Phenol peels resorcinol

With TCA-SAS, resorcinol, salicylic acid, azelaic acid or phenol peels, the skin needs to be thoroughly cleansed of make-up, degreased and disinfected. Easy TCA solution, on the other hand, contains saponins that make pre-peel make-up removal and degreasing unnecessary the skin s natural defenses are only very slightly diminished by this peel, and therefore there is no need for any particular prepeel preparation against infections. 

Erythema is inevitable after a phenol peel (Figure 37.18). ft can sometimes be less severe and of a shorter duration if a corticosteroid is injected intravenously at the beginning of the peel. Its intensity varies from patient to patient, from light and imperceptible to severe and deep. Resorcinol is a potentially allergenic phenol derivative persistent, pruritic erythema after a resorcinol peel might be a sign of contact dermatitis. 

Cardiac arrhythmia This may occur with phenol and resorcinol peelings. Death following a serious cardiac adverse reaction has been reported. 

A brief study of the chemistry of the molecules and solutions used in chemical peels immediately questions the hypothesis that acidity is the only basis for the action of peeling solutions. In fact, with the exception of trichloroacetic add (TCA) and non-neutralized glycolic acid solutions, the most commonly used peeling solutions are only weakly acidic, and phenol and resorcinol mixtures may not be acidic at all, having a pH greater than 7 in some formulations. 

When compared to 70% glycolic acid peels, no difference was found with respect to the frequency of side effects in patients of skin types IV-Vl. However, the phenolic compound, resorcinol, may cause some depigmentation jjroblems in skin types V and VI. 

Although rare, toxicities can occur with resorcinol, salicylic acid and phenol peels. 

See Chapter 24 for more details. Although resorcinol is known to have allergenic properties, there have been no allergies reported when it has been used in small quantities with phenol. However, the combined use of these two substances in the same peel solution does not appear to have any clinical value, as the phenol will have finished working before the resorcinol has started. Resorcinol cannot therefore modify the effect of phenol. No data are available on the potential clinical effect of resorcinol on skin that has just been coagulated by phenol. 

When making reference, even superficially as we do, to the chemical and pharmacological properties of these diverse molecules, we realize that acidity is far from being the only mechanism of action that causes the previously documented peel-induced modifications of the skin. The pH alone is only destructive in the case of trichloroacetic acid. The other substances act mainly through toxic effects (phenol, resorcinol and, at a lower level, salicylic... 

We understand well the interest in using peeling mixtures of different substances so as to combine caustic, toxic, and metabolic effects. This explains the interest in Jessner s solution (a mixture of resorcinol, lactic acid, and sahcyhc acid) Monheit s formula (a version of a modified Jessner s solution with the resorcinol replaced with citric acid) other secret modified phenol formulas and others (Fintsi,Kakowicz,De Rossi Fattaccioli, etc.). 

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