Skin type salicylic acid peels

In a randomized, split-face study of 10 patients with skin types IV to VI showing post-inflammatory hyperpigmentation, salicylic acid peels were found to be a safe treatment in dark skin. Treatment was judged effective by the patients, but efficacy ratings by blinded scores fell short of significance. 

In general, there are few conlraindicalions to salicylic acid chemical peeling. Salicylic acid peels are well tolerated in all skin types (Fitzpatrick s I through Vt) and all racial-ethnic groups. General contraindications... 

In 2002, Grimes reported the efficacy of combination salicylic acid/TCA 10% peeling [1]. She treated patients with moderate to severe melasma with this combination regimen. In the series, nine patients were classified as Fitzpatrick skin type IV, eleven were skin type V, and seven were skin type VI. Many of the subjects included in the study had not responded to salicylic acid or glycolic acid peels. The concentration of salicylic acid was 20 and 30%, and the TCA concentration was 10%. A series of four peels was performed at 2-week intervals. Thirty percent of the patients experienced moderate improve-... 

The combination of salicylic acid and TCA 15% is also an effective treatment for mild to moderate photodamage, acne and melasma in types 1-111. Moderate to excellent improvement has been observed (Figs. 10.3a, b, 10.4a, b and 10.5a, b). Hence, the combination salicylic acid/TCA peeling protocol can be used in all skin types. 

There are few contraindications to combination salicylic acid/TCA peeling. The combination regimen is tolerated in all skin types and all ra-cial/ethnic groups. General contraindications include salicylate hypersensitivity unrealistic patient expectations active inflammation/der-... 

Fig. 10.4. a Facial melasma in skin type 111. b Note significant improvement after combination salicylic acid/TCA peel... 

There is minimal published data on the use of combination peeling protocols in deeply pigmented skin (Fitzpatrick skin types IV-Vl). The author has reported the efficacy of combination peeling with salicylic acid 20 and 30% in combination with 10% TCA for recalcitrant melasma patients. This peeling regimen was well tolerated with minimal side effects in darker racial ethnic groups (see Salicylic acid/TCA peel section). 

Fig. 14.11a, b. Melasma of the face in a patient with skin type VI before and after combined peeling with 25% salicylic acid and 10% TCA gel. The improvement is mild... 

---