Depth of injury of Hetter's phenol-croton oil chemical peel formula using 2 different emulsifying agents

Justo, Aline da Silva; Lemes, Bruna Mikulis; Nunes, Bruna; Antunes, Kevin A.; Koga, Adriana Yuriko; Lipinski, Leandro Cavalcante; Netto, Mário Rodrigues Montemór; Campagnoli, Eduardo Bauml; Beltrame, Flávio Luís; Wambier, Carlos Gustavo

doi:10.1016/j.jaad.2020.02.064

Cited by 7 publications

(1 citation statement)

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“…The endpoint was a solid white frost followed by a fine gray cast. Because G2 and G3 are unable to form stable emulsions because of SEP, 5 they were carefully shaken (capped glass vial) within seconds before its application.…”

Section: Methodsmentioning

confidence: 99%

Characterization of the Activity of Croton tiglium Oil in Hetter's Very Heavy Phenol–Croton Oil Chemical Peels

Justo¹,

Lemes²,

Nunes³

et al. 2021

Dermatol Surg

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BACKGROUND Croton oil (CO) is used by dermatologists and plastic surgeons in deep chemical peels. It is mixed with phenol, water, and a soap in Baker–Gordon's or Hetter's formulas. There is controversy as to whether CO or phenol is the active agent in the dermal effect of deep chemical peels. OBJECTIVE To better clarify the role of CO in deep peels, by identification of active compounds in commercially available CO in the United States and biological effects in vivo. MATERIALS AND METHODS Liquid chromatography–tandem mass spectrometry on CO and a domestic pig model experiment using 3 different formulas: G1: 5% Septisol (SEP), G2: 1.6% croton oil in 35% phenol with 5% SEP, and G3: 35% phenol with 5% SEP. RESULTS Liquid chromatography–tandem mass spectrometry indicated the presence of phorbol esters. G1 was null overall. Extent of the coagulative necrosis: G2 > G3. Vascular ectasia: G2 > G3. Inflammation pattern: intense neutrophilic inflammatory band in G2 versus mild, sparse, perivascular mononuclear cell infiltrate in G3. Neocollagenesis: pronounced in G2, negligible in G3. CONCLUSION Coagulative necrosis of the epidermis, superficial fibroblasts, and vasculature can be attributed to the action of phenol. Phorbol esters on CO could be responsible for the dense deep acute inflammation and the distinctive neocollagenesis.

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Section: Methodsmentioning

confidence: 99%