Phenol peels preparation

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. 

Lip Eyelid formula is a phenol peel that I first developed to increase dermatological safety and to achieve results without any occlusion on the sensitive skin of the eyelids. The same solution was then applied to the wrinkles around the mouth and then to the whole face, but with 24 hours occlusion in these two indications. It is an oil solution of phenol at over 60%. Four different oils are used in the various stages of the product s preparation. The aim of the oily formulation is to slow down the penetration of the phenol through the skin and to improve dermal and epidermal maceration. It limits the toxicity of phenol by saturating the biochemical hepatic detoxification pathways more slowly. 

The qualitative formulas of recent products are known, but the percentages and preparation methods are not revealed. Fintsi explained that adjuvanted and tamed phenol peels must be prepared according to a precise method and that he was afraid that if he revealed the exact proportions of the ingredients, doctors would try to make up the formula themselves without keeping to the necessarily strict order of preparation, and that this could lead to disastrous results. 

The preparation procedure for a local phenol peel has some aspects in common with those for a full-face phenol peel -however, a local application of phenol is far easier. 

Many phenol peel techniques require skin preparation before the peel to ensure that penetration is even and to reduce complications (see Chapter 2). No specific preparation is necessary before Lip Eyelid formula. 

A porcine animal model of 40 different phenol-croton oil, hexachlorophene foam, and ethyl alcohol preparations noted that when any amount of croton oil was added, there was a more brisk inflanunatory response than when croton oil was not added [312]. Phenol peels were found to be deeper with increasing concentrations and with inCTeasing concentrations of croton oil, and multiple applications of phe-nol/croton oil increased the depth of the peel in this animal model [312]. 

Wexler MR, Halon DA, Teitelbaum A, et al (1984) The prevention of cardiac arrhythmias produced in an animal model by topical application of a phenol preparation in common use for face peeling. Plast Recontsr Surg 73 595-598... 

In cases of patients with olive skin (Fitzpatrick Results of phenol-based peels for various inskin type 3 or 4), the application of Kligman dications are shown in Figs. 8.11,8.12,8.13, 8.14 preparation is recommended to prevent reac- and 8.15. tive hyperpigmentation. 

Several hybrid epoxy emulsions have been commercially prepared. An epoxy emulsion blended with waterborne aliphatic urethanes exhibited peel strength on aluminum of 10 lb/in—1.5 times greater than with the polyurethane itself. The optimum concentration of urethane in the final emulsion was about 50 percent by weight.13 Epoxy-phenolic dispersions have also been developed to provide waterborne adhesive systems with high glass transition temperature and chemical resistance. 

Phenol is a benzyl alcohol and a major oxidized metabolite of benzene that was introduced into medicine as an antiseptic (1). Although it can be prepared in an aqueous solution or in glycerine, it appears to be more effective when mixed in aqueous compounds. At a concentration of 0.2% it is bacteriostatic and at over 1% bactericidal (2). In addition to its uses as an antiseptic and disinfectant, phenol is also used as a sclerosant, as a local anesthetic on the skin, and as an analgesic, by injection into nerves or spinally, but its use was limited by severe adverse effects. Current medical uses include cosmetic face peeling, nerve injections, and topical anesthesia. It is also an ingredient of various topical formulations, and is used as an environmental disinfectant. 

If we leave aside these variables, we can fit the dilferent types of peels into their appropriate slots. This is just for the beauty of the exercise however, as the variables stiU need to be taken into account. It is clearly possible to perform a superficial or medium peel using phenol. But, given the inherent toxicity of phenol, what would be the point What is more, 70% unbuffered glycolic acid that is left for 10-15 minutes on a thin, sensitive skin that has been prepared with retinoic acid can result in a cosmetic disaster. It is possible to carry out good-quality, deep peels with TCA, but the risks can be greater than if phenol is used correctly. 

Phenol does not usually require any specific preparation, but needs careful post-peel care. 

The peel solutions should never be prepared simply by dissolving phenol in one of its potential solvents. Since phenol was introduced into treatment, doctors who use it have tried to ... 

Glogau RG, Matarasso SL. Chemical peels trichloracetic acid and phenol. Dermatol Clin 1995 13 263-76. Ruedemann R, Deichmann WR. Blood phenol level after topical application of phenol-containing preparations. JAMA 1953 152 506-9. 

A syringe of physiological saline (200 cm at least) should be prepared, to be kept at hand to rinse the eyes out immediately in case of contact with phenol (which is highly unlikely if the peel is applied correctly). 

After the eyebrows, the doctor treats the upper eyelids. Any excess of phenol is avoided by using an applicator that has already been used to treat an adjacent area and that has not just been soaked in phenol. The upper eyelid tarsus does not have to be treated this would cause severe palpebral edema. When the eyelids are being treated, the assistant should be ready to rinse the eyes out with a syringe of sterile physiological saline (prepared before the peel) and sponge away any reflex tears. 

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