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 4-6months 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.