Jessner’s Peel

Jessner’s peel is a solution that combines resorcinol (14 g), salicylic acid (14 g), 85% lactic acid (14 g), and 95% ethanol (q.s.a.d. 100 ml). Jessner’s peels are indicated in the treatment of inflammatory and comedonal acne and melasma as well as hyperkeratotic skin disorders. Jessner’s solution was formulated to lower the concentration and toxicity of any one agent and to enhance the keratolytic effects. Jessner’s solution has intense keratolytic activity, initially causing loss of corneocyte cohesion within the stratum corneum and subsequently creating intercellular and intracellular edema within the upper epidermis if application is continued [37].

Prior to applying the wounding agent, the skin should be degreased with alcohol or acetone. Then Jessner’s solution is applied to the skin with 2" × 2" gauze or a sable brush, which produces erythema and a very light frost within 15–45 s. The clinical endpoint of treatment is the erythema and blotchy frosting. The depth of penetration of the peeling agent is related to the number of coats applied. The advantages of Jessner’s solution are that only a single solution is needed, timing the duration of application is unnecessary, and dilution or “neutralization” is not performed [7]. Jessner’s peel can also be combined with 5-FU delivered in a weekly pulse dose regimen, also known as the fluor-hydroxy pulse peel, to treat AKs with an associated improvement in cosmesis. This study showed an 88.14% clearing of AKs [29]. Both studies combining Jessner’s solution or glycolic acid with 5-FU showed synergism for the treatment of AKs,with no significant difference between the use of either Jessner’s or glycolic acid as adjuvant therapy.