RESUMEN
BACKGROUND: Chemical peels are applied to the face and neck to improve rhytides and the photoaged appearance of the skin. Peels can be applied to different skin depths depending on the types of chemicals, the volume of solution, and the amount of pressure or friction applied. If a peel is applied too superficially, rhytides will not be removed. If a peel is applied too deeply, scarring or hypopigmentation could occur. OBJECTIVE: To create face and neck depth maps for chemical peeling, which can guide safety when removing rhytides and improving the skin's appearance. MATERIALS AND METHODS: A multicenter retrospective review of records was conducted of patients who underwent phenol-croton oil peeling, from January 1, 2018, to December 31, 2018. Information was collected on facial and neck cosmetic units peeled, peel formula and strength used, outcomes, and complications. RESULTS: A total of 410 patients received deep peels. Two depth maps were created that corresponded to the most common patterns of deep chemical peel applications. CONCLUSION: Different areas of the face and neck are treated with different chemical peel application depths to safely improve rhytides and appearance. Depth maps are created to balance safety and efficacy.
Asunto(s)
Quimioexfoliación/métodos , Dermabrasión/métodos , Queratolíticos/administración & dosificación , Administración Cutánea , Adulto , Anciano , Anciano de 80 o más Años , Quimioexfoliación/efectos adversos , Aceite de Crotón/administración & dosificación , Aceite de Crotón/efectos adversos , Dermabrasión/efectos adversos , Cara/anatomía & histología , Femenino , Humanos , Queratolíticos/efectos adversos , Masculino , Persona de Mediana Edad , Cuello/anatomía & histología , Fenol/administración & dosificación , Fenol/efectos adversos , Estudios Retrospectivos , Piel/anatomía & histología , Piel/efectos de los fármacos , Envejecimiento de la Piel , Resultado del TratamientoRESUMEN
Once considered the standard for deep facial resurfacing, the classical Baker-Gordon phenol-croton oil peel has largely been replaced by formulas with lower concentrations of phenol and croton oil. The improved safety profile of deep peels has ushered in a new era in chemical peeling. Wrinkles can be improved and skin can be tightened with more subtle and natural results. No longer does a deep peel denote "alabaster white" facial depigmentation with complete effacement of wrinkles. Gregory Hetter's research showed that the strength and corresponding depth of penetration of the phenol-croton oil peel can be modified by varying the concentration of croton oil. This second article in this continuing medical education series focuses on the main historical, scientific, and procedural considerations in phenol-croton oil peels.
Asunto(s)
Quimioexfoliación/métodos , Aceite de Crotón/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Fenol/uso terapéutico , Quimioexfoliación/efectos adversos , Combinación de Medicamentos , Humanos , Selección de Paciente , Piel/patología , Envejecimiento de la PielRESUMEN
All fillers are associated with the risk of both early and late complications. Early side effects such as swelling, redness, and bruising occur after intradermal or subdermal injections. The patient has to be aware of and accept these risks. Adverse events that last longer than 2 weeks can be attributable to technical shortcomings (e.g., too superficial an implantation of a long-lasting filler substance). Such adverse events can be treated with intradermal 5-fluorouracil, steroid injections, vascular lasers, or intense pulsed light, and later with dermabrasion or shaving. Late adverse events also include immunologic phenomena such as late-onset allergy and nonallergic foreign body granuloma. Both react well to intralesional steroid injections, which often have to be repeated to establish the right dose. Surgical excisions shall remain the last option and are indicated for hard lumps in the lips and visible hard nodules or hard granuloma in the subcutaneous fat.