Association of Trichloroacetic Acid Peeling with Photobiomodulation in the Treatment of Photoaging of the Hands: A Randomized, Controlled, Double-Blind Clinical Trial

Abstract

Aims: To compare the photorejuvenating effects of 20% trichloroacetic acid (TCA) peeling applied alone and the effects of associating 20% TCA peeling with red LED photobiomodulation (PBM) on the treatment of the back of the hands (660 nm; 100 mW; 5 J/cm²) Study Design:  Randomized, controlled, double-blind clinical trial. Place and Duration of Study: Department of Medicine-Biophotonic, Universidade Nove de Julho, Campus Vergueiro, São Paulo, Brazil, between July 2020 and September 2021. Methodology: Forty-four participants were randomized into two groups. The experimental group underwent three sessions of 20% TCA peeling combined with PBM, while the control group received three sessions of 20% TCA peeling with simulated PBM. Treatments were administered monthly, with evaluations conducted biweekly. Assessment of photoaging characteristics, including fine and deep wrinkles, dyschromia, and global appearance, was performed using standardized photographs analyzed by two independent plastic surgeons. Pain and participant satisfaction were assessed using a visual analog scale and a 5-point Likert scale. Results: After three sessions, the experimental group demonstrated significant improvement in fine wrinkles, deep wrinkles, and pain levels, as well as in dyschromia and global assessment after two sessions. Both groups showed high satisfaction. Conclusion: This study supports the beneficial role of PBM as an adjunct to 20% TCA peeling in hand photoaging treatment.