Erbağci Z, Akçali C
Department of Dermatology, Faculty of Medicine, Gaziantep University, Turkey.
Int J Dermatol. 2000 Oct;39(10):789-94. doi: 10.1046/j.1365-4362.2000.00076.x.
Treatment of atrophic acne scars is difficult and generally unsatisfactory. Although many clinical studies have been performed to investigate the efficacy of glycolic acid in the treatment of acne vulgaris, to the best of our knowledge no placebo-controlled study has been carried out to ascertain the effect of glycolic acid on atrophic postacne scars.
A single, blind, placebo-controlled, randomized comparative clinical study was conducted in 58 women with atrophic acne scars. The subjects were randomly divided into three study groups. Glycolic acid peels with 20%, 35%, 50%, and 70% concentrations were applied serially at 2-week intervals to 23 patients in Group A. Twenty patients in Group B used a 15% glycolic acid cream once or twice daily for a period of 24 weeks. The remaining 15 patients in Group C applied a placebo cream twice daily during the same period.
The differences between the results in the different groups were statistically significant at week 24 (P<0.001). Home application of low-strength glycolic acid was better tolerated and had less side-effects than glycolic acid peels; however, repeated short-contact 70% glycolic acid peels provided superior results compared with the maintenance regimen (P<0.05), and apparently good responses were observed only in the peel group (P<0.01).
Glycolic acid peeling is an effective modality for the treatment of atrophic acne scars, but repetitive peels (at least six times) with 70% concentration are necessary to obtain evident improvement. Long-term daily use of low-strength products may also have some useful effects on scars and may be recommended for patients who cannot tolerate the peeling procedure.
萎缩性痤疮瘢痕的治疗困难且总体效果不尽人意。尽管已开展了许多临床研究来探究乙醇酸治疗寻常痤疮的疗效，但据我们所知，尚无安慰剂对照研究来确定乙醇酸对萎缩性痤疮后瘢痕的影响。
对58名患有萎缩性痤疮瘢痕的女性进行了一项单盲、安慰剂对照、随机比较临床研究。受试者被随机分为三个研究组。A组的23名患者每隔2周依次接受浓度为20%、35%、50%和70%的乙醇酸焕肤治疗。B组的20名患者每天使用一次或两次15%的乙醇酸乳膏，持续24周。C组的其余15名患者在同一时期每天使用两次安慰剂乳膏。
在第24周时，不同组的结果差异具有统计学意义（P<0.001）。与乙醇酸焕肤相比，在家中使用低浓度乙醇酸的耐受性更好且副作用更少；然而，与维持治疗方案相比，重复短时间接触70%的乙醇酸焕肤效果更佳（P<0.05），且仅在焕肤组观察到明显良好的反应（P<0.01）。
乙醇酸焕肤是治疗萎缩性痤疮瘢痕的有效方式，但需要使用70%浓度重复焕肤（至少六次）才能获得明显改善。长期每日使用低浓度产品可能对瘢痕也有一些有益效果，对于无法耐受焕肤 procedure 的患者可推荐使用。 （注：原文中“procedure”未翻译完整，推测可能是“治疗程序”之类的意思，需结合完整原文语境准确理解）
