No significant difference was observed for pretreatment with topical tretinoin before 40% TCA: AK was reduced by 20-75% in both groups. They used a reduction in the appearance of lesions, which was not necessarily a reduction in number of lesions. Scores for photodamage decreased, and telangiectasias improved with tretinoin pretreatment. Jessner's solution followed by TCA did not differ significantly from topical 5-FU: both yielded a 75% reduction in number of lesions that persisted for 12 months. Analysis of eight patients at 32-month follow up showed three (37%) had more lesions than at baseline, but that three patients maintained a 50% reduction from baseline.
Patients were extremely pleased with the cosmetic results of TCA facial peels, and scored improvement significantly higher than did the clinicians. Patients preferred the facial peel to 5-FU because of the convenient single application and the shorter duration of adverse effects.
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