Actinic keratoses chemical peels

Epidermal growths such as actinic keratosis, lentigines or thin seborrheic keratoses can all be treated effectively with 25-35% TCA peels. Thicker epidermal growths or growths involving the dermis will be more resistant to treatment such as hypertrophic actinic keratoses and thicker seborrheic keratoses and may even be resistant to a medium-depth peel. Resistant lesions many times are best treated with a combination of a medium-depth chemical peel and other modalities such as manual dermasanding or CO, laser. 

The treatment of actinic keratoses, like photoaging, is a common indication for chemical peels (Figure 13.14). The chemical elimination of actinic keratoses reduces the incidence of basocellular and/or spinocellular cancers. ... 

Light chemical peels include 20-35% TCA, 70% glycolic acid, and Jessner s solution (resorcinol, salicylic acid, lactic acid, and ethanol) and penetrate the entire epidermis. These peels are more effective than the very light peels for the treatment of actinic keratoses, solar lentigenes, and epidermal growths such as thin seborrheic keratoses. Skin texture may also be improved. Erythema and scaling will occur postoperatively however healing time is faster if... 

Figure 14.8 Medium depth chemical peel for treatment ot diffuse actinic keratoses and photoaging. Jessners + 35% TCA was used as a single treatment with healing in 8 days. (A) Preopeiative the white spots represent prior cryosurgical treatment (B) frosting after TCA - skip areas need retreatment as these represent thicker growths of stratum comeum (C) postoperative - 1 month...

---