Phenol peels hypopigmentation

Delayed hypopigmentation is a reason why some doctors dislike the long-term results of deep peels. Hypopigmentation after phenol peels is proportional to the depth of the peel, amount of the solution used, inherent skin color, and post-peel sun-related behavior. Complete avoidance of any sun exposure years after the peel creates ivory skin color. 

Fig. 20.4 Clinical changes in actinic keratosis (AK) in a 67-year-old female, (a, b) AK on the left cheek, in which a complete response (CR) was achieved 2.5 years after three phenol peel sessions, (a) Macroscopic appearance before treatment, and (b) hypopigmentation after treatment...

In a study of 46 Asian patients treated with a modified phenol peel (Exoderm), the most frequent side effects were postinflammatory hypapigmenta-tion (PIH) (74 %), temporary prolonged erythema, colloid, and milia. Hypopigmentation persisted for 6 months in a follow-up period. All these side effects were temporary and reversible, with the exception of hypopigmentation in one case [340]. 

Phenol peels have in the past been primarily indicated for deep rhytides in older, fair-skinned individuals because of the risk for hypopigmentation. Although any... 

Further application of TCA or phenol will penetrate the reticular dermis. We recommend caution with performing peels to this level. At this point the solid frost begins to take on a gray color. This is the maximum recommended depth for TCA peels. As with all resurfacing modalities that reach this depth, there is an increased incidence of scarring and hypopigmentation. 

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