Comparative study of efficacy and safety of 45% mandelic acid versus 30% salicylic acid peels in mild-to-moderate acne vulgaris

Background Chemical peels have become a popular modality in the treatment of acne vulgaris (AV). Mandelic acid (MA) is a new emerging peeling agent for AV owing to its antibacterial and anti-inflammatory properties. Hence, it is worthwhile to evaluate the effectiveness and safety profile of this newer agent and to compare it with an older established peeling agent, salicylic acid (SA) in the treatment of AV. Objective Comparison between therapeutic efficacy and safety of 45% MA peel with 30% SA peel in Indian patients suffering from mild-to-moderate facial AV. Methods A total of 50 patients suffering from mild-to-moderate AV were randomly divided into two groups, with one receiving 30% SA peels and the other receiving 45% MA peels at an interval of 2 weeks for six sessions. Total duration of the study was 12 weeks. Michaelsson acne scores (MAS) and clinical photographs were used to evaluate the efficacy of therapy objectively. Adverse effects of both the agents were also noted at each visit. Results Both agents showed almost equal efficacy in improving mild-to-moderate AV. Salicylic acid was found better in treating noninflammatory lesions, while MA had an upper hand in treating inflammatory lesions. Overall, there was no significant difference between the two peels in improving MAS and percentage decrease in MAS. However, adverse effects were lesser with MA peels. Conclusion About 45% MA peel was found to be equally effective as 30% SA peel in mild-to-moderate facial AV. However, safety and tolerability of MA peel were better than SA peel.