Light peels

Botulinum toxin, used alone, would only partially improve the areas around the eyes, lips and cheeks. A surgical facelift would tighten the neck and the cheeks, but it would not treat the crow s feet satisfactorily and would have no effect at all on the wrinkles on the lips and the overall skin quality. A light peel would only improve skin quality and even out skin tone, but would not get rid of the wrinkles. A peel to the papillary dermis would have a similar and more noticeable effect, but would not get rid of these deep and long-standing wrinkles. An experienced... 

The basic protocol for ETCA is intended to reach the basal layer of the epidermis or the Grenz zone. There are (many) other deeper protocols but they are not as straightforward as ETCA and the risk of complications is relatively much higher. ETCA is not necessarily a light peel it can be used to reach all depths, from the basal layer of the epidermis to the reticular dermis, depending on the protocol used. The relatively superficial action of the ETCA solution (basic protocol) strongly stimulates the skin regeneration... 

Very light peel Medium light peel Medium heavy peel Heavy peel... 

Mandelic acid is an a-hydroxy acid derived from almonds. It can be used alone or in combination with azelaic acid. It is considered a light peeling Side effects (erythema, exfoliation, burning) are rare and mild in severity. 

Superficial peels can be categorized further into very light and light peels. See Box 2.5. 

Light chemical peels include 20-35% TCA, 70% glycolic acid, and Jessner s solution (resorcinol, salicylic acid, lactic acid, and ethanol) and penetrate the entire epidermis. These peels are more effective than the very light peels for the treatment of actinic keratoses, solar lentigenes, and epidermal growths such as thin seborrheic keratoses. Skin texture may also be improved. Erythema and scaling will occur postoperatively however healing time is faster if... 

Although very light and light peels can be used in virtually all skin types, caution must still be taken in patients with darker skin, specifically Fitzpatrick skin types IV to VI (see Table 2.1). A thorough knowledge of the subtleties of these chemical peels will allow the practitioner the ability to treat all skin types safely and effectively. 

Light peel Medium peel Deep peel... 

Light peels which do not create as much inflammation, i.e., salicylic acid 30% solution or tretinoin peel, may be used to treat PIH if needed. 

Figure 14.6 (A) Combination procedure utilizing perioral-periotbital CO2 laser resurfacing with Jessner s + 35% TCA peel over remaining face. The peel will blend color and texture of the laser treated areas. Preoperative the eyelids and lips need deeper resurfacing than cheeks, which require only medium depth injury. (B-F) Combinations laser resurfacing to eyelids, perioral area medium-depth peel to face, light peel to neck. Preoperative the peel is performed first postoperative laser and peel postoperative 4 day postoperative 4 months...

Infections other than the activation of herpes are quite rare when the light peels are employed. Medium peels and deep peels can tii er herpetic infection so it is important to determine in advance whether patients are exposed to anyone with cold sores or fever blisters. Even if they deny ever having had herpetic infections, patients are advised... 

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