Chemical peeling of the dark skinned patient Fitzpatrick Type V + VI

ABSTRACT

There are fundamental, histological and physiological differences in the dark skinned patient which, to a large extent, determine the variation in response to and the indications for chemical peeling. This study is designed to assess the incidence of complications after superficial, medium and deep chemical peeling of dark skinned patients, using 70 percent glycolic acid (superficial) 70 percent glycolic acid with 35 percent trichloroacetic acid (TCA) (medium) and 70 percent glycolic acid with 50 percent TCA (deep). Clinical, glycolic acid with TCA was safe and effective in peeling the dark skin. It was very satisfactory in 62.4 percent, satisfactory in 34 percent and unsatisfactory in 1.2 percent. The incidence of complications was hyperpigmentation, 6.6 percent; erythema, 1.8 percent; scarring, 0.4 percent; milia, 0.2 percent; and poor physician/patient relationship 0.2 percent. The risk complications in peeling the dark skinned patient can be decreased if segmental medium and deep peels are done and if melanocytic activity is monitored before and after peeling. The destroyed stratum corneum immediately after peeling allows deeper penetration of tyrosinase inhibitor with better resolution of hyperpigmentation.(AU)