Chemical peeling with trichloroacetic acid and lactic acid for infraorbital dark circles.

BACKGROUND: Periorbital dark circles are relatively common, affecting individuals regardless of age, sex, and race. Available treatment includes bleaching creams, topical retinoid acid, chemical peels, laser therapy, autologous fat transplantation - injectable fillers, surgery (blepharoplasty), and chemical peeling.

OBJECTIVE: To evaluate the efficacy of a combination of trichloroacetic TCA 3.75% and lactic acid 15% on improving the periorbital hyperpigmentation.

PATIENTS/METHODS: Thirty patients with periorbital dark circles and skin types II, III, or IV were included in the study. Chemical peeling was performed every week for a series of four treatments. The effect was photo-documented, and a patient's and physician's global assessment was evaluated.

RESULTS: Almost all the patients showed significant esthetic improvement. Physicians assessed a fair, good, or excellent improvement in 93.3% of the patients. Patient's global assessment rated a fair, good, or excellent response in 96.7% of the patients. The procedure itself had only mild and temporary adverse effects, such as erythema, edema, frosting, dryness, and telangiectasias. The effects of treatment remained for at least 4-6 months in the majority of patients with appropriate sun protection.

CONCLUSION: The combination of trichloroacetic TCA 3.75% and lactic acid 15% showed encouraging results on improving periorbital hyperpigmentation.