Chemical Rejuvenation of Skin

Several agents are available for chemical peeling, each with unique properties for different therapeutic effects. Chemical peels according to depth may be superficial, medium or deep. Superficial or light peels penetrate the epidermis only and include α-hydroxy acids like Glycolic acid, beta hydroxy acids like salicylic acid and easy peel with trichloracetic acid (TCA ). These epidermal peels are used to treat mild photo aging and other epidermal dermatoses such as acne vulgaris and are generally performed with the use of a series of peels usually once in 2-4 weeks. Medium-depth peels, such as medium-strength TCA or combination peels extend into the papillary dermis or upper reticular dermis. They can eradicate fine lines and wrinkles, improve color variation, eliminate some actinic keratoses, and correct textural irregularities. Deep peels are usually performed with Phenolic acid and induce deep wounding into the mid-to-deep reticular dermis. These deep peels can be used to help eradicate heavy wrinkles and lines due to chronic photodamage and can have results as dramatic as a face-lift. Complications are largely related to infection, pigmentary alteration, delayed healing and scarring but appropriate patient screening and prophylaxis can minimize their incidence.

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