Alpha-hydroxy acid peels

Alpha hydroxy acids peel after microdermabrasion. 

Briden E, Jacobsen E, Johnson C (2(X17) Combining superficial glycolic add (alpha-hydroxy acid) peels with micro-dermabrasion to maximize treatment results and patient satisfaction. Cutis 79(1 Suppl Combining) 13-16... 

But the mainstay of therapy for skin resurfacing continues to be chemical peels together with abrasion [37 2], Chemical peels in use to improve facial scarring include alpha-hydroxy acid peels, trichloroacetic acid, and deep phenol-based methods [43 8], In this chapter, we discuss deep chemical peels for post-acne scars treatment. 

Glycohc acid peels, the prototype of alpha-hydroxy acid peels, are an excellent addition to the chemical peel family. As superficial peeling agents, they lend themselves to the modern day need for short recovery time with results. They are easy to perform in the office and require little in the way of additional office supplies. They are therefore cost effective. Their flexibility of use in not only photoaging skin but in other hallmarks of photodamage make their future use appealing to both physicians and patients alike. 

Figure 15.24 This patient developed perioral dermatitis following a 50% alpha-hydroxy acid peel...

Figure 15.31 A 4-minute application of 35% glycolic add produced vesiculation and exudation on this 22-year-old patient. Young patients are particularly prone to this type of complloatlon in this area following alpha-hydroxy acid peels. Transient hyperpigmentation also occurred...

Salicylic acid is a beta hydroxy acid. Glycolic acid is an alpha hydroxy acid, as are lactic acid, citric acid, and many others. Hydroxy acids are compounds that are both alcohols and acids at the same time. Hydroxy acids are used as chemical peeling agents. Alpha hydroxy acids can make the skin more sensitive to ultraviolet light by removing the skin s protective outer layers. Some alpha hydroxy acids ... 

Finally, glycolic acid is a member of the alpha-hydroxy acid family, which provides an important adjunctive therapy in a variety of skin disorders. It is widely used in chemical peels in a variety of concentrations, ranging from 20 to 70%. People of almost any skin type and color are candidates and almost any area of the body can be peeled. 

Fruit compresses have been applied to the face as beauty aids for millennia. The alpha-hydroxy acids contained in fruit extracts, tartaric acid in grapes, citric acid in citrus fruits, malic acid in apples, mandelic acid in almond blossoms and apricots are thought to be active principles for skin rejuvenation. Such alpha-hydroxy acids do stimulate HA production in cultured dermal fibroblasts (unpubl. exp.). The results of such alkaline preparations may depend more on their peeling effects rather than on the ability of alpha-hydroxy acids to stimulate HA deposition. 

Immediate post-peel care is described in detail in the chapters dealing with each type of peel. As a general rule, tretinoin and creams with an alpha-hydroxy acid (AHA) concentration of over 10% should be avoided before the exfoliation phase is completely finished. 

Another possibility would be one alpha-hydroxy acid (AHA) peel per week for 6-10 weeks or one Easy TCA (pinpoint frosting) per week for 4 weeks. The daily care routine should include DMAE to firm the skin, tyrosinase inhibitors and antioxidants to limit melanin production, ... 

It is essential to clean the skin beforehand with a come-done extractor to limit damage to the skin the skin should be cleaned in this way a week before an alpha-hydroxy acid (AHA) peep or immediately before each of four Easy TCA peels. Removing the comedones helps produce quicker results and prevents post-peel infections. 

Alpha-hydroxy acids application as cosmetics and as peels... 

Complications with alpha-hydroxy acid (AHA) peels are rare, easily avoided, and often spontaneously reversible or treatable by simple topical applications. More details on complications, their origins, prevention and treatment can be found in Chapter 37. 

Easy TCA is a stabilized, homogeneous and adjuvanted solution with a final TCA concentration of 15% m/m, combined with alpha hydroxy acids (AHAs), antioxidants, vitamins and saponins. Unideep is a TCA peel based on the same principles as Easy TCA and reaches the papillary dermis readily and evenly it has a TCA concentration of 23% m/m. The application protocols for these two peels allow all depths to be reached. There is no point using higher concentrations that could cause complications (see Chapter 37). 

Superficial peels with alpha-hydroxy acids (AHAs), on the other hand, are known to cause very few bacterial or viral complications after peeling, as their direct action is limited to breaking up the spaces between corneocytes. Even if the peel penetrates too deeply in places, it is, quite logically, exceedingly rare for an AHA peel to cause complications in the form of infection, when the endpoint is focal or localized frosting. 

---