Progressive Peel

This chapter will be an overview of this progressive peel. We outline the step-by-step skin rejuvenation program (Box 6.2) for the improvement of complexion problems, fine lines and/or blotchy dyspigmentations in 155 patients. This illustrates what types of patients will... 

Figure 6.1 The tray set-up. The peel tray Is always set up in a standard fashion with well marked bottles. 3" x 3" cotton gauzes and cotton-tipped applicators are available. The eye wash solution is always close at hand. The four bottles of the Progressive Peel are clearly labeled. (The progressive preel ProPeeP, Vivant Pharmaceuticals, Inc. Miami, Ft)...

After completing steps I, II, III of their skin care program the patient is ready for step IX the progressive peel. They wash their face to remove any residual make-up, remove contact lenses and ear rings. Again, the peel program is outlined for them. 

The Progressive Peel The Combined Jessner, TCA, Retinoid Peel... 

Figure 6.3 The foggy-red blanch of the progressive peel. After several coats of the progressive peel the skin develops a foggy-red blanch. This Is the end-point of the peel. The blanch will fade In ten to fifteen minutes and begin to peel in three to four days...

This progressive peel can be repeated monthly if the patient is on an aggressive rejuvenation program or three to four times annually on a more relaxed schedule. 

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. 

If the patient does not peel on the first progressive peel or the patient has very oily skin or lives in a humid climate the operator may choose to the extra strength formula. 

This 17-year-old patient had developed acne at age 12 years on the nose, chin and forehead. As the condition progressed out across the face it became more inflammatory. Even with his daily skin care program he was unable to control the flare-ups. With the addition of two progressive peels his condition was controlled (Figure 6.5). 

Figure 6.5 Improvement in the acne patient. The progressive peel helps clear the acne impactions. The peel will add to the acne skin care regimen and improve the complexion. Several peels maybe needed...

Figure 6.6 Improvement in dyspigmentation. Blotchy brown discolorations were improved when the progressive peel was added to the skin care program. Continual topical skin care was necessary to prevent a recurrence with sun exposure or hormone changes...

Figure 6.7 Improvement in fine lines. The sallow color and fine lines were Improved wifh several progressive peels in addition to the daily skin care program...

In addition, she underwent three progressive peels. TTie most prominent elevated keratotic lesions were treated individually with several additional coats of step III solution on a cotton swab (Figure 6.8). 

Figure 6.8 Improvement in actinic keratosis. Note the improvement in the actinic keratosis atter using the daily skin care program and undergoing three progressive peels...

With the addition of the progressive peel to the step-by-step skin care program it is possible to significantly accel-... 

The retinoid for progressive peel step IV can be either retinyl propionate 10%, retinol 1%, retinyl aldehyde 0.5% or retinoic acid 0.1 %. They are interchangeable. 

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