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Original Research | Dermatology | Volume 15 Issue 6, June 2026 | Pages: 1067 - 1072 | India
Efficacy of 15% Trichloroacetic Acid Peel versus 35% Glycolic Acid Peel in Acanthosis Nigricans - At a Tertiary Care Center in Central Karnataka
Abstract: Background: Acanthosis nigricans (AN) is a chronic dermatosis characterized by hyperpigmented, velvety thickening of the skin, commonly affecting intertriginous areas such as the neck, axillae, and groin. It is frequently associated with obesity, insulin resistance, diabetes mellitus, and metabolic syndrome. Various treatment modalities have been explored, including topical agents and chemical peels. However, comparative data on the efficacy of trichloroacetic acid (TCA) and glycolic acid (GA) peels remain limited. Objective: To compare the efficacy and safety of 15% trichloroacetic acid (TCA) peel versus 35% glycolic acid (GA) peel in reducing hyperpigmentation, skin thickness, and lesion extent in patients with acanthosis nigricans. Methods: A randomized comparative therapeutic study was conducted at the Department of Dermatology, Bapuji Hospital and Chigateri General Hospital, Davangere, from October 2025 to March 2026. A total of 40 adult patients (aged ≥18 years) with a clinical diagnosis of AN affecting the face, neck, or elbows were enrolled and randomly assigned to two groups: Group A received 15% TCA peel (n=20) and Group B received 35% GA peel (n=20). Three peeling sessions were performed at two-week intervals, followed by two weeks of additional follow-up. Efficacy was assessed using the Acanthosis Nigricans Area and Severity Index (ANASI) score at baseline and each session, Physician Assessment Score (PAS), and Patient Satisfaction Score (PSS). Safety was evaluated by recording adverse effects after each session. Statistical analysis was performed using SPSS version 27.0, with p<0.05 considered statistically significant. Results: Both groups showed a significant reduction in ANASI scores over time (TCA: from 13.35±2.78 to 7.95±3.43; GA: from 14.15±2.80 to 8.10±4.06; repeated measures ANOVA: p<0.001 for both groups, partial ??=0.927 and 0.921, respectively). No statistically significant difference was observed between the two groups at any follow-up visit (p>0.05 for all time points). The mean percentage improvement was 42.48±16.21% in the TCA group and 44.81±21.48% in the GA group (p=0.701). Median patient satisfaction scores were 3 and 4, respectively (p=0.491). The most common adverse effects were dryness (25.0% vs. 20.0%) and erythema with burning (20.0% vs. 30.0%). Post-inflammatory hyperpigmentation occurred in 10.0% of each group. No serious adverse events were reported. The overall distribution of adverse effects did not differ significantly between the groups (p=0.991). Conclusion: Both 15% trichloroacetic acid peel and 35% glycolic acid peel are effective and safe treatment options for acanthosis nigricans, producing significant and comparable improvement in ANASI scores, patient satisfaction, and clinical appearance of lesions with minimal adverse effects. The choice between the two agents may be guided by clinician experience, patient tolerance, and availability.
Keywords: Acanthosis nigricans, chemical peel, trichloroacetic acid, glycolic acid, ANASI score
How to Cite?: Dr. Ashwini K Ajjewadermath, Dr. Mangala H. C, Dr. Sugareddy, "Efficacy of 15% Trichloroacetic Acid Peel versus 35% Glycolic Acid Peel in Acanthosis Nigricans - At a Tertiary Care Center in Central Karnataka", Volume 15 Issue 6, June 2026, International Journal of Science and Research (IJSR), Pages: 1067-1072, https://www.ijsr.net/getabstract.php?paperid=SR26619190729, DOI: https://dx.doi.org/10.21275/SR26619190729