Phenol Peel Research Articles

Phenol peeling. Risks and medical care when performing this aesthetic procedure

Phenol chemical peeling is considered a deep peeling that promotes facial rejuvenation, an aggressive method, promoting the exchange of several layers of the epidermis and dermis generating local re-epithelialization, leading to intense cell renewal, which helps in rejuvenation, stimulating its collagen, and consists of accelerating the exfoliation of the skin, through the use of chemical agents (acids), accelerating the speed of cell renewal.

Intense pulsed light therapy for the treatment of facial erythema and hypertrophic scar after phenol peeling

Intense pulsed light therapy for the treatment of facial erythema and hypertrophic scar after phenol peeling

Chemical peelings for the treatment of actinic keratosis: a systematic review and meta-analysis.

Actinic keratosis (AK) is a common precancerous lesion of the skin that may be treated with chemical peelings. Despite their long-standing usage and clinical experience, no evidence-based recommendation regarding the efficacy and safety of chemical peelings for AK exists. To systematically review and synthesize the current knowledge on chemically exfoliative peelings as interventions for AK. We performed a systematic literature research in Medline, Embase and CENTRAL and hand-searched pertinent trial registers for eligible records until 5 August 2019. Results from individual studies were pooled using a random-effects model or described in a qualitative synthesis. The risk of bias was estimated with the tools provided by the Cochrane Collaboration (randomized and non-randomized trials) and the Evidence Project (single-arm trials). Four randomized controlled trials, two non-randomized controlled trials and two single-arm studies with a total sample size of n=170 patients were included. Trichloroacetic acid (TCA) plus Jessner's solution showed significantly lower participant complete clearance (RR 0.36, 95% CI: 0.14-0.90, two studies, I2 =0%, P=0.03) and lower lesion clearance (RR 0.92, 95% CI: 0.85-0.99, one study, P=0.03) compared to 5-fluorouracil (5-FU) 5% cream. TCA as monotherapy showed lower lesion complete clearance (RR 0.75, 95% CI: 0.69-0.82, two studies, I2 =7%, P<0.001) and lower mean lesion reduction per patient compared to conventional photodynamic therapy (cPDT) (MD -20.48, 95% CI: -31.55 to -9.41, two studies, I2 =43%, P=0.0003). Pain was more pronounced in patients treated with cPDT in comparison with TCA (MD -1.71 95% CI: -3.02 to -0.41, two studies, I2 =55%, P=0.01). In the single-arm studies, 5-FU plus glycolic acid showed 92% lesion clearance and phenol peeling 90.6% participant complete clearance. All studies showed a high risk for bias. Future high-quality studies and a standardization of peeling protocols are warranted to determine the value of chemical peelings in the treatment of AK.

Is there still a place for deep chemical peels in the treatment of perioral wrinkles?

Baker-Gordon formula phenol chemical peel remains the most effective and long-lasting treatment for deep facial lines. However, this treatment is associated with risk of serious complications, such as arrhythmias and dystrophic scars. With the emergence of new and safer technologies for facial rejuvenation, such as fractionated carbon dioxide (CO2) lasers and microneedling, there has been a decrease in the use of deep chemical peels. This raises the question of whether there is still a place for deep phenol chemical peels. In this sense, we present a successful case of using Baker-Gordon formula phenol chemical peel at the perioral region for treating advanced wrinkles. This technique is called "Regional Phenol Peeling" and is safer than the use of the formula applied to the entire face, since it does not need systemic monitoring.

Regional phenol peel and botulinum toxin: still an efficient and affordable treatment for periorbital and perioral wrinkles

Regional phenol peel and botulinum toxin: still an efficient and affordable treatment for periorbital and perioral wrinkles

Modified phenol peels for treatment-refractory hyperpigmentation of lichen planus pigmentosus: A retrospective clinico-dermoscopic analysis.

Lichen Planus Pigmentosus (LPP), a disorder with stubborn treatment-refractory hyperpigmentation predominantly affects the darker skin. Deep dermal pigmentary incontinence of LPP renders the condition treatment-refractory. Lack of a consistently effective depigmenting treatment protocol of inactive LPP mandates exploration of novel approaches. We analyzed the effect of six sessions of modified phenol peel on reduction of pigmentation of LPP in Indian patients. The results of a retrospective analysis of the efficacy and safety of six sessions of Croton oil free phenol combination (CFPC) peel done every 3weeks, for inactive LPP-associated hyperpigmentation in 17 patients are presented. Efficacy evaluation was done with patient-reported improvement, physician-evaluated improvement (photographic comparison of baseline and post-treatment clinical images), and pre- and posttreatment comparison of dermoscopic images using a simple scale. Out of 17, 5 (29%) patients sustained excellent improvement with >75% reduction of pigmentation. Overall 13 (76%) patients had moderate to excellent improvement, that is, at least 25% or more reduction in pigmentation. The patient-reported improvement, physician-graded improvement, and dermoscopic changes-all three measures showed harmonious overlap. Lightening of the background color and reduction in density and color intensity of pigmented structures was observed on dermoscopy in majority of patients. The treatment was well tolerated with no serious local/systemic adverse effects. Modified phenol peels seem effective in reduction of hyperpigmentation of LPP. They are safe and well tolerated. Thorough priming, stringent sun protection and use of post-peel adjuvant topicals boost the peel effect and aid in maintaining the effect for up to a year.

Canopy attachment position influences metabolism and peel constituency of European pear fruit

BackgroundInconsistent pear fruit ripening resulting from variable harvest maturity within tree canopies can contribute to postharvest losses through senescence and spoilage that would otherwise be effectively managed using crop protectant and storage regimes. Because those inconsistencies are likely based on metabolic differences, non-targeted metabolic profiling peel of ‘d’Anjou’ pears harvested from the external or internal canopy was used to determine the breadth of difference and link metabolites with canopy position during long-term controlled atmosphere storage.ResultsDifferences were widespread, encompassing everything from expected distinctions in flavonol glycoside levels between peel of fruit from external and internal canopy positions to increased aroma volatile production and sucrose hydrolysis with ripening. Some of the most substantial differences were in levels of triterpene and phenolic peel cuticle components among which acyl esters of ursolic acid and fatty acyl esters of p-coumaryl alcohol were higher in the cuticle of fruit from external tree positions, and acyl esters of α-amyrin were elevated in peel of fruit from internal positions. Possibly the most substantial dissimilarities were those that were directly related to fruit quality. Phytosterol conjugates and sesquiterpenes related to elevated superficial scald risk were higher in pears from external positions which were to be potentially rendered unmarketable by superficial scald. Other metabolites associated with fruit aroma and flavor became more prevalent in external fruit peel as ripening progressed and, likewise, with differential soluble solids and ethylene levels, suggesting the final product not only ripens differentially but the final fruit quality following ripening is actually different based on the tree position.ConclusionsGiven the impact tree position appears to have on the most intrinsic aspects of ripening and quality, every supply chain management strategy would likely lead to diverse storage outcomes among fruit from most orchards, especially those with large canopies. Metabolites consistently associated with peel of fruit from a particular canopy position may provide targets for non-destructive pre-storage sorting used to reduce losses contributed by this inconsistency.

Punctuated 88% Phenol Peeling for the Treatment of Facial Photoaging: A Clinical and Histopathological Study.

Phenol peeling is considered an important agent in the treatment of facial rejuvenation; however, its use has limitations due to its high potential for side effects. This article proposes a new peeling application technique for the treatment of photoaging, aiming to evaluate, clinically and histopathologically, the efficacy of a new way of applying 88% phenol, using a punctuated pattern. The procedure was performed in an outpatient setting, with female patients, on static wrinkles and high flaccidity areas of the face. Accompanying photographs and skin samples were taken for histopathological analysis before and after treatment. It was shown that 88% phenol applied topically using a punctuated technique is effective in skin rejuvenation. The authors thus suggest, based on this new proposal, that further studies be conducted with a larger group of patients to better elucidate the action mechanisms of 88% phenol. This new form of application considerably reduced patients' withdrawal from their regular activities, besides reducing the cost, compared with the conventional procedure.

Commentary on Punctuated 88% Phenol Peeling for the Treatment of Facial Photoaging.

Commentary on Punctuated 88% Phenol Peeling for the Treatment of Facial Photoaging.

Chemical Peeling with a Modified Phenol Formula for the Treatment of Facial Freckles on Asian Skin.

Chemical peeling is an efficient method for the treatment of pigment disorders. For freckles, medium-depth to deep peeling using a phenol solution is one of the most effective chemical peels, and modifications of facial skin can be observed up to 20years after peeling. However, applying phenol to the skin may cause serious side effects. Phenol peeling has been rarely used in Asia due to its tendency to cause permanent pigmentary changes and hypertrophic scars. In total, 896 Chinese inpatients with facial freckles were enrolled in this study. The phenol formula was modified with crystalline phenol, dyclonine, camphor, anhydrous alcohol and glycerin and adjusted to a concentration of 73.6-90.0%. The entire peeling treatment was divided into two procedures performed separately on 2days. All patients exhibited 26% or greater improvement, and 99.66% of patients exhibited 51% or greater improvement (good and excellent). Scarring and systemic complications were not observed in any patient. The modified phenol formula is very effective and safe for the treatment of facial freckles in Asian patients. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Comments: Hemiface comparative study of two phenol peels (Baker-Gordon and Hetter formulas) for the correction of facial rhytids

Comments: Hemiface comparative study of two phenol peels (Baker-Gordon and Hetter formulas) for the correction of facial rhytids

Take, Give, and Peel

Surgeons performing lower eyelid blepharoplasties continue to seek an efficient method and predictable outcome to restore the aesthetic ideal of the lower eyelid and cheek junction. Current popular methods frequently fall short. Three patients were chosen as examples from the senior author’s past 30 years of practice where they desired improvement in the aesthetic appearance of their lower eyelids. They were treated with a combination of transconjunctival blepharoplasty, fat grafting, and 88% phenol peel. The preoperative and postoperative photos of the patients were analyzed by the patient and senior author. Having undergone the methods described for treatment, all selected patients reported significant improvement with their postoperative appearance. Minimal complications were reported and are mentioned below. No surgical revisions were requested, and the results were stable over an acceptable period of time with an average follow-up time of 2 years. Two of the 3 patients chosen had a follow-up time of at least 8 years. Transconjunctival lower eyelid blepharoplasty when combined with fat grafting and phenol peeling offers a treatment modality to restore the aesthetic ideal of the lower eyelid and cheek junction and, in our hands, is superior to other methods previously described.

Idiopathic Guttate Hypomelanosis: A Review of its Etiology, Pathogenesis, Findings, and Treatments

Idiopathic guttate hypomelanosis is a common acquired leukoderma characterized by multiple, discrete round or oval, porcelain-white macules on sun-exposed areas, especially on the extensor surface of forearms and pretibial areas. It usually affects individuals aged over 40years and the likelihood of acquiring it increases with age. The exact pathogenesis remains controversial. However, there are several factors that are believed to be involved such as aging, ultraviolet exposure, trauma, genetic factors, autoimmunity, and local inhibition of melanogenesis. Despite the benign course of progression, many patients visit medical centers owing to cosmetic concerns and to confirm the natural course of idiopathic guttate hypomelanosis. Because there is no standard therapy for this condition, numerous medical and surgical treatments including intralesional corticosteroids, topical retinoids, topical calcineurin inhibitors, phenol peeling, cryotherapy, superficial dermabrasion, skin grafting, and ablative and non-ablative lasers have been tested with mixed results. This article will thoroughly review the etiology, pathogenesis, clinical presentations, histologic, dermoscopic, and ultrastructural findings, and the treatment of idiopathic guttate hypomelanosis.

Reflectance confocal microscopy as a support for the clinical evaluation of the changes caused by aging skin

Introducao: The beneficial role of medium peelings and microneedling in photoaging and scars yield satisfactory results. Objective: A retrospective, descriptive, single-center study evaluating the results of the association of 88% phenol and microneedling for treating sagging, wrinkles and acne scars on the face. Methods: Medical records and standardized photographs, taken before and 3 months after the procedure, of 28 patients diagnosed with wrinkles, sagging or acne scars and treated with 88% phenol peeling followed by microneedling with 2.5 mm needles, were analyzed. Events and complications were recorded 15 days after the procedure. The investigator physician performed clinical and photographic assessments 3 months after the procedure, when patient satisfaction questionnaires were also applied. Results: Twelve patients had only wrinkles and sagging, 5 had only acne scars and 10 had both pictures, with skin phototypes I to III. Erythema persisted for 30 days and post-inflammatory hyperpigmentation was observed in 7 of 28 patients. Based on the clinic and photographic evaluations, the author considered the results as good and very good. 100% of patients reported satisfaction with the outcomes. Conclusions: Good results were observed with the association of 88% phenol and microneedling. Few patients experienced adverse effects, allowing the author to suggest that the procedure showed a good safety profile.

Micropunch Blepharopeeling of the Upper Eyelids: A Combination Approach for Periorbital Rejuvenation – A Pilot Study

Upper eyelid skin excess is commonly treated using a surgical excision that is then sutured, resulting in a linear scar. Deep chemical peeling of the upper eyelids using the Baker Gordon formula has been described as a nonsurgical alternative to tighten upper eyelid skin with the advantage of lessening periorbital rhytides, although prolonged healing and hypopigmentation are risks. The goal of this study was to show the benefits of a less-invasive approach to periorbital rejuvenation that combines 89% phenol peeling with small, nonlinear excisions that heal by secondary intention. Eight patients were chosen (mean age 59.6). All patients had thin to medium-thick skin, diffuse periorbital rhytides, and mild to moderate upper eyelid skin excess. Their eyelids were peeled using 89% phenol. Immediately after peeling, a scissor was used to make multiple small nonlinear excisions of upper eyelid skin that healed by secondary intention. Patients were satisfied with the results, and no complications or scarring occurred. Eighty-nine percent phenol peeling combined with multiple small upper eyelid skin excisions effectively tightens upper eyelid skin excess and lessens periorbital rhytides. The procedure has the advantage of not creating a linear scar and decreases the risk of prolonged healing and hypopigmentation, which is more likely with deeper peels.

Aknetherapie in der Schwangerschaft

Acne should be treated during pregnancy to prevent worsening, scarring, secondary infection or psychological impairment of the mother. Safe products must be chosen. Systemic tetracycline, doxycycline, minocycline or isotretinoin can not be used. Topical benzoyl peroxide or topical azelaic acid are safe therapeutic options. According to the guidelines, systemic corticosteroids or systemic erythromycin (the latter not in lactation) can be employed beginning in the second trimester for severe flares of acne and should be started in cooperation with the patient's gynecologist. Oral zinc is another option, but not for longer than 3 months. Accessory cosmetic measures may be useful, including mechanical peeling or chemical peeling with glycolic or alpha-hydroxy-acids. In contrast, salicylic acid, trichloracetic acid or phenol peels should not be performed in pregnancy. Camouflage makeup can clearly lower the psychological stress.

Commentary on Clinical Protocol for Punctuated 88% Phenol Peels in the Treatment of Photoaging: A Histopathologic Study of Three Cases

Commentary on Clinical Protocol for Punctuated 88% Phenol Peels in the Treatment of Photoaging: A Histopathologic Study of Three Cases

Clinical Protocol for Punctuated 88% Phenol Peels in the Treatment of Photoaging: A Histopathological Study of Three Cases

Clinical Protocol for Punctuated 88% Phenol Peels in the Treatment of Photoaging: A Histopathological Study of Three Cases

フェノールによる日光角化症とボーエン病の治療効果とケモカインレセプターに関する免疫組織化学的検討

我々は高齢者の表皮内癌に対し，外来で行える非観血的治療としてフェノール治療を行っている。今回はその治療効果を組織学的に検討し，ケモカインレセプターに関する免疫組織化学的検討をあわせて報告する。対象は2001年より2010年までに当科で治療を行った日光角化症44例とボーエン病18例で，平均年齢は76.6歳であった。そのうち治療により完全寛解した9例と無効7例，コントロールとして正常皮膚9例，有棘細胞癌6例について比較検討した。組織学的検討として初診時生検標本の腫瘍の厚さを測定し，免疫組織化学的検討としてCXCR4，CCR6，CCR7を用いて免疫組織化学的染色を施行し，治療効果との関連性を検討した。正常皮膚や完全寛解例と比較して，無効例では腫瘍の厚さが厚く，SCCと同様に初診時のCXCR4の発現が有意に高値を示した。その結果，腫瘍の厚さとCXCR4の発現は，治療効果と関連性があると考えられた。

Phenol application to angiosarcomas: implications and histologic studies

Cutaneous angiosarcoma (AS) is an aggressive endothelial sarcoma that arises in elderly people. Effective treatment options are limited. Phenol application has been reported to be effective and economical. To evaluate the efficacy of phenol application for the treatment of AS, and to examine the histologic changes in three cases of cutaneous AS with phenol application. After phenol application, biopsy specimens were collected from three patients with cutaneous AS. Paraffin-embedded sections of the skin specimens were then stained with hematoxylin and eosin. The detection of apoptosis was performed using the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-digoxigenin nick end labeling (TUNEL) method, and the depth of TUNEL-positive cell staining was examined. Phenol treatment induced a strong degeneration of tumor cells and endothelial cells in the dermis, when compared with nontreated areas. Positive staining of tumor cells and/or endothelial cells by the TUNEL method was found in phenol-treated lesions, but not in nontreated lesions. The injurious effects on these tumor cells persisted for as long as 6 h after phenol application. From a comparison of noninvasive therapy with standard surgical therapy, it is obvious that phenol peeling has several advantages with regard to the ease of the procedure, time efficiency, no need for special equipment, low therapeutic costs, good pain control, and post-treatment follow-up. This study suggests that phenol application can be a supportive treatment for AS.