الفهرس | Only 14 pages are availabe for public view |
Abstract Chemical peels represent a time-tested and cost-effective tool to use either solo or as an adjunct to surgery in the eternal quest for facial rejuvenation. Chemical peels are agents that induce a controlled caustic injury to the epidermis and/or dermis with resulting exfoliation that renders the underlying and reepithelialized skin refreshed with respect to texture and appearance. Indications for the application of chemical peels are relatively similar to those presented for laser resurfacing and include: photoaging, rhytids, actinic keratoses, pigmentary dyschromias, postinflammatory hyperpigmentation, superficial scarring, and acne vulgaris. Unlike laser resurfacing, certain peels can be useful in treatment of active acne . Each peeling agent has different properties, with different depths of penetration and potential for irritation. Mild peeling agents, such as alpha hydroxy acids (AHA), 20%-30% of salicylic acid and 10%-25% of trichloracetic acid (TCA) remove the stratum corneum, while strong peeling agents, such as >50% of TCA and 55% of phenol, remove deeper layers of the epidermis and also remove the papillary dermis. These deeper agents cause irritation, which often leads to unacceptable post inflammatory hyperpigmentation . Alpha-hydroxy acids are group of organic acids found in natural foods and are often commercially referred to as fruit acids. Although they are found in nature in sugarcane (glycolic acid), sour milk (lactic acid), and fruits (malic, citric and tartaric acids), the alpha-hydroxy acids used in dermatological and cosmetic products are usually produced synthetically . |