Download - Salicylic Peel @ Chennai Plastic Surgery
SALICYCLIC ACID PEELS
CONTENTS
• Introduction
• Peel formulations
• Equipments and Reagents
• Indications
• Contraindications
• Priming and Prepeel preparation
• Procudure
• Postpeel care
• Complications
INTRODUCTION• Salicylic acid is a beta hydroxy acid derived
from the willow bark, wintergreen leaves and sweet birch (hydroxyl derivative of benzoic acid.)
• It is lipophilic and acts as a keratolyticagent by dissolving the intercellular lipids, surrounding the keratinized epithelial cells.
• Due to its lipophilic nature, it preferentially acts on the sebaceous follicle, has excellent comedolytic activity and hence is very useful for acne.
• It also has anti-inflammatory and antimicrobial properties.
• It is safe for all skin types.• It has limited penetration and is
effective for superficial epidermal conditions like oily, rough skin, epidermal melisma and mild photoaging.
PEEL FORMULATION
• It is available as Salicylic acid powder, slightly soluble in water, but highly soluble in 95% ethanol, ether or methanol (common spirit).
• On application, the alcohol evaporates and the salt crystallizes on the skin forming a white precipitate, this appears like a frost and is called ‘pseudofrost”.
• 1. Hydroethanolic solution
• 2. 2% solution as skin cleaner- acne washes.
• 3. salicylic acid peels kits (beta lift, bioglan pharma).
• 4. salicylic acid paste.
EQUIPMENTS AND REAGENTS
• 1. SA solution 20%, 30%, 40%, 50%.
• 2. Alcohol
• 3. Acetone
• 4. Cold water
• 5. Petrolatum or Vaseline.
• 6. Syringes
• 7. Glass cup or Beaker.
• 8. Cotton tipped applicators
• 9. Cotton gauge pieces.
• 10. Gloves
• 11. Head band or cap for patient.
• 12. Fan.
INDICATIONS
• SA Peels used for all skin types 1-IV.
• 1. ACNE
• Comedonal Acne
• Inflammatory Acne
• Pigmented Acne Scars
• Superficial Acne Scars
• 2. HYPER PIGMENTATION
• Epidermal melisma
• Postinflammatory hyperpigmentation
• Freckles
• Lentigines
• 3. PHOTOAGING
• Fine wrinkles
• Dyschromias
• 4. TEXTURAL CHANGES
• Oily skin
• Rough uneven skin
• Dilated pores
• 5. KERATOTIC LESIONS
• Keratosis pilaris
• Warts
• 6. ACNE ROSACEA
CONTRAINDICATIONS
• Pregnancy
• Aspirin hyper sensitive
• Lactation
• Unrealistic patient expectations
• Dermatitis at the peeling site
PREPEEL PREPARATION
• Patient selection and counseling , detailed history and examination , informed consent and photographiv documentation are mandatory before peeling.
Darker pigmented skins
( Priming )
Hypo pigmenting agents - intended to use post peeling ( such as hydroquinone, kojic acid, azelaic acid or arbutin)
• Proper use of broad spectrum sunscreens and safe sun protection.
• Retinoids should stoped 1 week before peeling
PROCEDUREFace wash
Hairband to cover hair
Head elevated to 45degrees
2”x2” cotton gauze
Cleanser and degreased
Sensitive areas covered with petrolactum
Peeling agent in a glass cup 20%
Wash the face and dry it
Instructed to limit sun exposure & use sunscreens appropriately
Pseudofrosting seen in salipeels
Before After
POSTPEEL CARE
• Feel tightness of skin after peel.
• Post peel till desquamation subsides sunscreens and moisturizers are used.
• Topical antibacterial ointments- prevent bacterial infection.
• Total skin regimen of Hypopigmenting agents, acne medications, glycolic acid and retinoidsshould use till the next peel.
COMPLICATIONS
• Uncommon, usually mild and transient.
• Excessive crusting, desquamation, inflammation and erythema.
• Salicylism observed when 50% SA paste are applied to 50% of the body surface- characterized by tinnitus, dizziness, abdominal cramps and deafness. ( patient is asked to drink copious water to prevent salicylism )