Rosacea peelings

Given these findings, indications for salicylic acid peels include acne vulgaris (inflammatory and non-inflammatory lesions), acne rosacea, melasma, post-inflammatory hyperpigmentation, freckles, lentigines, mild to moderate photodamage, and texturally rough skin. 

Fig. 6.6a,b. Acne rosacea before and after three salicylic acid peels, moderate improvement... 

Salicylic acid peelings performed at 3- to 4-week intervals are a good choice for patients with rosacea. Salicylic acid peeling has antimicrobial activity, reduces erythrosis and prevents relapses. 

In papulo-pustular rosacea 25-30% salicylic acid peeling is utilized in association with systemic treatment with metronidazole or antibiotics and topical treatment as for erythrosis (Figs. 1715,1716 and i/.i/)-... 

Salicylic acid penetrates more deeply in the areas of inflammation and produces rapid drying of papules and pustules 1 or 2 days after the peeling. These beneficial effects are determined by the antimicrobic activity of salicylic acid, which also stimulates fibroblasts, inducing an improvement of the vascular component of rosacea. Application of salicylic acid in inflammatory rosacea is equally as safe and effective in residual or initial lesions. 

Fig. 17.15a, b. Papulo-pustular rosacea before (a) and after (b) chemical peel... 

Fig. 11. Carotenoids from peel extracts of Malus domestica L. (Rosaceae, Golden delicious apple) with potent anti-HP activities.

Citramalic acid (= 2- Malus domestica (apple peel) (Rosaceae) Sour (acid) taste... 

Citral A (Geranial) Citral B(Neral) = trans- cis-3,7-Dimethyl-2,6-octadienal) (monoterpene) Myrcia acris (bay oil) (Myrtaceae), Citrus Andropogon citratus (lemon grass oil) (Poaceae), Rosa spp. (rose oil) (Rosaceae), Citrus lirrwn (lemon peel), C. sinensis (orange) (Rutaceae) [flower], Verbena triphylla (verbena) (Verbenaceae) [antiseptic]... 

Xylopia aethiopica (Annonaceae), Malus sp., Pyrus sp. (pear) (Rosaceae) [fruit peel]... 

Leaf, fruit petal of various plants e.g. Malus spp. (apple peel) (Rosaceae), Citrus sinensis (orange peel) (Rutaceae)... 

Folds, wrinkles and fine lines should be treated beforehand with dermal fillers, thread lifts, mesotherapy, stimulation or any other treatment chosen by the doctor. Benign tumors can be excised or treated by shave biopsy or lasers. Rosacea should be treated before the peel during this same period. Botulinum toxin, ideally should be injected 8 days before the first water-based glycolic acid peel. 

Telangiectasias, seborrheic dermatitis, eczema, acne rosacea, lupus and other autoimmune disorders are among the forms of dermatitis that may be aggravated by a phenol peel. 

Literature data about the use of peelings in rosacea are very poor. This is due to the fact that peelings can induce worsening of the disease, prolonged erythema, and delayed healing [62]. However, in very selected cases, some patients with mild varieties of papulopustular rosacea can improve by means of peelings with salicylic acid, azelaic acid, and mandeUc add [63]. 

Examples of simple phenols (Ce) include catechol and phloroglucinol. Although most of the more complex plant polyphenols contain these two simple phenols as a parts of their stracmres, catechol and phloroglucinol are uncommon in plant tissues. Catechol has been found in leaves of Gaultheria species, while phloroglucinol has been found as glucoside in the peel of various Citrus fruits. Arbutin (III) is found in leaves of various Vaccinium spp., such as bluebeny, cranberry, cowberry, and pear trees (Pyrus communis L., Rosaceae) [41-43]. 

XXIII cis-4-Hydroxymethyl-L-proline apple peel Malus sylvestris Rosaceae... 

Patients with acne and rosacea may not benefit from a medium-depth peel. Rosacea patients may experience jjTolonged erythema while patients with acne may experience a flare-up due, perhaps, to swelling and inflammation induced in their skin or to the use of heavy emollients as part of the postpeel regimen. 

Glycolic acid peels are used as adjunctive treatments in conditions such as acne, postinflammatory hyperpigmentation usually resulting from acne, shallow acne scars, papulopustular rosacea, melasma, seborrheic and actinic keratoses, keratosis pilaris, and some warts resistant to conventional treatments. 

Unlike some other chemical peeling agents that pose a risk of hyper or hypojrigmentation to darker skin types, glycolic acid peels can be used on all Fitzpatrick skin types 1 through VI, male or female, teens to adults. The most sensitive skin types appear to tolerate glycolic acid peels in lower concentrations (20-35%) only. Patients with rosacea and atopic dermatitis and patients of Asian descent appear to fall into this category. 

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