describes a novel use of two caustic agents, glycolic acid and trichloroacetic acid, to effect a predictable approach to medium depth peeling.

Methods: Without other skin preparation, 70% glycolic acid was applied to the entire face and diluted with water after 2 minutes. Then, 35% trichloroacetic acid was applied over the same areas. Biopsies were done on selected patients after 24 hours and 30, 60, and 90 days.

Results: Both clinically and histologically the glycolic trichloroacetic acid peel resulted in medium depth injury. Improvement in pigmentary dyschromias and actinic damage was impressive.

Conclusions: The GA-TCA peel provides a consistent approach to medium depth peeling to add to the armamentarium of the dermatologic surgeon.