A comparison of the efficacy of 50% trichloroacetic acid (TCA) application and dermabrasion in patients with idiopathic guttate hypomelanosis (IGH): a pilot study

Idiopathic guttate hypomelanosis (IGH) is characterized by discrete, multiple, round-to-oval hypopigmented macules of approximately 2-5 mm diameter, especially on the forearms and pretibial area,which increase in number with aging. Recent focus has been on therapeutic wounding, which stimulates melanocytes from the periphery and surrounding hair follicles to proliferate, migrate, and repigment the lesions. This study aimed to evaluate and compare the efficacy of trichloroacetic (TCA) 50% application and dermabrasion in IGH patients. Twenty patients of IGH were enrolled after considering various inclusion and exclusion criteria. IGH lesions over the right side were treated with trichloroacetic acid (TCA) 50% witha cotton-tipped applicator. IGH lesions over the left side were treated with dermabrasion. Of the 153 macules in 20 patients, all 81 macules in the dermabrasion group showed some repigmentation, whereas 7 (9.7%) out of 72 macules treated with 50% TCA Touch™ showedno improvement. At the end of 3 months, repigmentation up to 25%, between 25–50%, and between 51–75% was seen in 18.5%, 66.7%, and 14.8% of lesions treated with dermabrasion, respectively. This is while TCA 50% touch-treated macules showed up to 25% and between 25–50% repigmentation in 48.6% and 41.7% of instances, respectively. The analysis suggested that both dermabrasion and TCA 50% Touch are effective in the treatment of IGH. Dermabrasion proved to be more effective than TCA peel and can be tried before or with the medical line of therapy in the treatment of IGH.