Skin type peel selection

To better select the right patient for the right peel it is important to obtain a detailed history that evaluates all potential risks linked to the peeling agents. It is important to identify all potential factors that may adversely affect the outcome of a peel and fully characterize a patient s skin type and jjropensity to scar and hyperpigment (see Table 13.3). 

The level of improvement can vary with regard to different diseases and individual patients. With training and experience, one will be able to select the most apjjropniate peel type(s) to address a patient s specific skin condition. For example, a patient with ice-pick acne scars can expect only mild improvement in the scars even if skin texture is remodeled. Conversely, a patient with isolated box car scars can obtain a significant improvement with focal application of TCA at 50-90% to individual scars. This technique called TCA CROSS (chemical reconstruction of skin scars) can produce more than 70% improvement of visible scars with homogeneous tightening of the skin. 

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