Abstract
Chemical peels are an effective and time-tested treatment for photoaging, dyschromia, actinic changes, and superficial scarring. Treatment ranges from superficial to deep. The deeper the peel, the more significant the result and the higher the risk and downtime. Standard skin type classification systems including Fitzpatrick and Glogau scales are reviewed. Superficial peels, including Jessner’s solution and 10–20% TCA, can be used to treat epidermal issues without penetrating into the dermis. Medium-depth peels, including 35% TCA, cause injury extending into the papillary dermis and upper reticular dermis. Deep peels, including the Baker-Gordon peel or modified Hetter peels, cause injury into the reticular dermis. While deep peels can result in dramatic skin rejuvenation, the risk profile is increased. Risks include hypo- or hyperpigmentation, cardiac arrhythmias, and prolonged post-peel erythema (PPPE). Standard pre- and post-peel protocols are reviewed as well as management of complications.
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References
Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. 1988;124(6):869–71.
Glogau RG, Matarasso SL. Chemical face peeling: patient and peeling agent selection. Facial Plast Surg. 1995;11(1):1–8.
Clark CP 3rd. Office-based skin care and superficial peels: the scientific rationale. Plast Reconstr Surg. 1999;104(3):854–64.
Kligman D, Kligman AM. Salicylic acid peels for the treatment of photoaging. Dermatol Surg. 1998;24(3):325–8.
Monheit GD. The Jessner’s + TCA peel: a medium-depth chemical peel. J Dermatol Surg Oncol. 1989;15(9):945–50.
Kligman AM, Baker TJ, Gordon HL. Long-term histologic follow-up of phenol face peels. Plast Reconstr Surg. 1985;75(5):652–9.
Hetter GP. An examination of the phenol-croton oil peel: part IV. Face peel results with different concentrations of phenol and croton oil. Plast Reconstr Surg. 2000;105(3):1061–83. discussion 1084-7
Botta SA, Straith RE, Goodwin HH. Cardiac arrhythmias in phenol face peeling: a suggested protocol for prevention. Aesthet Plast Surg. 1988;12(2):115–7.
Maloney BP, Millman B, Monheit G, McCollough EG. The etiology of prolonged erythema after chemical peel. Dermatol Surg. 1998;24(3):337–41.
Fisher GJ, Datta SC, Talwar HS, Wang ZQ, Varani J, Kang S, Voorhees JJ. Molecular basis of sun-induced premature skin ageing and retinoid antagonism. Nature. 1996;379(6563):335–9.
Weiss JS, Ellis CN, Headington JT, Tincoff T, Hamilton TA, Voorhees JJ. Topical tretinoin improves photoaged skin. A double-blind vehicle-controlled study. JAMA. 1988;259(4):527–32.
Kang S, Fisher GJ, Voorhees JJ. Photoaging and topical tretinoin: therapy, pathogenesis, and prevention. Arch Dermatol. 1997;133(10):1280–4.
Additional Resources
Been MJ, Harmych BM, Mangat DS. Dermabrasion, chemical peels, and dermaceuticals. In: Ira D, editor. Papel’s facial plastic and reconstructive surgery. 4th ed. New York: Thieme; 2016.
Fedok FG, Paul J. Carniol’s minimally invasive and office-based procedures in facial plastic surgery. New York: Thieme; 2014.
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Lieberman, D.M., Roy, S. (2021). Chemical Peels. In: Wong, B.JF., Arnold, M.G., Boeckmann, J.O. (eds) Facial Plastic and Reconstructive Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-45920-8_20
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DOI: https://doi.org/10.1007/978-3-030-45920-8_20
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