Salicylic acid peels indications

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. 

When treating acne vulgaris, topical and systemic therapies (if indicated) are initiated 2 to 4 weeks prior to peeling. Topical antibiotics and benzoyl peroxide based products can be used daily and discontinued 1 or 2 days prior to peeling. However, unless a deeper peel is desired, retinoids should be discontinued 7-10 days prior to salicylic acid peeling. Broad-spectrum sunscreens (UVA and UVB) should be worn daily (see Photo damage. Sunscreen section). 

In a study from Korea, by Lee and Kim, 35 patients with facial acne were treated with 30% salicylic acid peels biweekly for 12 weeks. Lesion counts and Dr. Cunliffe s scores revealed a decrease in both inflammatory and noninflammatory acne lesions. The peels were also well tolerated [17]. In another prospective, noncomparative study of 268 Asian patients who underwent 30% salicylic acid peels weekly for 8 weeks for various indications including melasma, acne vulgaris, freckles, postinflammatory scars/pigmentation, the peels were tolerated well. Mild discomfort, bum-... 

Deep peels TCA (30%), salicylic acid (50%). These peels cause a deep frosting phenomena and they require home postpeeling management for the intense erythema. These peels are used in medium and deep acne scars. Ice-pick and boxcar scars can be treated with TCA 30% application all over the face when they are diffuse. When they are isolated, TCA cross 50-90% using cotton tips is the gold standard [15] (Fig. 13.13a. b). In Table 13.5, we sununarize the principal chenucal peels and their indication in acne. 

The most common indications we use TCA peels to treat are solar lentigos and severe acne scars [Figure 13.3). TCA can also be combined with salicylic acid for treatment of solar lentigos. For the treatment of recalcitrant hyperpigmentation and melasma, TCA can be combined with salicylic acid or glycolic acid. 

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