Phenol peels Progressive Peel

Squeamish patients will overwhelm the doctor with complaints, worries, questions and reproaches. It is better to test a patient s mental and physical resistance by first suggesting a painless peel without complications and then progressing onto a medium-depth peel before considering a phenol peel. Individual tolerance can be tested in this way, and the patients themselves gradually learn what a peel is and what it can do for them. 

Fig. 20.8 Clinical changes in actinic keratosis (AK) in a 94-year-old female, (a-c) A case of AK on the face that progressed. After 7 phenol peel sessions, the lesion was surgically...

The solutions of step I and step IV are the same, but the solution for step II is TCA 10%, salicylic add 4% and phenol 1%. Step 111 is TCA 20%, salicylic add 8% and phenol 2% (ProPeel Extra Strength, Vivant Pharmaceuticals, Miami, FL). This program should not be attempted by the operator until they are familiar with the standard progressive peel. 

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