Chemical Peels in der �sthetischen Dermatologie

Abstract

Chemical peels are classified as very superficial (exfoliation), superficial (epidermal), medium (papillary dermal) and deep (reticular dermal). A successful peel depends upon a number of variables, such as choice of the peeling agent, its concentration, and the pressure and frequency of the applications; all must be adjusted to the patient's skin condition. Through standardization of the peeling agents, the level of injury can be determined pre-operatively and complications minimized. Trichloroacetic acid (TCA) is the most popular peeling agent used in different concentrations. It has the broadest spectrum of indications due to its versatility in combination with other peeling agents. Indications for superficial peels include skin resurfacing, wrinkles, actinically damaged skin, actinic keratoses and benign pigmented lesions. Superficial peels have the advantage that they can be used on most regions of the body. The use of different chemical peels, their varying effects and their potential complications are reviewed. There are at present more than 45 chemical peels with different combinations of agents available on the European market.

Comparative study of 15% TCA peel versus 35% glycolic acid peel for the treatment of melasma

“…Specific peeling agents should be selected based on the disorder to be treated and used with an appropriate peel depth, determined by the histological level or severity of skin pathology to maximize success. [2] However, other considerations, such as skin characteristics, area of skin to be treated, safety issues, healing time, and patient adherence, should also be taken into account for best overall results.…”

Cosmetic and dermatologic use of alpha hydroxy acids

“…The most frequent side effect following AHAs’ peelings is a persistent erythema. While burning sensation probably last only for hours in case of a mild peeling they can last for months if a deep peeling was applied [3, 23]. Depending on the AHA concentration, patients with a history of herpes simplex might require an antiviral prophylaxis for full facial treatments.…”

A study on fractional erbium glass laser therapy versus chemical peeling for the treatment of melasma in female patients

“…[678] Clinically, melasma can be divided into centrofacial, malar and mandibular, according to the pigment distribution on the skin. By Wood's light examination, melasma can be classified into epidermal, dermal or mixed type.…”