Chemical Peel Procedures Research Articles

Chemical Peeling in Skin-Aging Patients: A Retrospective Study

Background: Skin aging is a degenerative process that involves a decrease in the structure and function of skin cells and theextracellular matrix due to intrinsic and extrinsic factors. Chemical peeling is one of the skin aging treatments that involvesskin ablation using chemical agents. Purpose: To evaluate the profile of skin-aging patients treated with chemical peeling atthe Dermatology and Venereology Outpatient Unit of Dr. Soetomo General Hospital Surabaya from January throughDecember 2019. Methods: The data were obtained from patients’ medical records through a total sampling technique, whichconsisted of age, gender, occupation, history taking, physical examination, diagnosis, therapeutic agents, follow-up frequency,and therapeutic result. Result: The study included 37 patients, the majority of whom were between the ages of 46 and 55(35.1%), female (100%), and private employees (32.4%). In history taking, patients’ main complaint is dull skin (94.6%), withthe risk factor of sun exposure (97.3%) and the history of sunscreen usage (81.1%). Pigmentary changes were found in allpatients (100%). The most common diagnoses are photoaging Glogau II and Glogau III, found in 15 patients (40.5%),respectively. The common priming agents were sunscreen (97.3%), cleanser (94.6%), and 8% glycolic acid (75.7%). Themajority of patients (62.2%) received 20% glycolic acid as a peeling agent and sunscreen (86.5%) as a post-peeling agent.The majority of patients (43.2%) did not follow up. Glogau II photoaging (57.1%) was the main therapeutic result.Conclusion: Proper chemical peeling procedures and patients compliance are important factors to improve therapeuticoutcomes.

Insurance Coverage of Dermabrasion and Chemical Peel Procedures: A Critical Analysis of 58 American Insurance Companies.

Introduction Dermabrasion and chemical peels are infrequently utilized methods of treatment for medical-grade conditions despite demonstrations of favorable outcomes. Insurance coverage status has previously been shown to impact availability and accessibility to specific treatments. The purpose of this study is to evaluate the rate of insurance coverage provided for dermabrasionand chemical peel procedures in the treatment of acne, acne scarring,and non-melanoma skin cancers (NMSC). Methods A cross-sectional analysis of 58 insurance companies by web-basedsearch or phone interview determined the number of insurers with a publicly available policy on dermabrasion or chemical peels. Coverage status and any corresponding criteria were extracted from existing company policies. Results Thirteen (22%) and 22 (38%) policies discussed dermabrasion in the treatment of basal cell carcinoma and actinic keratosis, with 62% and 73% of these policies providing coverage. Acne scarring was discussedin significantly more dermabrasion policies than basal cell carcinoma (45% vs 22%; p=0.018). However, significantly more insurers denied coverage of dermabrasion for active acne and acne scarring when compared to dermabrasionto treat basal cell carcinoma or actinic keratosis (p<0.001).Eighty-seven percent of companies (n=20) with a chemical peel policy for premalignant lesions would providecoverage, with required criteria present in 95% (n=19) of thepolicies that would coverchemical peels for actinic keratosis specifically. Of the 25 companies (43%) that discussed the treatment of acne with chemical peel procedures, 14 (56%) provided coverage, and 11 (44%) denied coverage. Coveragewas denied by significantly less insurersfor the treatment of active acne with chemical peel procedures compared to treatment with dermabrasion(44% vs 83%; p<0.006). Conclusion Significant discrepancies were noted in both the presence of a publicpolicy and the coverage status of dermabrasion or chemical peel proceduresamong the United States health insurance companies. These inconsistencies, along with multiple criteria required for coverage, may create an artificial barrier to receiving care for specific medical-grade conditions.

Public Interest in Cosmetic Surgical and Minimally Invasive Plastic Procedures During the COVID-19 Pandemic: Infodemiology Study of Twitter Data.

BackgroundThe unprecedented COVID-19 pandemic has brought drastic changes to the field of plastic surgery. It is critical for stakeholders in this field to identify the changes in public interest in plastic procedures to be adequately prepared to meet the challenges of the pandemic.ObjectiveThe aim of this study is to examine tweets related to the public interest in plastic procedures during the COVID-19 pandemic and to help stakeholders in the field of plastic surgery adjust their practices and sustain their operations during the current difficult situation of the pandemic.MethodsUsing a web crawler, 73,963 publicly accessible tweets about the most common cosmetic surgical and minimally invasive plastic procedures were collected. The tweets were grouped into three phases, and the tweeting frequencies and Google Trends indices were examined. Tweeting frequency, sentiment, and word frequency analyses were performed with Python modules.ResultsTweeting frequency increased by 24.0% in phase 2 and decreased by 9.1% in phase 3. Tweets about breast augmentation, liposuction, and abdominoplasty (“tummy tuck”) procedures consecutively increased over the three phases of the pandemic. Interest in Botox and chemical peel procedures revived first when the lockdown was lifted. The COVID-19 pandemic was associated with a negative impact on public sentiment about plastic procedures. The word frequency pattern significantly changed after phase 1 and then remained relatively stable.ConclusionsAccording to Twitter data, the public maintained their interest in plastic procedures during the COVID-19 pandemic. Stakeholders should consider refocusing on breast augmentation, liposuction, and abdominoplasty procedures during the current phase of the pandemic. In the case of a second wave of COVID-19, stakeholders should prepare for a temporary surge of Botox and chemical peel procedures.

Combining in-office chemical peel procedures with topical therapy of a comprehensive pigmentation control product for multiethnic subjects with moderate to severe facial hyperpigmentation

Combining in-office chemical peel procedures with topical therapy of a comprehensive pigmentation control product for multiethnic subjects with moderate to severe facial hyperpigmentation

The Evolution of Chemical Peeling and Modern-Day Applications.

Despite the growth of technically more sophisticated skin resurfacing modalities, such as those based on light, radiofrequency, and ultrasound, chemical peel procedures have risen 5 to 25 percent over the past year alone. Chemexfoliation carries historical significance and has markedly evolved since its inception in ancient times. As a result of plastic surgery and dermatologic advancements, modern-day chemexfoliation offers plastic surgeons additional safe and effective options for patients with rhytides, dyschromias, and other signs of light- and environment-induced skin damage. This review discusses the historical evolution of chemexfoliation procedures, highlights modern-day practice habits, and touches on the clinically relevant applications of chemical peels.

Combining In-Office Chemical Peel Procedures with Topical Therapy of a Comprehensive Pigmentation Control Product for Multi-Ethnic Subjects with Moderate-to-Severe Facial Hyperpigmentation

Abstract Not AvailableStudy supported by Allergan.

Efficacy and safety of superficial chemical peeling in treatment of active acne vulgaris.

Acne vulgaris is an extremely common condition affecting the pilosebaceous unit of the skin and characterized by presence of comedones, papules, pustules, nodules, cysts, which might result in permanent scars. Acne vulgaris commonly involve adolescents and young age groups. Active acne vulgaris is usually associated with several complications like hyper or hypopigmentation, scar formation and skin disfigurement. Previous studies have targeted the efficiency and safety of local and systemic agents in the treatment of active acne vulgaris. Superficial chemical peeling is a skin-wounding procedure which might cause some potentially undesirable adverse events. This study was conducted to review the efficacy and safety of superficial chemical peeling in the treatment of active acne vulgaris. It is a structured review of an earlier seven articles meeting the inclusion and exclusion criteria. The clinical assessments were based on pretreatment and post-treatment comparisons and the role of superficial chemical peeling in reduction of papules, pustules and comedones in active acne vulgaris. This study showed that almost all patients tolerated well the chemical peeling procedures despite a mild discomfort, burning, irritation and erythema have been reported; also the incidence of major adverse events was very low and easily manageable. In conclusion, chemical peeling with glycolic acid is a well-tolerated and safe treatment modality in active acne vulgaris while salicylic acid peels is a more convenient for treatment of darker skin patients and it showed significant and earlier improvement than glycolic acid

Commentary on: unattractive consequences: litigation from facial dermabrasion and chemical peel procedures.

The success of any plastic surgery practice rests on patient satisfaction. Disappointment is a natural consequence of unmet expectations. Plastic surgeons attempt to mitigate disappointment through detailed discussions and documentation. The surgeon explores the patient’s goals as well as surgical and psychological complications, all the while avoiding promises and guarantees to manage the patient’s possibly unrealistic expectations. Plastic surgeons are largely successful in this effort but not always. Lawsuits are the quintessential expression of patient dissatisfaction. In the accompanying article, “Unattractive Consequences: Litigation From Facial Dermabrasion and Chemical Peel Procedures,” the authors have examined 25 legal proceedings to determine why a patient becomes a plaintiff.1 As with any retrospective analysis of lawsuits, conclusions hinge on whether the sample pool represents the general population. Here the data source is Westlaw, which, similar to LexisNexis, obtains published appellate court decisions from all state and federal courts.2 State trial court decisions, jury verdicts, and settlements—which are not published in bound volumes gathering …

New formulation of chemical peeling agent: 30% salicylic acid in polyethylene glycol: Absorption and distribution of 14C-salicylic acid in polyethylene glycol applied topically to skin of hairless mice

Salicylic acid is used in chemical peeling procedures. However, they have caused many side effects, even salicylism. To achieve a salicylic acid peeling that would be safer for topical use, we recently developed a new formulation consisting of 30% salicylic acid in polyethylene glycol (PEG) vehicle. In an extension of our previous research, we studied the absorption of 30% salicylic acid labeled with 14C in PEG vehicle applied topically to the intact and damaged skin of male hairless mice. An ointment containing 3 mg salicylic acid in 10 mg vehicle was applied to both groups. In animals with intact skin, 1 h after application the plasma concentration of radioactivity was 1665.1 ng eq/ml, significantly lower than the 21 437.6 ng eq/ml observed in mice with damaged skin. Microautoradiograms of intact skin showed that the level of radioactivity in the cornified cell layer was similar at 6 h after application. However, in damaged skin, the overall level of radioactivity showed a decrease by 3 h after application. In the carcasses remaining after the treated intact and damaged skin had been removed, 0.09 and 11.38% of the applied radioactivity remained, respectively. These findings confirm that 30% salicylic acid in PEG vehicle is little absorbed through the intact skin of hairless mice, and suggest that salicylism related to absorption through the skin of quantities of topically applied salicylic acid is not likely to occur in humans with intact skin during chemical peeling with this preparation. This new preparation of 30% salicylic acid in PEG vehicle is believed to be safe for application as a chemical peeling agent.

The principle of a three-staged operation in the surgery of acne scars

Background: Acne scars cannot be effectively corrected by a single treatment modality because of their widely varied depth and width. Objective: We assessed the effectiveness of staged combinations of several surgical modalities in the treatment of acne scars. Methods: Focal chemical peeling, carbon dioxide (CO 2 ) laser, scar excision, punch grafting, and dermabrasion were used. Initially, focal chemical peeling was performed on all patients and then CO 2 laser, scar excision, and punch grafts were used for deep scars. Finally, dermabrasion was done for the remaining scars. Results: Seventy-five percent of patients showed excellent or good results. The degree of improvement increased as the follow-up periods and number of focal chemical peeling procedures increased and as the 3-staged operation progressed. Conclusion: A 3-staged operation is effective in the treatment of patients with various types of acne scars. (J Am Acad Dermatol 1999;40:95-7.)

The Art of the Trichloroacetic Acid Chemical Peel

Despite escalating interest in laser resurfacing techniques, chemical peel procedures remain an integral part of the armamentarium for resurfacing aging, sun-damaged, and diseased skin. Like other chemicals, the advantage of the technique of tricholoracetic (TCA) acid application is that the degree and depth of penetration within the skin can be controlled accurately according to specific requirements. This article reviews the preoperative evaluation of skin and the techniques for preconditioning, intraoperative peel, and postoperative management of TCA-treated skin.

EKG Changes in Relationship to the Chemical Peel

Holter monitor-type EKG studies were done in a series of 10 patients during preoperative baseline and intra- and postoperative periods of Baker-type chemical peel procedures. The intention was to assess the quantitative and qualitative EKG changes occurring before, during, and after the procedures. The results show that there were many spontaneously occurring ectopic beats and changes unrelated to the actual application of the chemical peel formula. Only one of the patients demonstrated such changes, which can be potentially life threatening, occurring in relationship to application of the chemical peel formula.