Chemical Peels Flashcards
TCA mechanism of action?
Controlled keratin protein coagulant
- Coagulate/denatures proteins of cellular membrane = epidermal necrosis
- Stimulates epidermal basal layer mitosis = improve structure epidermis (thickens epidermis and keratinocyte uniform shape)
- Clinical endpoints: white (frosting), erythema, oedema
Dermal Alterations
-Medium/deep peels: collagen remodelling and neocollagenesis
- Stimulates collagen production and improve elastic fibres
- Smooths and compact collagen bundles
GAGS (Glysaminoglycans) deposition increase = hydration
Reduction of melanin
-Via long lasting hydration, necrosis and shedding (does not inhibit melanocytes or melanogenesis)
Increased production of platelet derived growth factor from keratinocytes
-Stimulates epidermal proliferation = re-epithelialisation
-Stimulates tissue fibroblasts to proliferate
TCA clinical indications?
- Dyschromia
- Texture
- Rhytides and aging
- Rejuvenation
- Basal layer mitosis
- Scar (ice picked scars)
Percentages and their depths of TCA?
Epidermis (superficial): 12%
Epidermis (superficial): 15%
Upper papillary dermis (superficial/dermis): 18%
Upper papillary dermis (superficial/medium): 20%
Papillary dermis (medium): 30%
Reticular dermis (deep): >50%
Jessner’s Solution contents?
-Original formula: Salicylic acid (14g), lactic acid (85%) 14g, resorcinol (14g)
- Modified Jessner’s solution: Lactic acid (17%), salicylic acid (17g), Citric acid (8%)
Benefits of using Jessner peel?
- Deeper penetration of the peel while using low concentrations
- Salicylic acid enhances penetration of other ingredients
- Maximise outcomes while minimise potential side effectsS
Jessner’s Solution clinical indications?
- Acne
- Photodamage
- Melasma
- Epidermal Pigment
- Ephelides
- Post Inflammatory
- Hyperpigmentation
- Hyperkeratotic Skin Disorders
- Degreaser for oily skin
- Penetration enhancer for other peels
Jessner’s peel ingredients skin benefits? (Mechanism of action)
Salicylic acid: Lipophilic; dissolves intercellular lipids = enhance penetration of other ingredients, comedolytic, anti-inflammatory.
Resorcinol: Anti-pruritic and antiseptic
Lactic and Citric Acid: Reduce corneocytes adhesion = induce desquamation, stimulate basal layer mitosis, water binding, dispersion
Resorcinol Peel mechanism of action?
- Keratolytic
- Pigment inhibitor: Inhibits conversion of tyrosinase to L-Dopa during melanogenesis
- Antiseptic
- Antipruritic
Resorcinol Peel clinical indications?
- Acne
- Comedones
- Folliculitis
- Superficial scarring
- Actinic Damage
- Dyschromia
Phenol Peels clinical indications?
- Dyschromia
- Fine and deep rhytids
- Premalignant skin tumours
- Acne Scars
- Photodamage
- Glogau skin types II-IV
- Seborrhoeic keratosis
Phenol Peel mechanism of action?
-Protein coagulation
-Epidermal effects: remodel keratinocytes into uniform shape,
-Dermal effects: horizonal compact collagen bundles, elastic fibres dense
-Pigment alterations: inhibits melanosomes transfer to keratinocytes
-Antiseptic, antifungal and anaesthetic
