Clinical role and application of superficial chemical peels in today's practice.

Chemical peeling is a popular, relatively inexpensive, and generally safe method to refresh and rejuvenate skin. This review focuses on superficial chemical peels and their use in routine clinical practice. A wide variety of peels are available, utilizing various actives and concentrations, including a recently introduced salicylic acid derivative, beta-lipohydroxy acid, which has properties that may expand the clinical use of peels. Superficial peels can be used to enhance treatment within a variety of conditions, including acne, melasma, dyschromias, photodamage and actinic keratoses. In addition, peels can be combined with other in-office procedures to optimize outcomes and enhance patient satisfaction, and allow clinicians to tailor the treatment to individual patient's needs. Successful outcomes are based on a thorough understanding and application of correct chemical peel procedures, including history-taking, pretreatment, preparation, peel selection, patient communication and maintenance regimens.Used properly, the superficial chemical peel has the potential to fill an important therapeutic need in the treatment armamentarium of dermatologists and plastic surgeons.

Evidence and considerations in the application of chemical peels in skin disorders and aesthetic resurfacing.

Chemical peeling is a popular, relatively inexpensive, and generally safe method for treatment of some skin disorders and to refresh and rejuvenate skin. This article focuses on chemical peels and their use in routine clinical practice. Chemical peels are classified by the depth of action into superficial, medium, and deep peels. The depth of the peel is correlated with clinical changes, with the greatest change achieved by deep peels. However, the depth is also associated with longer healing times and the potential for complications. A wide variety of peels are available, utilizing various topical agents and concentrations, including a recent salicylic acid derivative, beta-lipohydroxy acid, which has properties that may expand the clinical use of peels. Superficial peels, penetrating only the epidermis, can be used to enhance treatment for a variety of conditions, including acne, melasma, dyschromias, photodamage, and actinic keratoses. Medium-depth peels, penetrating to the papillary dermis, may be used for dyschromia, multiple solar keratoses, superficial scars, and pigmentary disorders. Deep peels, affecting reticular dermis, may be used for severe photoaging, deep wrinkles, or scars. Peels can be combined with other in-office facial resurfacing techniques to optimize outcomes and enhance patient satisfaction and allow clinicians to tailor the treatment to individual patient needs. Successful outcomes are based on a careful patient selection as well as appropriate use of specific peeling agents. Used properly, the chemical peel has the potential to fill an important therapeutic need in the dermatologist's and plastic surgeon's armamentarium.