Only Touch erythema

Effective neutralization as soon as erythema appears. Author s note The comparison was made using Only Touch peel combined with Easy TCA. ... 

Normal erythema after Only Touch and Easy TCA for lentigines (a) before (b) 2 weeks after treatment. 

Local erythema is inevitable after a peel to the reticular dermis. Pulling off scabs must be avoided at aU costs. Only Touch can be combined with Easy TCA to reduce erythema and hyperpigmentation. The maximum frequency for repeating the peel is when the erythema has completely disappeared. Effective sun protection is essential. 

Applying Only Touch peel too deeply can cause prolonged punctiform erythema that has a strong tendency to cause hyperpigmentation when exposed to daylight. The contact time between the applicator and the skin must be brief - the equivalent of the contact time between the fingers and a phone keypad (Figure 37.30). 

If an application of Only Touch is followed by prolonged, punctiform erythema, treatment consists in avoiding pulling off the small scabs, effective sun protection of the whole face and sun avoidance, applying a cortisone cream locally, applying an antioxidant cream and tyrosinase-inhibitors on the whole face and close monitoring. 

A 25-year-old woman presents to the emergency department complaining of acute onset of shortness of breath and pleuritic pain. She had been in her usual state of health until 2 days prior when she noted that her left leg was swollen and red. Her only medication was oral contraceptives. Family history was significant for a history of "blood clots" in multiple members of the maternal side of her family. Physical examination demonstrates an anxious woman with stable vital signs. The left lower extremity demonstrates erythema and edema and is tender to touch. Ultrasound reveals a deep vein thrombosis in the left lower extremity chest computed tomography scan confirms the presence of pulmonary emboli. What are the likely risk factors in this woman—hereditary, acquired, or both What therapy is indicated acutely What are the long-term therapy options How long should she be treated Should this individual use oral contraceptives ... 

If the selected peel turns out not to be strong enough, a different peel should be used or it should be combined with other treatments. Local or general touch-ups can be done as soon as the condition of the skin permits, that is, when the skin has completely regenerated and when all erythema and flaking has finished. The rest time between two peels is usually between 4 and 6 weeks. Many peels only produce results after fairly frequent repetition. 

Phenol (Lip Eyelicf formula) if a full-face phenol peel does not produce adequate results, a second peel can be applied to the areas that did not respond to the first peel. The touch-up can be localized or full-face, if the condition of the skin permits and if there has been a long rest period. Skin regeneration after the second peel is much quicker, there is less edema and post-peel erythema is of a much shorter duration (2 weeks at the most). If a third phenol peel were indicated (in extremely rare cases of very thick skin, patients who smoke, or rapid resumption of facial expressions), it would most often be localized. The author has only once had to do a third phenol peel on the lip and cheek area after inadequate results on skin that was extremely oily and thick. Recovery was even faster after a third application of phenol and there was hardly any erythema. It should be noted that if a second phenol peel can boost inadequate results, a third phenol peel only brings a very slight improvement over the second. 

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