Efficacy and safety of Jessner’s solution peel in comparison with salicylic acid 30% peel in the management of patients with acne vulgaris and postacne hyperpigmentation with skin of color: a randomized, double‐blinded, split‐face, controlled trial

• Published in: International journal of dermatology Vol. 59; no. 7; pp. 804 - 812
• Main Authors: How, Kang N., Lim, Poh Y., Wan Ahmad Kammal, Wan Syazween Lyana, Shamsudin, Norashikin
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-07-2020
• Subjects: Acne; Acne Vulgaris - complications; Acne Vulgaris - drug therapy; Adult; Antibiotics; Burning; Chemexfoliation - adverse effects; Chemexfoliation - methods; Complications; Double-Blind Method; Drug Combinations; Ethanol - adverse effects; Ethanol - therapeutic use; Facial Dermatoses - drug therapy; Female; Humans; Hyperpigmentation; Hyperpigmentation - drug therapy; Hyperpigmentation - etiology; Inflammation; Keratolytic Agents - adverse effects; Keratolytic Agents - therapeutic use; Lactic Acid - adverse effects; Lactic Acid - therapeutic use; Lesions; Male; Pain - chemically induced; Patients; Randomization; Resorcinols - adverse effects; Resorcinols - therapeutic use; Retinoids; Safety; Salicylates - adverse effects; Salicylates - therapeutic use; Salicylic acid; Salicylic Acid - adverse effects; Salicylic Acid - therapeutic use; Severity of Illness Index; Skin; Skin Pigmentation; Statistical analysis; Treatment Outcome; Young Adult
• ISSN: 0011-9059; 1365-4632; 1365-4632
• DOI: 10.1111/ijd.14948

Objective
Antibiotics and retinoids have been used for acne vulgaris for decades. Though effective, each has its own drawbacks. Chemical peels have been used for treatment of acne vulgaris with inadequate clinical evidence. We sought to determine the efficacy and safety of Jessner’s solution (JS) in comparison with salicylic acid (SA) 30% in the management of acne vulgaris and postacne hyperpigmentation in patients with colored skin.
Methods
A total of 36 subjects (94.5% Fitzpatick Type IV‐V) were recruited in this randomized double‐blinded, split‐face, controlled trial. Each side of the face was randomly assigned for treatment with either JS or SA. Subjects were treated once fortnightly for a total of three sessions. Lesion counting, Michaelsson acne score (MAS), photographs, and postacne hyperpigmentation index (PAHPI) were used to objectively assess the improvement. Complications were assessed during each visit. Statistical analysis was conducted using SPSS v22.0. Significance was set at P = 0.05.
Results
At the end of therapy, significant reduction in inflammatory, noninflammatory lesions, MAS, and PAHPI scores (P < 0.001, respectively) were noted in comparison to baseline. Mixed model analysis revealed no significant outcome difference between the two groups. Patients who reported good and very good outcome were 76.4% (JS) and 85.3% (SA). Burning, stinging sensation, and exfoliation were the common complications reported. Postinflammatory hyperpigmentation was reported only once in the JS arm.
Conclusion
Both JS and SA were equally effective in the treatment of acne vulgaris and reducing postacne hyperpigmentation in patients with colored skin.