Chemical peels hold an irreplaceable place in a dermatology practice in treating acne, photoaging and pigmentary dyschromia. Oral isotretinoin is the gold standard in managing acne. However, combining both the efficient therapies is not currently recommended, due to the augmented risk of complications like dryness, erythema, post-inflammatory hyperpigmentation and scarring.

Thus, a recent study assessed the safety and efficacy of superficial chemical peels in patients with acne consuming isotretinoin and in those who were not.

Sixty patients were included in the analysis who underwent 214 sessions. Among all, 47 patients were consuming oral isotretinoin (Group A) while 13 were not (Group B). In Group A, 22 patients received a salicylic acid-mandelic acid peel (SMP), 18 patients received a glycolic acid peel and 7 patients received a modified Jessners peel. In Group B, 8 received an SMP, 4 received glycolic acid peel and 1 received modified Jessners peel. The occurrence of any complications was noted, and incidence rates were compared by photographic assessment.

The results were as follows:

•  One patient in each group showed complications (persistent hyperpigmentation). 
•  The discrepancy in the incidence of complications was negligible between the two groups for all three superficial peels. 
•  Patients in the isotretinoin group showed to experience faster and better improvement than those in the non-isotretinoin group.

As the use of isotretinoin was not associated with any complications; combination therapy should be used to achieve enhanced and faster resolution of acne.

Source: Bs C, Vadlamudi SL, Shenoy C. Safety of performing superficial chemical peels in patients on oral isotretinoin for acne and acne-induced pigmentation. J Clin Aesthet Dermatol. 2021;14(11):41-3.