Patient salicylic acid

The keratolytics are contraindicated in patients with known hypersensitivity to the drugs and for use on moles, birthmarks, or warts with hair growing from them, on genital or facial warts, on warts on mucous membranes, or on infected skin. Prolonged use of the keratolytics in infants or patients with diabetes or impaired circulation is contraindicated. Salicylic acid... 

Grimes et al. [8] reported substantial efficacy and minimal side effects in 25 patients treated with 20 and 30% salicylic acid peels in darker racial-ethnic groups. Conditions treated included acne vulgaris, melasma and post-inflammatory hyperpigmentation. 

Thirty-five Korean patients with facial acne were treated biweekly for 12 weeks with 30% salicylic acid peels [9]. Both inflammatory and non-inflammatory lesions were significantly improved. In general, the peel was well tolerated with few side effects. 

Salicylism, or salicylic acid toxicity, is characterized by rapid breathing, tinnitus, hearing loss, dizziness, abdominal cramps, and central nervous system reactions. It has been reported with 20% salicylic acid applied to 50% of the body surface, and it has also been reported with use of 40 and 50% salicylic acid paste preparations [7]. The author has peeled more than 1,000 patients with the current 20 and 30% marketed ethanol formulations and has observed no cases of salicylism. 

Lee HS, Kim IH (2003) Salicylic acid peels for the treatment of acne vulgaris in Asian patients. Dermatol Surg 29 1196-1199... 

In 2002, Grimes reported the efficacy of combination salicylic acid/TCA 10% peeling [1]. She treated patients with moderate to severe melasma with this combination regimen. In the series, nine patients were classified as Fitzpatrick skin type IV, eleven were skin type V, and seven were skin type VI. Many of the subjects included in the study had not responded to salicylic acid or glycolic acid peels. The concentration of salicylic acid was 20 and 30%, and the TCA concentration was 10%. A series of four peels was performed at 2-week intervals. Thirty percent of the patients experienced moderate improve-... 

There are few contraindications to combination salicylic acid/TCA peeling. The combination regimen is tolerated in all skin types and all ra-cial/ethnic groups. General contraindications include salicylate hypersensitivity unrealistic patient expectations active inflammation/der-... 

Fig. 10.2. a Patient with recalcitrant melasma unresponsive to glycolic acid or salicylic acid peels, b Responded to combination salicylic acid/TCA peeling... 

Fig. 10.3. a Patient with photodamage of the chest, b Note significant improvement after combination salicylic acid/TCA peel... 

There is minimal published data on the use of combination peeling protocols in deeply pigmented skin (Fitzpatrick skin types IV-Vl). The author has reported the efficacy of combination peeling with salicylic acid 20 and 30% in combination with 10% TCA for recalcitrant melasma patients. This peeling regimen was well tolerated with minimal side effects in darker racial ethnic groups (see Salicylic acid/TCA peel section). 

Fig. 14.11a, b. Melasma of the face in a patient with skin type VI before and after combined peeling with 25% salicylic acid and 10% TCA gel. The improvement is mild... 

Superficial salicylic acids have been shown to be safe and efficacious for treatment of PIH. In a study of five patients with Fitzpatrick s Skin Types V and VI with PIH, pretreatment for 2 weeks with hydroquinone 4% cream followed by a series of five 20-30% salicylic acid chemi-... 

Salicylic acid peelings performed at 3- to 4-week intervals are a good choice for patients with rosacea. Salicylic acid peeling has antimicrobial activity, reduces erythrosis and prevents relapses. 

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