Jessner’ solution

Some authors use m/m instead of m/v, which changes the actual concentration of the active ingredients. It is also important to stress the need for the pharmacist to use the crystal form of the lactic acid and not the solution form. Lactic acid in fact comes in liquid form with a concentration of 85%. The pharmacist should use lactic acid crystals and not solution to prepare the Jessner solution. Moreover, different molecules, many of them unknown, are used to denature alcohol, to make it unfit for drinking, and there is a risk of potential chemical interactions with the acids. The alcohol used by the pharmacist must be pure, not denatured. Resorcinol solutions have been used at concentrations of 10-50% in alcohol or ether to treat keratoses. 

Figure 7.3 (A) Speckled white frost following Jessners solution peel In preparation for 35% TCA medium-depth peel (B) even, white frost with a background erythema following application of 35% TCA medium-depth peel...

Glycolic acid Jessner s solution Pyruvic acid Resorcinol Salicylic acid Trichloracetic acid Deep chemical peels... 

Salicylic acid 20-30% Jessner s solution Glycolic acid 20,35,50,70% Trichloracetic acid 10-30%... 

Salicylic acid 20-30% Glycolic acid 70% Jessner s solution Pyruvic acid 40%... 

Kim SW, Moon SE, Kim JA, Eun HC (1999) Glycolic acid versus Jessner s solution which is better for facial acne patients A randomised prospective clinical trial of split-face model therapy. Dermatol Surg 25(4) 270-273... 

Jessner s Solution has been used for over 100 years as a therapeutic agent to treat hyperkera-totic epidermal lesions [1]. This superficial peeling agent constitutes a mixture of salicylic acid, resorcinol, and lactic acid in 95% ethanol. Jessner s solution causes loss of corneocyte cohesion and induces intercellular and intracellular edema. Jessner s typically induces wounding to the level of the papillary dermis. Historically, resorcinol (a key component of Jessner s peels) was used in concentrations of 10-50% in the early twentieth century. High concentrations of resorcinol were associated with side effects such as allergic contact dermatitis, irritant contact... 

Each component of Jessner s solution has specific effects (Fig. 3.1). Salicylic acid (ortho hydroxy benzoic acid) is a beta hydroxy acid agent... 

The standard formulation of Jessner s solution is listed in Table 3.1. Modified Jessner s solutions that do not contain resorcinol are also available (Delasco, Council Bluffs, lA) (Table 3.2). 

Tkble 3.1. Preparation of Jessner s Solution with resorcinol... 

The skin is usually degreased with alcohol followed by a mild acetone scrub. After cleaning, Jessner s solution is appUed to the face with a sable brush, cotton tipped apphcators, cotton balls, or 2 X 2 gauze sponges. The author prefers the use of cotton tipped applicators. Typically, the cheeks are treated first, working from medial to lateral areas followed by application to the chin and forehead area. For superficial peeling, two coats are usually applied. Additional coats increase the depth of peeling. 

If a Jessner s-35% TCA peel (Monheit) is performed, Jessner s solution is applied first prior to the TCA in an even sequential fashion from the forehead to the rest of the face, waiting 2 to 3 min to allow for penetration and assessment of frost. Typically this will produce a level 1 frost, erythema with faint reticulate whitening... 

TCA 10-30% Tretinoin Salicylic Acid Glycolic Acid Jessner s Solution... 

Jessner s solution contains 14% resorcinol, 14% salicylic acid and 14% lactic acid. Jessner s solution has been used alone for superficial peeling, or in combination with TCA 35% to achieve a medium-depth peel. Increasing the number of coats applied to the treated area increases the depth and reaction induced by the Jessner s peel. These peels are well tolerated with minimal side effects in the author s practice. As with glycolic acid and salicylic acid peels, Jessner s peels are most commonly used as adjimctive therapy for moderate to severe facial dyschromias, acne, oily skin, texturally rough skin, fine wrinkles, and pseudofolliculitis barbae. 

Lawrence et al. [21] compared the efficacy of Jessner s solution and 70% glycolic acid in a split-face study of 16 patients. Of the total group, five were skin type IV, three were skin type V, and one was skin type VI. There was no statistically significant difference in improvement between the two groups. The investigator did not report an increased frequency of side effects in patients of skin types IV-VI. 

Lawrence NL, Cox SE, Brady HJ (1977) Treatment of melasma with Jessner s solution versus glycolic acid a comparison of clinical efficacy and evaluation of the predictive ability of Wood s light examination. J Am Acad Dermatol 36 589-593... 

Lawrence et al. [66] in a split face study, compared the efficacy and safety of Jessner s solution and 35% TCA with 5% fluorouracil in the treatment of widespread facial actinic keratoses. Fifteen patients were treated. Both treatments reduced the number of visible actinic keratoses by 75%. Similarly, both caused equivalent reductions in keratinocyte atypia, hyperkeratosis, and parakeratosis. Compared to fluorouracil, only one application of the peel was necessary. 

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