Salicylic acid peels formulations

Despite some general predictable outcomes, even superficial chemical peeling procedures can cause hyperpigmentation and undesired results. Popular standard salicylic acid peeling techniques involve the use of 20% and 30% salicylic acid in an ethanol formulation. Salicylic acid peels are performed at 2-4 week intervals. Maximal results are achieved with a series of 3-6 peels. 

A variety of formulations of salicylic acid have been used as peeling agents. These include 50% ointment formulations (Table 6.1) [2,3], as well as 10, 20 and 30% ethanol formulations (Table 6.2) [4,6]. More recently, commercial formulations of salicylic acid have become available (BioGlan Pharmaceuticals Company, Malvern, PA Bionet Esthetics, Little Rock, AR). 

Salicylism, or salicylic acid toxicity, is characterized by rapid breathing, tinnitus, hearing loss, dizziness, abdominal cramps, and central nervous system reactions. It has been reported with 20% salicylic acid applied to 50% of the body surface, and it has also been reported with use of 40 and 50% salicylic acid paste preparations [7]. The author has peeled more than 1,000 patients with the current 20 and 30% marketed ethanol formulations and has observed no cases of salicylism. 

Ethanol formulations of salicylic acid (20 and 30%) are used for combination peeling (see salicylic acid section). Trichloroacetic acid is prepared as an aqueous solution, since ethanol solutions do not penetrate the skin. It is prepared by mixing the appropriate concentration of crystals with up to 100 cc of distilled water. Ten and fifteen percent TCA is prepared by mixing 10 or 15 g of crystals in up to 100 cc of total volume, respectively. Aqueous solutions of TCA remain stable for up to 6 months unless contaminated. Other methods have been used to formulate TCA peeling solutions however, the weight/volume methods appear to be the most reliable formulation [5]. Premixed TCA solutions are available from a variety of medical... 

Mild keratolytic (exfoliating, peeling) formulations unblock pilosebaceous ducts, e.g. benzoyl peroxide, sulphur, salicylic acid, azelaic acid. 

Chemical skin peeling with salicylic acid in ethanol or another vehicle may cause adverse effects of a stinging or burning sensation followed by postinflanunatory hyperpigmentation in treated areas. A formulation of 30 % salicylic acid in polyethylene glycol (SA-PEG) was tested in mice and 44 human volunteers [320, 321], It did... 

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