Very light peels

Very light peel Medium light peel Medium heavy peel Heavy peel... 

Light chemical peels include 20-35% TCA, 70% glycolic acid, and Jessner s solution (resorcinol, salicylic acid, lactic acid, and ethanol) and penetrate the entire epidermis. These peels are more effective than the very light peels for the treatment of actinic keratoses, solar lentigenes, and epidermal growths such as thin seborrheic keratoses. Skin texture may also be improved. Erythema and scaling will occur postoperatively however healing time is faster if... 

The very light erythema that follows Easy TCA disappears very rapidly. It is the only peel where it is not strictly forbidden to help flaking along. Bleeding should, of course, be avoided, as this would trigger erythema. The erythema soon subsides and does not cause any adverse sequelae unless there is a secondary infection. The maximum frequency for repeating the basic protocol (pinpoint frosting) is four peels at 5-day intervals. The ideal frequency is four peels at 8-day intervals. Effective sun protection is essential. 

In patients with Fitzpatrick skin types IV to VI, the use of salicylic acid as a very light chemical peeling agent seems to result in a much lower incidence of PIH Combination peels have replaced 50% TCA as the gold standard for medium-depth peels... 

Superficial peels can be categorized further into very light and light peels. See Box 2.5. 

Although very light and light peels can be used in virtually all skin types, caution must still be taken in patients with darker skin, specifically Fitzpatrick skin types IV to VI (see Table 2.1). A thorough knowledge of the subtleties of these chemical peels will allow the practitioner the ability to treat all skin types safely and effectively. 

Figure 15.7 Patients are often unhappy with the outcomes following a very light TCA or glycolic peel, as evidenced by this phone call...

The more severe the photoaging, the more important it is to consider the depth of the peel. The patient shown in Figure 5.7 has a light skin type that is sensitive to the sun s rays. She has developed a number of solar lentigines and fine wrinkles caused by UV rays. The eyelids are very wrinkled and the nasolabial folds and marionette lines are slack. 

Skin phototype is even more important when using phenol locally a locaP phenol peel can only really be applied on light skin phototypes that will not show any significant and visible difference in color on the eyelids and around the mouth. The same applies to patients with a lot of freckles, keratoses or lentigines, which only disappear from the areas treated with phenol but still remain in the surrounding areas. The difference in skin quality is also very visible. These patients should only be treated with a full-face peel. 

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