Peeling glycolic acid

Glycolic acid can be applied simultaneously with TCA, which represents another technique for a medium-depth peel. Glycolic acid is also used in creams for self-treatment. Since complications such as hyperpigmentation, infection, irritation, and photosensitivity are very rare, it is well tolerated. 

Tse Y, Ostad A, Lee HS, Levine VJ, Koenig K, Kamino H, Ashinoff R (1996) A clinical and histologic evaluation of two medium-depth peels. Glycolic acid versus Jessner s trichloroacetic acid. Dermatol Surg 22 781-786... 

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... 

Glycolic acid, an AHA, has become one of the most widely used organic carboxylic acids for skin peeling. Glycolic acid formulations include buffered, partially neutralized, and esterified products. Previous studies have recommended the use of a buffered or partially neutralized glycolic acid, which is safer than free glycolic acid. 

Salicylic acid is a beta hydroxy acid. Glycolic acid is an alpha hydroxy acid, as are lactic acid, citric acid, and many others. Hydroxy acids are compounds that are both alcohols and acids at the same time. Hydroxy acids are used as chemical peeling agents. Alpha hydroxy acids can make the skin more sensitive to ultraviolet light by removing the skin s protective outer layers. Some alpha hydroxy acids ... 

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

Glycolic acid peels are contraindicated in contact dermatitis, pregnancy and in patients with glycolate hypersensitivity. Moreover, they can increase skin sensitivity to ultraviolet light. 

Patients with melasma (Eig. 2.3) applied topical sunscreens (sun protection factor 15) and 10% glycolic acid lotion at night for 2 weeks. They were then treated with 50% glycolic acid facial peels once a month for 3 consecutive months. At regular intervals and at the end of the follow-up period (3 months) after the last peel, the degree of improvement in pigmentation was assessed by measuring MASl (Melasma Area and Severity Index) [11]. 

In patients with acne (Fig. 2.4), the chemical peels were performed with a 70% glycolic acid solution, for 2 to8 min. The number and frequency of the applications depended on the intensity of the clinical response. The most rapid improvement was observed in comedonic acne, in the papulo-pustular forms. An average of six applications were necessary (Fig. 2.5a, b). 

Fig. 2.7a, b. Acne scars before and after 70% glycolic acid peeling... 

Following the peel the skin is carefully observed for any complications such as hyperpigmentation and infection. Results are maintained with serial peels and by using at-home tretinoin or glycolic acid, as well as by sun avoidance. 

Glycolic acid peeling is a medical procedure that requires the informed consent of the patient. The medical doctor must obtain from the patient a well-standardized formal consent that shows that all information about the medical procedure performed was explained to the patient. We include below the formal consent form submitted to the patient before the glycolic acid peeling procedure. 

Becker FF, Langford FP, Rubin MG, Speelman P (1996) A histological comparison of 50% and 70% glycolic acid peels using solutions with various pHs. Dermatol Surg 22(5) 463-465... 

Moy LS, Murad H, Moy RL (1993) Glycolic acid peels for the treatment of wrinkles and photoaging. J Dermatol Surg Oncol 19(3) 243-246... 

Murad H, Shamban AT, Premo PS (1995) The use of glycolic acid as a peeling agent. Dermatol Clin 13(2)... 

Javaheri SM, Handa S, Kaur I, Kumar B (2001) Safety and efficacy of glycolic acid facial peel in Indian women with melasma. Int J Dermatol 40(5) 354-357... 

Atzori L, Brundu MA, Orru A, Biggio P (1999) Glycolic acid peeling in the treatment of acne. J Eur Acad Dermatol Venereol 12 119-122... 

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-... 

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

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