Chemical peel

Jump to navigation Jump to search

WikiDoc Resources for Chemical peel

Articles

Most recent articles on Chemical peel

Most cited articles on Chemical peel

Review articles on Chemical peel

Articles on Chemical peel in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Chemical peel

Images of Chemical peel

Photos of Chemical peel

Podcasts & MP3s on Chemical peel

Videos on Chemical peel

Evidence Based Medicine

Cochrane Collaboration on Chemical peel

Bandolier on Chemical peel

TRIP on Chemical peel

Clinical Trials

Ongoing Trials on Chemical peel at Clinical Trials.gov

Trial results on Chemical peel

Clinical Trials on Chemical peel at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Chemical peel

NICE Guidance on Chemical peel

NHS PRODIGY Guidance

FDA on Chemical peel

CDC on Chemical peel

Books

Books on Chemical peel

News

Chemical peel in the news

Be alerted to news on Chemical peel

News trends on Chemical peel

Commentary

Blogs on Chemical peel

Definitions

Definitions of Chemical peel

Patient Resources / Community

Patient resources on Chemical peel

Discussion groups on Chemical peel

Patient Handouts on Chemical peel

Directions to Hospitals Treating Chemical peel

Risk calculators and risk factors for Chemical peel

Healthcare Provider Resources

Symptoms of Chemical peel

Causes & Risk Factors for Chemical peel

Diagnostic studies for Chemical peel

Treatment of Chemical peel

Continuing Medical Education (CME)

CME Programs on Chemical peel

International

Chemical peel en Espanol

Chemical peel en Francais

Business

Chemical peel in the Marketplace

Patents on Chemical peel

Experimental / Informatics

List of terms related to Chemical peel

Editors-In-Chief: Martin I. Newman, M.D., FACS, Cleveland Clinic Florida, [1]; Michel C. Samson, M.D., FRCSC, FACS [2]


Overview

A chemical peel is a body treatment technique used to improve and smooth the texture of the facial skin using a chemical solution that causes the skin to blister and eventually peel off. The regenerated skin is usually smoother and less wrinkled than the old skin. Thus the term chemical peel is derived. Some types of chemical peels can be purchased and administered without a medical license, however people are advised to seek professional help from a plastic surgeon or dermatologist on a specific type of chemical peel before a procedure is performed.

Types

There are several types of chemical peels.

Alpha hydroxy acid peels

Alpha hydroxy acids (AHAs) are naturally occurring organic carboxylic acids such as glycolic acid, a natural constituent of sugar cane juice and lactic acid, found in sour milk and tomato juice. This is the mildest of the peel formulas and produces light peels for treatment of fine wrinkles, areas of dryness, uneven pigmentation and acne. Alpha hydroxy acids can also be mixed with a facial wash or cream in lesser concentrations as part of a daily skin-care regimen to improve the skin's texture.

AHA peels are used to:

  • reduce fine wrinkling
  • treat areas of dryness
  • reduce uneven pigmentation
  • aid in the control of acne
  • smooth rough dry skin
  • improve the texture of sun-damaged skin

AHA peels may:

  • cause stinging
  • cause skin redness
  • cause mild skin irritation
  • cause dryness
  • take multiple treatments for desired results

Beta hydroxy acid peels

It is becoming common for the use of Beta Hydroxy Acid(BHA) peels to be used instead of the stronger Alpha Hyroxy(AHA)peels due to BHA's albility to get deeper into the pore than AHA. Studies show that BHA peels control oil, acne as well as remove dead skin cells to a certain extent better than AHA's, due to AHA's only working on the surface of the skin.

Jessner's peel

Jessner's peel is a combination of salicylic and lactic acids, and resorcinol. It is thought to break intracellular bridges between keratinocytes.

Retinoic acid peel

Trichloroacetic acid peels

Trichloroacetic acid (TCA) is used as an intermediate to deep peeling agent in concentrations ranging from 20-50%. Depth of penetration is increased as concentration increases, with 50% TCA penetrating into the reticular dermis. Concentrations higher than 35% are not recommended because of the high risk of scarring.

Trichloroacetic acid peels:

  • are referred for darker-skinned patients over Phenol
  • smooth out fine surface wrinkles
  • remove superficial blemishes
  • correct skin pigment problems

Trichloroacetic acid peels may:

  • require pre-treatment with Retin-A or AHA creams
  • require repeat treatment to maintain results
  • require the use of sunblock for several months (this is a must)
  • take several days to heal depending on the peel depth

Phenol peels

Phenol is the strongest of the chemical solutions and produces a deep skin peel. Recent studies suggest that phenol is most likely only the carrier for another active component in the solution, namely croton oil. In fact, phenol alone produces only a light peel which is ineffective for restructuring the deeper dermal structures (such as wrinkles). The term Phenol/Croton oil peel has been proposed as a more accurate descriptor, but the established terminology phenol peel continues to be the dominant usage, as the role of croton oil in the mix is not as widely understood.

Effects of a phenol chemical peel are long lasting, and in some cases are still readily apparent up to 20 years following the procedure. Improvements in the patient’s skin can be quite dramatic. A single treatment usually achieves the desired result.

Phenol peels are used to:

  • correct blotches caused by sun exposure or aging
  • smooth out coarse deep wrinkles
  • remove precancerous growths

Phenol peels may:

  • pose a risk for patients with heart problems
  • permanently remove facial freckles
  • cause permanent skin lightening by reducing the ability to produce pigment
  • take several months to heal
  • require increased protection from the sun for life

Anesthesia

Light chemical peels like AHA and glycolic acid peels are usually done in dermatologists’ offices. There is minimal discomfort so usually no anesthetic is given because the patient feels only a slight stinging when the solution is applied. If a patient were to request something for pain, an oral pain pill like Tylenol with codeine would be appropriate.[1]

Medium peels like TCA are also performed in the doctor’s office or in an ambulatory surgery center as an outpatient procedure and are a bit more painful. Frequently, the combination of a tranquilizer like Valium and a pain pill usually suffice. TCA peels often do not require anesthesia because the solution itself has a numbing effect on the skin. The patient usually feels a warm or burning sensation.[2]

Phenol is the classic deep chemical peel. The application is very painful and most practitioners will perform it under either general anesthesia, administered by an MD-anesthesiologist or nurse anesthetist. Less often, the procedure is done using very heavy sedation, usually intravenous or intramuscular. But that approach is less desirable for several reasons including possible adverse influences of the phenol upon the heart.[3]

References:

  1. Demas PN, Bridenstine JB, Braun TW: Pharmacology of agents used in the management of patients having skin resurfacing. J Oral Maxillofac Surg 1997 Nov; 55(11): 1255-8.
  2. Halaas YP: Medium depth peels. Facial Plas Surg Clin North Am 2004 Aug; 12(3):297-303
  3. Resnick SS, Resnik Bl: Complications of chemical peeling. Dermatol Clin 1995 Apr; 13(2):309-12

External links:

Cleft lip and palate Microchapters

Home

Patient Information

Overview

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Treatment

Surgery

Psychosocial Issues

Primary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Chemical peel On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Chemical peel

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Chemical peel

CDC on Chemical peel

Chemical peel in the news

Blogs on Chemical peel

Directions to Hospitals Treating Cleft lip and palate

Risk calculators and risk factors for Chemical peel

Template:WikiDoc Sources