Indications

Indications for superficial chemical peeling include fine to mild rhytids, photoaging, actinic and seborrheic keratoses, acne, dyspigmentation in the form of melasma and postinflammatory hyperpigmentation (PIH), and to improve overall textural alterations of the skin (Table 4.2). There are several different chemical agents classified under superficial peels, which will be discussed individually.They include glycolic acid (20–70%), salicylic acid, Jessner’s solution, solid CO₂, and TCA (10–35%).

Table 4.2. Chemical peel indications   Peel depth   Indications   Contraindications       Fine wrinkling, Glogau I Atrophic acne scars, minimal   Active herpes simplex infection Active eczema   Superficial   Melasma, epidermal Postinflammatory hyperpigmentation Acne vulgaris Pseudofolliculitis barbae Mottled dyschromia (ethnic skin)   Presence of tan Isotretinoin use within 1 year Skin malignancy   Medium   Mild to moderate photoaging/Glogau II and III Actinic keratoses Melasma, dermal Atrophic acne scars,moderate Pigmentary dyschromias   As above Deeply pigmented skin (Relative contraindication)   Deep   Severe photodamage, Glogau IV   As above Deeply pigmented skin Cardiac disease Renal disease Liver disease