Superficial peels salicylic

Jessner s Solution has been used for over 100 years as a therapeutic agent to treat hyperkera-totic epidermal lesions [1]. This superficial peeling agent constitutes a mixture of salicylic acid, resorcinol, and lactic acid in 95% ethanol. Jessner s solution causes loss of corneocyte cohesion and induces intercellular and intracellular edema. Jessner s typically induces wounding to the level of the papillary dermis. Historically, resorcinol (a key component of Jessner s peels) was used in concentrations of 10-50% in the early twentieth century. High concentrations of resorcinol were associated with side effects such as allergic contact dermatitis, irritant contact... 

Salicylic acid (ortho hydroxybenzoic add) is a beta hydroxy acid agent. It is a lipophilic compound which produces desquamation of the stratum corneum via removal of intercellular lipids [3] (see salicylic acid section). Given its keratolytic effects, it has become an increasingly popular superficial peeling agent. Salicylic acid peels induce injury via thinning or removal of the stratum corneum. In addition, salicylic acid potentially enhances the penetration of TCA. 

Jessner s solution contains 14% resorcinol, 14% salicylic acid and 14% lactic acid. Jessner s solution has been used alone for superficial peeling, or in combination with TCA 35% to achieve a medium-depth peel. Increasing the number of coats applied to the treated area increases the depth and reaction induced by the Jessner s peel. These peels are well tolerated with minimal side effects in the author s practice. As with glycolic acid and salicylic acid peels, Jessner s peels are most commonly used as adjimctive therapy for moderate to severe facial dyschromias, acne, oily skin, texturally rough skin, fine wrinkles, and pseudofolliculitis barbae. 

Superficial peeling with 25% salicylic acid in alcoholic solution (Figs. 14.5a, b and 14.6a, b)... 

Salicylic acid has a keratolytic effect, thus eliminating superficial pigmented keratinocytes and stimulating cells turnover. This superficial peeling allows TCA to act a low concentration to remove pigmented keratinocytes through papillary dermis (see Fig. 14.12). 

Though using phenol to do a superficial peel means both patient and doctor taking a pointless risk where less toxic agents are available (TCA, AHA, salicylic acid, etc.). Left-handers wfll understand that they must reverse the hands used. 

Chemical peels can be classified by the depth of penetration into the skin (Table 9.2). Superficial peelings (epidermis to upper papillary dermis) are the most commonly used peels in all phototypes. These agents include tretinoin 1-5%, TCA 10-35%, glycolic acid solution 30-50% or glycolic gel 70%, salicylic acid 20-30% in ethanol and Jessner s solution (Combes formula). 

Jessner s solution contains 14% resorcinol, 14% salicylic acid and 14% lactic acid. It has been used alone for superficial peeling, or in combination with TCA 35% for medium-depth peeling. 

For more mild sun damage, a series of retinoic acid (1— 10% peels can also be performed. A series of 3-4 peels are done at 2 week intervals. If a patient s sun damage is more pronounced, a combination of superficial peels can employed. In this case, the Jessner or Salicylic acid (20-30% peel is applied first followed by the retinoic acid peel. The retinoic acid peel imparts a yellowish hue to the skin during its application period, which is then rinsed off with water at home by the patient in 4—6 hours. Postpeel care is similar to other superficial peels. 

Despite some general predictable outcomes, even superficial chemical peeling procedures can cause hyperpigmentation and undesired results. Popular standard salicylic acid peeling... 

Trichloroacetic Acid (TCA) causes precipitation of proteins and coagulative necrosis of epidermal cells [4]. The extent of damage is indeed concentration dependent. Concentrations range from 10 to 50%. Superficial TCA peeling is induced by concentrations of 10-30% whereas higher concentrations cause medium depth or deep peeling. The combination of salicylic acid followed by TCA 10-15% induces superficial wounding. 

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