Chemical peels

Chemical peels have only been investigated for AK.

Quality of evidence: II-I

We found no systematic reviews or RCTs. We found two comparative studies53,54 (with one follow up study55) using trichloroacetic acid (TCA). Pretreatments included topical tretinoin (0-05%, increasing to 0-1%) for the first study,53 and Jessner's solution for the second study.54,55 The concentrations of TCA varied from 35% to 40%.

The first study53 was reportedly randomised. However, all patients pretreated with tretinoin previously received topical therapies in addition to cryotherapy, whereas all patients without tretinoin pretreatment previously received only cryotherapy. This study reported a 6-month follow up. In the second study, a split-face design was used. One side of the face received a TCA chemical peel after pretreatment with Jessner's solution, and the other side received 5% topical 5-FU twice daily for 3 weeks. Despite a small sample size, follow up was reported at 12 months54 and 32 months.55

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