ABSTRACT
Topical skin care and its place in plastic surgery today are often overlooked by clinicians formulating a plan for facial rejuvenation. Not only is it important to consider topical skin care as part of comprehensive care, but clinicians should also be educated with the data available in today's literature. This review aims to familiarize the reader with the biological processes of skin aging and evidence-based clinical outcomes afforded by various topical therapies. Furthermore, this review will focus on solar damage, the value of retinoids, and how they can be used in conjunction with forms of treatment such as chemical peel, dermabrasion, and lasers. Finally, guidelines will be provided to help the physician administer appropriate skin care based on the data presented.
Subject(s)
Retinoids/therapeutic use , Skin Aging/drug effects , Dermabrasion , Dermatologic Agents/administration & dosage , Dermis/anatomy & histology , Dermis/physiology , Epidermis/anatomy & histology , Epidermis/physiology , Humans , Isotretinoin/administration & dosage , Keratolytic Agents/administration & dosage , Keratolytic Agents/classification , Laser Therapy , Retinaldehyde/therapeutic use , Retinoids/classification , Retinoids/pharmacology , Tretinoin/administration & dosage , Wound Healing/physiologyABSTRACT
Chemical peels are a method of resurfacing with a long-standing history of safety in the treatment of various skin conditions. This article reviews the classification of different chemical agents based on their depth of injury. The level of injury facilitates cell turnover, epidermal thickening, skin lightening, and new collagen formation. Preprocedural, periprocedural, and postprocedural skin care are briefly discussed. To select the appropriate chemical peel, the provider should evaluate the patient's expectations, medical history, skin type, and possible complications to determine the best chemical peel to achieve the desired results. Patients with Fitzpatrick skin types IV to VI have increased risk of dyspigmentation, hypertrophic, and keloid scarring. These individuals respond well to superficial and medium-depth chemical peels. Advances in the use of combination peels allow greater options for skin rejuvenation with less risk of complications.
Subject(s)
Chemexfoliation , Keratolytic Agents , Chemexfoliation/methods , Humans , Keratolytic Agents/classificationABSTRACT
Chemical peeling is becoming increasingly popular for the treatment of skin rejuvenation where it can improve damaged skin and fine wrinkles. The basic procedure aims at obtaining a controlled chemical burn of the epidermis and/or dermis. This results in epidermal regeneration and postinflammatory collagen neoformation with remodeling of collagen and elastic fibers and deposition of glycosaminoglycans in the dermis. Various chemicals have been used as peeling agents, of which the most used are the alpha-hydroxy acids, such as glycolic acid, or beta-hydroxy acids, such as salicylic acid. The choice of the compound is linked to the different indications and to the depth of the desired peeling. Phenol is still the best agent for deep peeling but requires specific indications, prescription, and post-peeling care. Combination of different compounds is one innovation in the field of chemical peelings. Further controlled studies are necessary to set up specific guidelines.
