CHEMICAL PEELS
Dermatologists, Plastic Surgeons, even
some Estheticians and cosmetologists are now proudly advertising various
methods to rejuvenate the skin or improve one's appearance with chemical
peels, moisturizers, creams, potions and lotions. There is no question
that appropriate use of vitamin A cream or Retin-Aź, chronic use of weak
acids, such as glycolic acid creams and serial chemical peels can improve
the ravages of the sun. These sorts of regimes will improve fine wrinkles
and brown or age spots on the face at the risk of some redness, peeling
and irritation but little other known risks. Deeper peels can cause
scarring and color changes.
No specific peeling agent has been shown to be better
than another. The mechanism of action is simply peeling off the skin to
varying depths. This seems to stimulate the skin to produce some new
collagen which is probably responsible for improvement in some fine
wrinkles. Superficial chemical peels when done in a serial fashion can
also improve the patient's appearance and remove age spots, particularly
when combined with vitamin A cream (Retin-Aź or Renovaź) and weak
acid-containing creams (glycolic acid, lactic acid, etc.). Vitamin A cream
is not a peeling agent but has many powerful effects on the skin.
Medium depth peels can be done with numerous agents,
usually a combination of Jessner's which is lactic acid 14%, salicylic
acid 14%, and resorcinol 14% followed by trichloroacetic acid 30- 40%.
This usually gives, in experienced hands, a uniform medium depth peel
which will improve brown spots and fine wrinkles and minimize some acne
scars, but to really produce a dramatic change, a deeper injury is needed,
such as a deep peel using phenol or a laser resurfacing procedure.
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