Chemical peels peeling technique

Herbig K, Trussler AP, Khosla RK, Rohrich RJ 2009 Combination Jessner s solution and trichloroacetic acid chemical peel technique and outcomes. Plastic and Reconstructive Surgery 124 955-964... 

The full description of the deep chemical peel procedure is found in Chapter 8. Before the peeling, the subcision (subcutaneous incision) technique is used to free the fibrous bands from the base of the scars. For this purpose we use an i8-gauge 1.5-inch NoKor Admix needle (Becton Dickinson and Co). This needle has a triangular tip similar to No. 11 blade (Fig. 9.5). it allows smooth separation of fibrous cords. The needle is inserted through a skin surface, and its sharp edges are maneuvered under the defect to make subcutaneous cuts or incisions. The depression... 

Fulton JE, Porumb S (2004) Chemical peels their place within the range of resurfacing techniques. Am J Clin Dermatol 5 179-187... 

The book provides information about each single chemical peel, fully explained in terms of its properties, formulations, indications, performing technique, advantages and disadvantages. 

At the other end of the scale, what is the minimum age for having a chemical peel The answer is simple in the majority of cases, a peel is only necessary for young patients if they have acne. Acne responds extremely well to intraepidermal peels or peels to the basal layer of the epidermis. Deeper peels are not recommended when the skin is infected. Very young patients benefit from relatively superficial techniques... 

Facial acne scars are difficult to treat, sometimes even with phenol. Acne scars on the back, decoUetage or face can fade or improve with a combined technique of chemical peeling and dermabrasion. It is still difficult, however, to get rid of them completely. 

Other authors have suggested using a combined technique of chemical peeling and dermabrasion, but always in the order of a peel followed by dermabrasion. This technique is known as chemabrasion . We could use the term post-chemabrasion for a peel followed by dermabrasion, and pre-chemabrasion , the technique described in this chapter, for dermabrasion followed by a peel, in order to distinguish between the two techniques. 

Side effects, such as temporary hyperpigmentation or irritation, are not very significant. 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. Glycolic acid can be applied simultaneously with TCA, which represents another technique for a... 

Despite some general predictable outcomes, even superficial chemical peeling procedures can cause hyperpigmentation and undesired results. Popular standard salicylic acid peeling techniques involve the use of 20% and 30% salicylic acid in an ethanol formulation. Salicylic acid peels are performed at 2-4 week intervals. Maximal results are achieved with a series of 3-6 peels. 

As with any other chemical peeling procedure, the art and science of TCA chemical peels is dependent on the proper peeUng technique. TCA is a versatile peeling agent, and depending on its concentration can be used... 

TCA is the most versatile of all the peehng agents and can be effectively used to perform superficial to medium-depth chemical peels in the treatment of a variety conditions ranging from pigmentary dyschromias to moderate photoaging. A proper understanding of the correct techniques, indications, limitations, and complications is... 

It is the most compact, and perhaps the only doctor s brand to consist of just one product. It is a basic skin-care product in the form of a bi-phase exfoliant that was inspired by techniques of esthetic dermatology (miCTodermabrasion and chemical peel) with integrated preliminary hydration. 

A number of small studies have indicated that the amelioration of more severe acne scars, moderately deep rhytides, and the effects of photoaging, which are often recalcitrant to standard treatment regimens, can be improved by combining microdermabrasion and super-hcial chemical peels in one treatment session. While more published data to support the use of this combined technique would be welcome, the data that are available indicate that it is highly effective, well tolerated, and more convenient for patients. 

Monheit GD, Kayal JD (2003) Chemical peeling. In Nouri K, Leal-Khouri S (eds) Techniques in dermatologic surgery. Mosby, Philadelphia... 

Superficial peels are usually safe and well tolerated, with such undesirable effects as burning, irritation, and erythema [281]. With superficial peels, scarring and infection are rare. With medium and deep peels, demarcation lines (technique-related) may occur [281]. Deeper peels may have adverse effects of postinflammatory hyperpigmentation (PIH in dark-skinned individuals), infections, allergic reactions, improper healing, disease exacerbation, and complications secondary to improper application [281]. Chemical injuries may occur when glacial acetic acid is not properly used for chemical peeling [341]. 

The following definition of chemical peels found in the literature has been chosen and adapted by the authors for the purposes of this chapter. A chemical peel is a treatment technique used to improve and smooth the facial and/or body skin s texture using a chemical solution that causes the dead skin to slough off and eventually peel off. The regenerated skin is usually smoother and less wrinkled than the old skin. 

Since certain TCA peel modifications speed up TCA penetration, physicians less experienced with TCA peels are encouraged to start with relatively slower peeling techniques. Anatomic variations in skin thickness must also be considered when performing chemical peels to achieve uniform depth and to avoid complications from peeling too deeply in areas of thinner skin. 

Brody HJ 1995 Trichloracetic acid application in chemical peeling operative techniques. Plastic and Reconstructive Surgery 2[2) 127-128... 

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