Test Spots in Dermabrasion and Chemical Peeling

Abstract

Small, inconspicuous test spots performed in advance of a planned dermabrasion or chemical peel can be an excellent adjunct to surgery. Greater predictability of efficacy, pigmentary response, healing characteristics, and side effects is achieved with this preliminary test. Comparisons can also be made between various brushes or fraises, as well as types and strengths of peeling chemicals. Patient anxiety will be alleviated and reliability enhanced with this simple procedure. The relatively few drawbacks of test spots are discussed.

Chemical peels: A review of current practice

“…60 The advantages of test-spot testing include the more accurate predication of peel efficacy, healing time, pigmentary response and post-peel complications. 59,60 It also facilitates the proper selection of candidates, alleviates their anxiety and discourages impulsivity.…”

“…60 The advantages of test-spot testing include the more accurate predication of peel efficacy, healing time, pigmentary response and post-peel complications. 59,60 It also facilitates the proper selection of candidates, alleviates their anxiety and discourages impulsivity. 60 The disadvantages of this technique include a delay of treatment, misrepresentative results and the persistence of the test-spot until the definitive procedure takes place.…”

“…59,60 It also facilitates the proper selection of candidates, alleviates their anxiety and discourages impulsivity. 60 The disadvantages of this technique include a delay of treatment, misrepresentative results and the persistence of the test-spot until the definitive procedure takes place.…”

Response

“…We have seen several cases where the clinical results with 50% TCA clearly equal that which can be routinely obtained with Baker's formula. We feel that there are enough risks of scarring, delayed healing, and dyschromia associated with concentrations of TCA above 35% that on the basis of risk factors alone , one may consider TCA 50% to be “deep” rather than “medium” but the distinctions are purely artificial. Xanthelasma are unquestionably dermal lesions, and we regret the editorial “publishing by committee” process failed to catch this embarassing error, but we were not given final galleys to proofread prior to publication. The use of the test spot 8 is an invaluable tool in building the therapeutic alliance between patient and doctor, in establishing the concept of “shared risk,” in maintaining options for the patients who will occasionally decline to proceed with a full face peel after seeing the effects of the test spot. We usually perform the test spot at the initial consultation, and find it adds no extra time, but saves hours of hand holding after a full face peel.…”

Chemexfoliation and Superficial Skin Resurfacing

“…Any history of abnormal scar formation, either hypertrophic scar or keloids, creates a greater risk to scar with deep as opposed to medium-depth peeling. In addition, the patient's pregnancy history and medications should be considered, Paula E. Bourelly, Angela J. Lotsikas-Baggili 56 It is worth mentioning that a postauricular test peel may be useful in select patients to assess their suitability for chemical resurfacing and may be especially helpful in identifying patients at increased risk of postoperative pigmentary dyschromias [11].Although a favorable test post is reassuring, it does not guarantee a positive outcome following full-face resurfacing.…”