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Superficial peeling.

J J Stagnone
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Abstract

Superficial peeling involves the topical use of mild exfoliating chemicals to rejuvenate actinically damaged facial skin and to treat acne, pigmentary disturbances, fine wrinkling, and superficial scarring. Some of the chemicals that can be used and the various techniques employed are discussed.

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BibTeXRIS

J J Stagnone. 1989. Superficial peeling.. https://doi.org/10.1111/j.1524-4725.1989.tb03179.x

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PubMed2000

Efficacy of hydroquinone cream (USP 4%) used alone or in combination with salicylic acid peels in improving photodamage on the neck and upper chest.

BACKGROUND: Salicylic acid, hydroquinone, and glycolic acid have been proved effective in the treatment of photodamaged facial skin. Few reports are available on the treatment of photodamage on the neck and upper chest. OBJECTIVE: This study's purpose was to evaluate the efficacy of a cream containing 4% hydroquinone and 2% glycolic acid (LUSTRA) used alone or with salicylic acid peels in reversing actinic damage on the neck and upper chest. METHODS: Nineteen women with moderate to advanced photodamage on the neck and upper chest applied a cream containing 4% hydroquinone and 2% glycolic acid twice daily on photodamaged areas for 12 weeks. Nine of these subjects had salicylic acid peels every 3 weeks. Improvements were assessed by the investigator, the subjects, and Mexameter readings measuring melanin and erythema levels. RESULTS: The result shows that there was a 33-71% improvement in photodamage, hyperpigmentation, texture, fine lines, dryness, tone, and clarity in both groups. There were no significant differences between the two treatments. CONCLUSION: Hydroquinone 4% cream with 2% glycolic acid is safe and effective in improving photodamage on the neck and upper chest when used alone or in combination with salicylic acid peels.

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PubMed2000

An examination of the phenol-croton oil peel: Part II. The lay peelers and their croton oil formulas.

From the turn of the century, lay face peelers, known as "skinners," ran "beautifier" salons. Beginning in the 1920s, lay peelers were using croton oil-phenol formulas in Hollywood. These persons were renowned, made a good living, and treated many, if not most, of the leading "stars" of the day. They had a treatment, a "secret," that physicians did not. Physicians brought their own wives to the peelers for their expertise. The leading lay peel personalities from the 1920s through to our time are presented. The lay peelers dominated the field until the 1960s, when legal attacks on them, often directly instigated by the newly educated physician peelers, put them at a legal disadvantage. Nevertheless, there was considerable interaction with many plastic surgeons along the way. Some plastic surgeons came into possession of the techniques and some also into knowledge of the ingredients in a formula. The author has presented the recipes of four of the renowned lay peelers, two from Hollywood, Gradé and Kelsen, and two from Miami, Coopersmith and Maschek. These recipes all have 80 to 90 percent less croton oil than the "classic" Baker formula and, therefore, wound less deeply. The Hollywood formulas were used on many celebrities both inside and outside the film world from the 1920s to the early 1990s. These lay recipes are cumbersome to prepare. The author has simplified the preparation of these lay recipes by using USP liquid phenol instead of crystals. These simple formulas are provided in a table and are as easy to prepare as the Baker formula.

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PubMed2000

An examination of the phenol-croton oil peel: Part III. The plastic surgeons' role.

In Part II, the author focused on the lay peelers' history and success using croton oil-containing phenol peeling recipes. In Part III, the author reviews what was known or should have been known about croton oil and phenol as physicians became keenly interested in face peeling in the mid-1950s. The lay peelers recognized that croton oil was a critical ingredient of the so-called phenol peel while physicians focused on phenol without recognizing the intense cytotoxic effect of croton resin. Physicians have persisted in this systematic error for 40 years. Both dermatology and plastic surgery have shown a remarkable credulity about phenol's action and lack of curiosity about croton oil's action. A hitherto unreferenced and unknown croton oil-containing formula of Adolph Brown, patented in 1959, has been unearthed, preceding Litton's and Baker's formulas in time. The recollections of Litton, Baker, Truppman, and Georgiade shed some light on the interaction between them and the lay peelers and how the formulas were transferred. Other plastic surgeons probably acquired the same knowledge, used it in their practices, but chose not to draw attention to it. None of the physicians credited the lay peelers. Brown, Litton, and Baker each could have published a complete formula, but only Baker did. However, his formula was vastly stronger than the lay formulas but, nevertheless, came to dominate medical peeling for the next 35 years because of its simplicity of preparation. A review of the peel literature reveals many oft-repeated but unsupported dogmas regarding the mode of action of phenol, which have obscured our understanding of the phenol-croton oil peel. Animal studies exist that refute these dogmas, e.g., (1) lesser concentrations of phenol wound more deeply; and (2) phenol has an all-or-nothing action. As well, studies from the early 1980s showed that the presence of croton oil caused much deeper burns than phenol alone. Suggested areas of research that could solve the conundrum of the phenol-croton oil peel are presented.

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