Complications of chemical resurfacing.

Complications of chemical resurfacing may occur even though a controlled chemical wound has been induced. The surgeon must be totally familiar with the types of peels and the management of postoperative wound care based on the skin type of the patient. A thorough understanding of the concepts involved will enable early treatment and avoidance of permanent sequelae, such as pigmentary dyschromias, infection, or scarring.

Complications of expanded polytetrafluoroethylene (e-PTFE) facial implant.

Implantation of the expanded polytetrafluoroethylene (e-PTFE) implant to achieve correction of nasolabial folds or thinning lip has been fraught with complications in spite of patient acceptance since its introduction in 1997. The four most frequent postoperative complications are extrusion, movement, infection, and swelling. In examination of 86 insertions of the 3.2 mm tubular implants, these sequelae are generally manageable for the physician and patient. If the patient understands possible courses of healing, both physician and patient satisfaction may be achieved.

Treatment of melasma with Jessner's solution versus glycolic acid: a comparison of clinical efficacy and evaluation of the predictive ability of Wood's light examination.

BACKGROUND: Melasma can be resistant to topical therapy. OBJECTIVE: Our purpose was to evaluate the efficacy of superficial peels in conjunction with topical tretinoin and hydroquinone in patients with melasma and to evaluate the ability of Wood's light examination to predict response to treatment. METHODS: We measured increased light reflectance in melasma areas with a colorimeter. Clinical observations were scored through an index designed to weigh numerically homogeneity, intensity of color, and area of melasma. RESULTS: Colorimetric analysis showed an average lightening of 3.14 +/- 3.1 on the glycolic acid-treated side and 2.96 +/- 4.84 on the Jessner's solution-treated side. There was no statistically significant difference between the right and left. There was an overall decrease in melasma area and severity of 63%. CONCLUSION: Superficial peels hasten the effects of topical therapy in melasma. Wood's light examination did not help predict response to treatment.

Advances in chemical peeling.

Chemical peeling is traditionally discussed in terms of the depth of injury: superficial, medium, or deep. There have been a number of important advances in both superficial and medium-depth chemical peeling over the last several years. This article reviews the state of the art of these techniques and the increasing understanding of their effects on skin.

Deep chemical peeling.

Facial skin wrinkling and sagging are concerns that often compel patients to seek counsel on rejuvenative procedures. Facial plasty procedures will alleviate many of these concerns. However, deep chemical peels, in conjunction with surgery or alone, can often significantly improve both the ravages of excess sun exposure and the stigmata of aging.

Treatment of facial telangiectasia with sclerotherapy, laser surgery, and/or electrodesiccation: a review.

BACKGROUND: Facial telangiectasia is extremely common in patients with fair complexion. Electrosurgery has been the primary form of treatment in the past. OBJECTIVES: The authors retrospectively evaluated over 300 patients treated with sclerotherapy for facial telangiectasias. METHODS: Retrospective analysis of over 300 patients with facial telangiectasia treated with sclerotherapy and 55 facial spider telangiectasias treated with laser. RESULTS: Sclerotherapy utilizing hypertonic saline, Sclerodex, polidocanol, and sodium tetradecyl sulfate resulted in-between 50 and 100% resolution of facial telangiectasia with minimal complications. CONCLUSION: The treatment of facial telangiectasia should include sclerotherapy and laser treatment modalities, which effect a higher rate of clearance with less adverse sequela.

Update on chemical peels.

The area of chemical peeling has seen an explosion of growth and interest in the last 5 years. The use of peeling for the therapy of pigmentary dyschromias, actinic keratoses and rhytides, depressed scarring, and in selected cases, irradiation dermatitis, is amplified by the discovery of new wounding agents and new variations in technique. Appropriate growth in the objective evaluation of these agents and techniques is dependent on the demonstrative histology and the sharing of knowledge of both excellent results and significant complications in the dermatologic surgical literature.

Variations and comparisons in medium-depth chemical peeling.

Two effective methods in chemical peeling, solid carbon dioxide plus trichloroacetic acid and Jessner's solution plus trichloroacetic acid, were compared clinically with photographs and histologically with serial biopsies. Carbon dioxide produced a deeper wound than Jessner's solution, and CO2 + TCA was slightly deeper than Jessner's + TCA but was probably not significantly deeper from a clinical standpoint except in correcting scarring. Triple consecutive applications of TCA can substantially increase wound depth with both combination peels.

Complications of chemical peeling.

In spite of controlled wounding with chemical peeling agents, complications may occur, resulting in patient and physician dissatisfaction. Precautions and factors causing these complications are examined, and relative contraindications to chemical peeling are discussed.