Advances in the Application of Chemical Peels in the Treatment of Pigmentary Skin Disorders

BACKGROUNDPigmentary disorders, including melasma, postinflammatory hyperpigmentation (PIH), solar lentigines, Riehl's melanosis, and periorbital hyperpigmentation, are common concerns in cosmetic dermatology, particularly in patients with skin of color. Chemical peels remain widely used due to their accessibility, flexibility, and compatibility with combination therapies.

AIMSTo summarize current clinical evidence on chemical peels for common pigmentary skin disorders and highlight practical considerations for cosmetic dermatology.

METHODSPubMed and citation tracking were used to identify representative English-language studies and reviews published up to January 2026. Emphasis was placed on randomized trials, split-face studies, prospective cohorts, case series, and recent reviews addressing peel agents, protocols, efficacy, and safety.

RESULTSSuperficial glycolic acid is supported by the strongest evidence, especially for melasma, where it performs best as an adjunct to photoprotection and depigmenting therapy. Salicylic acid is particularly useful for acne-prone patients and PIH because of its keratolytic and anti-inflammatory properties. Trichloroacetic acid can be effective for selected localized lesions and some melasma protocols but has a narrower safety margin in darker phototypes. Evidence for Jessner's solution, lactic acid, retinoid peels, and peels used for Riehl's melanosis, solar lentigines, and periorbital hyperpigmentation is encouraging but less standardized. Across disorders, outcomes depend on cautious depth selection, priming, interval control, and maintenance therapy.

CONCLUSIONSChemical peels are best used as individualized adjuncts rather than stand-alone treatments for pigmentary disease. In routine cosmetic practice, superficial glycolic acid and salicylic acid peels offer the most consistent balance of efficacy, tolerability, and versatility.

Abstract from Crossref