Chemical Peel Journal Reviews
Chemical Peels for Melasma in Dark-Skinned Patients
Melasma is an acquired disorder of hyperpigmentation characterized by blotchy brown patches on the face. Risk factors include sun exposure, genetic predisposition, and pregnancy. Chemical peels are an effective treatment option. However, people with darker pigmented skin are especially difficult to treat with chemical peels due to elevated risk of post-inflammatory hyperpigmentation. Priming or preparing the skin for 2 weeks prior to the peel, with an agent such as hydroquinone or tretinoin, can be a helpful technique for ensuring uniform penetration of the peeling agent and enhancing the efficacy of the peel. Read the full article here: Chemical Peels for Melasma in Dark-Skinned Patients
Assessing the safety of superficial chemical peels in darker skin: A retrospective study
Chemical peeling is a resurfacing procedure that utilizes chemical exfoliating agents to produce controlled skin injury, and subsequent regrowth of the skin. It can be utilized for a variety of skin conditions. There has been limited data available about the side effects of chemical peels in patients with darker skin. However, this relatively large retrospective study showed that when performed in an appropriate manner, superficial chemical peels have a low complication rate (3.8%) in those with darker skin. Read the full article here: Assessing the safety of superficial peels in darker skin: A retrospective study
Basic chemical peeling: Superficial and medium-depth peels
Superficial and medium depth chemical peels are used to treat a variety of conditions including acne, acne scarring, actinic keratosis (pre-cancerous skin lesion), skin pigment abnormalities like melasma, and signs of aging like fine wrinkles. Superficial peels penetrate the top layer of the skin, the epidermis, and include tretinoin, salicylic acid, trichloroacetic acid (TCA), Jessner solution, glycolic acid, and pyruvic acid. Medium depth chemical peels penetrate the next layer of the skin, the papillary dermis. Medium peels typically include pretreatment with either dry ice, glycolic acid, or Jessner solution to remove the top layer of the skin followed by application of 35% TCA. Medium depth peels penetrate deeper, so they are associated with more significant results of improving sun damaged skin, but because of their greater potency, they can also result in more complications. The most common adverse effects after medium depth chemical peels are prolonged redness, scarring, lighter or darker in skin color in treated areas (hyper or hypopigmentation), and skin infection. These results are minimal with superficial peels. Patients preparing for superficial/medium chemical peels may be given a topical medication ahead of time like tretinoin or hydroquinone to improve results. After chemical peels, it is important for patients to protect themselves from sun with sunscreen, keep the skin moist with emollients, and monitor for signs of infection. Those patients with a history of herpes simplex virus should be placed on preventative medications to decrease the risk of an outbreak occurring after the peel. Read the full article here: Basic chemical peeling - Superficial and medium depth peels
Advanced chemical peels: Phenol-croton oil peel
The deep chemical peel has been in use for over 100 years by plastic surgeons and aestheticians. It is appropriate for individuals with very wrinkled skin or pre-malignant skin lesions. It is only for fair to lighter skin types as complications are far more likely with darker skin types. The deep chemical peel consists of phenol and croton oil (plant derivative) which causes a controlled chemical destruction of the superficial (epidermis) and deeper layers of skin (dermis) followed by deposition of new, rejuvenated skin and collagen. The croton oil concentration can be modified to treat different depths of wrinkles such as those around the eyes and mouth. The post-operative care involved application of topical ointment several times a day and close follow-up with your doctor. The acute healing process lasts two weeks and will initially involve impressive facial swelling. Much of the treated skin may slough in the days following application. The skin will remain red for up to 3 months or longer and is actually indicative of an excellent effect. Following the prolonged period or reddened, healing skin the final result will be youthful, healthy, lighter skin.
Deep Chemical peels must be performed in an operating room setting with IV access and cardiac monitoring due to the potency of the substances in the peel. The procedure will typically last for 60-90 minutes depending on the amount of skin treated. Medicated tape or ointment is placed over the treated skin immediately following the procedure. Your physician may place you on antiviral or antibiotic medications before and after the procedure. Individuals with oily skin are often treated with topical retinoids in the weeks leading up to the procedure. The main long-term risks of the procedure are scarring and excessive skin lightening. The results in the appropriately selected patient can be dramatic and are well known to last for 15-20 years. Read the full article here: Advanced chemical peels: Phenol-croton oil peel