Bismuth subgalate powder

Fig. 8.11. a Fifty-two-year-old patient with wrinkles and solar lentigines before the peel, b First day after the peel. The face is covered by bismuth subgalate powder... 

Bismuth subgallate powder mask end of making the mask. Note that the peri ophthalmic area is covered with petrolatum jelly. 

Eye protection before sprinkling the bismuth subgallate powder on the skin. 

The bismuth subgallate powder comes away from the skin automatically (figure 36.14) with the Vaseline that prevents transepidermal water loss (TEWL) evaporation. The downtime is 8-10 days maximum. 

Protective mask of bismuth subgallate powder after treatment of wrinkles on the upper lip with Lip Eyelid formula. 

Deep peels are not typically performed in Fitzpatrick skin types IV-VI, but can be done successfully by experienced physicians. Rullan Karam found deep peels to be particularly effective for the treatment of challenging acne scars. These require taping the face for 24 hours, removal, debridement of the coagulum, and application of a bismuth subgallate powder mask. This mask is left in place for about 7 days and then is carefully removed. The vast majority (99%) of patients are over 95% reepithehalized by the 8 day following the peel. 

After the tape mask removal the exudate is cleaned by sterile saline. Spot peeling and retaping may be done if the skin looks underpeeled, particularly in areas with severe wrinkling. It is usually accompanied by a short-duration burning sensation. The tape is left for an additional 4-6 h and then removed by the patient. We cover the face with bismuth subgalate antiseptic powder for 7 days (Fig. 8.10). Other options include occlusive moisturizers, antibiotic ointments, and biosynthetic occlusive dressings such as Meshed Omiderm. 

Bismuth subgallate [12552-60-2] (basic bismuth gallate), Dermatol, is a bright yellow powder that can be prepared by the interaction of bismuth nitrate and gallic acid in an acetic acid medium. It has been employed as a dusting powder in some skin disorders and as an ingredient of suppositories for the treatment of hemorrhoids (183,185). It has been taken orally for many years by colostomy patients in order to control fecal odors, but the dmg may cause serious neurological problems (186). 

The sandpaper abrasion kit consists of 10 sheets of singleuse sandpaper (3M Wet-or-Dry P220) sterilized with gamma rays and a yellow disinfecting and healing powder bismuth subgallate. 

Bismuth subgallate (BSG) is a yellow powder that makes post-peel care easier and spares patients having to apply complicated localized treatments themselves, which could cause infection (see also Chapter 34). A generous amount of BSG is sprinkled directly onto the moist areas of skin where the epidermis has been destroyed, ft can also be spread on with a gloved hand or sterile swab. 

Any excess liquid is mopped up with sterile gauze, although the skin is not dried completely. Some liquid is needed for the bismuth subgallate (BSG) powder to stick. 

Bismuth subgallate comes in two formats the Lip Eye-Kd kit contains 12 separate sachets for deep localized peels (Figure 35.11a). A large bottle is also available (Figure 35.11b) that allows for easy application by sprinkling the powder directly on the skin. An assistant should gently compact the powder with sterile gauze. 

The eyes are protected before powdering with bismuth subgallate. 

The bismuth subgallate mask should not be too thick. Too much powder makes the mask rigid, which is unpleasant for the patient and is sometimes difficult to remove later. 

It is difficult to diagnose and impossible to monitor herpes outbreaks, large or small, beneath an opaque occlusive mask of bismuth subgallate or thymol iodide. If there is any hint of herpes, any acute pain between the 4th and 7th day after the phenol, the powder mask" should be removed immediately in order to examine the skin thoroughly. If the doctor s suspicions are confirmed, the herpes should be treated as described above. Once the diagnosis has been made, the powder mask should not be replaced, and the moist technique should be used instead, with regular application of an antibiotic cream (e.g. bacitracin) to avoid secondary bacterial infection. 

Bismuth subgallate or thymol iodide powder mask (see Chapter 35). 

Fig. 6.11 (a) Tape mask removal after 24 h (b) Spot re-peeling and re-taping is performed of needed (c) Face is covered by bismuth subgalate antiseptic powder... 

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