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 )