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Junior’s Journal Club
It can simply accelerate the natural processes
A chemical peel is chemexfoliation intended to
of exfoliation, but can also completely destroy
visibly improve the structure of treated tissue
Definition
the epidermisbyand external or less large
the a more
proportion of the of a caustic solution.
application dermis, essentially by
• protein coagulation
• lysis.
10. Al-Haud AL-Marsud
Junior’s Journal Club Indications
AAD identified the therapeutic and
aesthetic indications in which chemical
peels can be used
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Junior’s Journal Club Indications
Committee for the 2001 Guidelines of Care for Chemical
Peeling of the Japanese Dermatological Association
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Junior’s Journal Club
Procedure
Level 1: Erythema with Level 2: White frosting Level 3:Solid Opaque
blotchy or wispy with areas of white, no erythema
areas of white frosting erythema showing
through
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Combinations and ready made kits
• Classical Jessner's:Resorcinol (14%)+ lactic acid
(14%)+ salicylic acid (14%) in alcoholic solution
• Modified Jessner's: lactic acid (17%)+ salicylic acid
(17%)+ (8%) in ethanol.
• Monheit's:17% Jessner's +35% TCA
17. Al-Haud AL-Marsud
Junior’s Journal Club
Combinations and ready made kits
Only Touch®
Cosmo Peel®
Approximately 44% TCA used for AK and lentigenes.
Easy TCA®
A Mixture of TCA 15% +AHAs + saponins
Needs no preparation
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New Advances in Chemical Peeling
• 50 patients, 25 received Co2 laser, 25 received 30% TCA
sessions weekly
to a maximum of 15 sittings
• Co2 Laser: 100% cure rate
• TCA 30% : 12/ 25 remission.
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• Retrospective review
• 51 patients, 17 patients reported no recurrence, 22 patients had
experienced a recurrence, 9 patients had persistence of the lesion and
3 patients undergone surgical excision
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• Three strengths of TCA 100%, 70%, 50%
• 100% or 70% TCA give similar results in flat plaque xanthelasma.
Hypopigmentation is the commonest side effect, followed by
hyperpigmentation
• Macular lesions responded to only one application of 50 %.
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New Advances in ChemicalPeeling
32 Actinic Keratosis
patients, 29 showed
complete remission
14 Bowen’s Disease patients,
10 showed complete
remission
Protocol: Pure Phenol 100%,
each m, max 8 sessions.
That’s why peels in Hairy areas give much better results than others
Japanese Study2010: Glycolic , Lactic,there was dissociation and vacuolation between the basal cells and increases in vimentin filaments within fibroblasts and endothelial cells were seen. These findings suggest that chemical peeling of the skin with this type of agent directly induces collagen formation within the dermis and thus directly stimulates remodeling of the dermis.Read More: http://informahealthcare.com/doi/abs/10.3109/14764170903376224
Salicylic 50% can be used in paste under occlusion for non facial areas35% TCA may or may not penetrate through the epidermis after a single application and is classified as a superficial peel; with multiple applications it may penetrate into the papillary dermis and is less superficial and more medium in depth.Combinations with lower strength TCA- Glycolic-JessnerFull-strength phenol, USP 88%-penetrates less than diluted
Which type of skin and historyDermatologists have the edge in knoowing the depth of the lesions in the skin
Twice daily 2 days before and 5 days after which also applies for resurfacing techniquesDegreasing is not always required e.g. Easy TCATo avoid pooling of the agent in … apply vaseline