post-peeling care and complications, 67 side effects, 68
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1 A Acne deep peels, 102 medium, 102 superficial, technique, 101 definition, 95 diagnosis lesions, 100 mimic rosacea, perioral dermatitis, 99 sebaceous hyperplasia, 99 epidemiology, 95 pathogenesis blockage, 96 colonization, early stage, 96 hyperkeratinization, 95 sebum, 96 vulgaris, 96 patterns classifications, 98 description, 96 Grading System, 96 non-inflamed and inflamed lesions, 96, 97 papulopustolar, 97 scars and pigment changes, severity, 96 treatment, 97 therapy aims, 100 Local Therapy, measures and management, 100 Systemic Therapy, types adult, 98, 99 conglobata, cosmetica and iatrogenic, 99 excoriée, 99 fulminans, 99 infantile, 98 inversa/hidradenitis suppurativa, 99 lesional pleomorphism, 99 neonatorum, 98 vulgaris, 98 Acne scars needling and clinical types, 89 definition, 87 epidemiology, 87 pathophysiology ablative techniques vs. Derma Roller, 87, 88 defined, demarcation current, 89 effects, epidermis, 89 inflammation proliferation maturation, neutrophils, 87 PCI, 87 platelets, 87 tissue remodeling, 88 patient preparation therapy clinical peeling sessions, AHA, 90 epidermis and stratum corneum, 90 occlusion, needling treatment, 90 replacement, vitamins and antioxidants, 89 skin-needling procedure, 90 posttreatment care, Actinic keratoses (AKs) advantages, 170 contra, 170 frequency, 170, 167 types, clinical types, 165 complications, definition, 165 diagnostic criteria, 166 differential diagnosis, 166 epidemiology and etiology, 165 fungal infection, 174 histological photographs, 173 histopathology, management, patient, 172 phenol treatment, 171 therapy cryotherapy, 166 laser therapy, PDT, 167 A. Tosti et al. (eds.), Color Atlas of Chemical Peels, DOI / , Springer-Verlag Berlin Heidelberg
2 206 Index Adapalene description, 112 effects, range photodamage parameters, 113 retinol, Adverse reactions and complications hypo/hyperpigmentation, 195 local corneal damage, 197 ochronosis, 198 minor acneiform eruption, 197 prolonged erythema, 196, 197 topical tretinoin, 197 responsibility, patient, 196 skin erosion, 195, 196 systemic, 198 AHAs. See Alpha-hydroxy acids AKs. See Actinic keratoses Alpha-hydroxy acids (AHAs), 87, 114, 130 Ascorbic acid, 129 Azelaic acid, 113, 128, 161 B Benzoyl peroxide, Beta-lipohydroxy acid (BHA), 131 BHA. See Beta-lipohydroxy acid Bio-rejuvenation and peelings advantages, 79 description, 77 erythema, 77, 79 hand photoaging, 77, 78 improvement, skin brightness, 77 injections, 77 needles utilization, 77, 78 picotage, 77, 79 procedures, bio-revitalization, 77 retrograde technique, 77, 79 serial threading technique, 77, 79 treatment, 77 B SAND defined, 71 functions, 72 patient satisfaction, 73 peeling, skin care, 73 tolerance and safety profile, 73 treatments, 72 C Chemical peels acne, acneiform dermatitis, 53 actinic keratosis, 6 advantages/disadvantages glycolic acid, 3 Jessner s solution, 3 malic acid, 4 5 pyruvic acid, 3 4 resorcinol, 4 salicylic acid and TCA, combination, 4, 5 tretinoin, 4 trichloroacetic acid, 4, 5 aftercare farmer skin and multiple solar keratosis, 48, 52 grid, removal, 46 idiopathic thrombocytopenia, 48, 51 painkillers, 47 premature skin, 48, 50 tape mask removal, 47, 48 upper lip wrinkles, 48, 51 wrinkles and solar lentigines, cardiac arrhythmias hydration and diuresis, 50 oral poisoning, 52 phenol blood level, 48 chemical background benzene ring components formulas, croton oil, 41 phenol/carbolic acid, 41 contra, dark skin, 6 description, 41 disadvantages, 53 formulations, 42 histology, and patient selection eyelids, 43 ideal patient, thick male skin, 43 infection, 53 melasma, peeling preparation, 45 peeling technique, photoaging, 6 pigmentary changes, postinflammatory hyperpigmentation, 6 pre-peeling preparation, 44 role, 41 rosacea, 6 scarring, 53 senile lentigo, skin atrophy, 53 skin preparation, solar lentigos, 6 CIT. See Collagen induction therapy Collagen induction therapy (CIT), 87 Combination salicylic acid/tca chemical peeling advantages, chemical background/properties, 63 contra, 64, 65 description, 63 disadvantages, 68 ethanol formulations, African American male, post-inflammatory hyperpigmentation, 64 chest photodamage and improvement, 64, 65 facial melasma, skin type III, 64, 66 recalcitrant melasma, 64, 65 peeling preparations, 65, 67 peeling technique, 67
3 207 post-peeling care and complications, 67 side effects, 68 D Dark skin, definition, 175 epidemiology, 175 histology, , 176 morphologic and physiologic differences, peel selection, 178 preparation and techniques, peeling, 178 superficial agents glycolic acid, Jessner s solution, 181 medium and deep peels, 182 melasma, 180 salicylic acid, TCA, tretinoin peeling, 181 Dermabrasion, 133 Dermoscopy, 141 E Etiology, melasma genetic predisposition, 124 hormonal influences, 124 ultraviolet radiation exposure, F Formulations content, 42 croton oil content, 42 formulas, 42 Jessner s solution peel components, 57, 58 preparation, 57, 58 Fractional resurfacing, 133 G GA. See Glycolic acid Global Acne Grading System, 96 Glogau s classification, photoaging, 108, 110, 201, 202 Glycolic acid (GA) AHA, chemical background, 9 contra, 10 description, 9 disadvantages, 14 forehead postinflammatory hyperpigmentation, 179 formulations, 10 acne, 10 description, 10 photoaging, 10 LHA, 18 peeling preparation, peeling technique, post-peeling care and complications, 14 properties, 9 10 safety and efficacy, 179 side effects TCA, 15 temporary hyperpigmentation/irritation, 15 H Herpes simplex virus (HSV), 201 Home peeling B SAND, defined, 71 characteristics AHAs, 72 fundamentals, B SAND, 72 ingredients and effects, 72 mechanisms, actions, 72 dermatological clinical treatment, 71 and application, 73, 76 mechanisms, action, results and patient satisfaction, HQ. See Hydroquinone HSV. See Herpes simplex virus Hydroquinone (HQ), 113, 127 I Intense pulsed light (IPL), 130, 133 Iontophoresis, 133 IPL. See Intense pulsed light J Jessner s solution advantages, 61 chemical background, 57 contra, 58, 59 description, 57 disadvantages, 61 formulations, 57, 58 acne, excoriation, 57, 58 melasma, 57, 59 postinflammatory hyperpigmentation, 57, 59 peeling technique, 60 post-peel care, 60 side effects, 61 skin preparation, 60 K KA. See Kojic acid Kojic acid (KA) ascorbyl palmitate, 114 description, 113 vitamin C, L Lentigo maligna, 141 LHA. See Lipohydroxy acid
4 208 Index Lipohydroxy acid (LHA), 18, 131 Local therapy, acne antibiotics, 100 benzoyl peroxide, 101 chemical peel, daily retinoid scheme, 100, 101 resveratrol, topical retinoids and adverse effect, 100, 101 M MASI. See Melasma area and severity index MCA. See Multitrepannic collagen actuation Melanosome transfer, melasma niacinamide, 129 ODA, 129 soybeans extract, 129 Melasma bilateral symmetric patterns, 124 chemical peeling agents, superficial depth peel, 132 alpha-hydroxy acids, BHA, 131 contra, 132 description, 130 Jessner s solution, level of evidence, 130 LHA, 131 medical therapy, 130 TCA, 132 tretinoin, 132 definition, 123 depigmenting agents, 127 diagnostic criteria histopathological classification, 125 MASI, 125 pigmentary distribution, 124 types, 124 Wood s lamp, 125 differential diagnosis, 125 epidemiology, 123 etiology, inhibitors, melanosome transfer, 129 management, patient mild, Jessner s solution, 135 moderate, TCA, 134 multisectoral approach, 134 peroxidase inhibitors, point strategy, therapy, procedural options dermabrasion, 133 fractional resurfacing, 133 iontophoresis, 133 lasers, 133 light therapy, 133 microdermabrasion, Ros scavengers/reduction agents, 129 skin turnover accelerators, 130 tyrosinase inhibitors, Melasma area and severity index (MASI), 187 Metronidazole, 161 Microdermabrasion and advantages, 84 appearance, scars, 82 classification, 81 contra, description, 81 disadvantage, 84 histopathological effects, 81, post-procedure care antibiotic ointment and cold compress, 83 retinoid acid and hydrocortisone cream, side effects, 84 skin preparation, 83 superficial physical abrasion, 82 symptoms, 82 techniques, using units, 83 treatments, 81 Multitrepannic collagen actuation (MCA), 87 N Niacinamide, 13, 129 O Octadecene dioic acid (ODA), 129 ODA. See Octadecene dioic acid 4-OH-anisole (Mequinol), 128 P Patient management complications, peeling herpes simplex infection, 203 pigmentary changes, 202 scarring, 202 photographs, 202 pre-and post-peeling treatment, 202 selection and evaluation Glogau classification, photoaging, 201, 202 herpes simplex virus (HSV), 201 skin-related factors, 201 PCI. See Percutaneous collagen induction PDT. See Photodynamic therapy Peeling agent, Asian skin alpha-hydroxy acids, 186 complications, 191 contra, combination peels, 190 exfoliation process, 185 formulations, GA, 186, Asian origin hyperpigmentation, 186 photoaging, 185 Jessner s solution, 190 lactic acid peels, MASI, 187 melasma, 186, 187
5 postinflammatory hyperpigmentation, 191 prepeel preparation/priming, 186 salicylic acid peels advantages, aspirin, 189 formulations, 188 melasma and photodamage, 188, 189 TCA, tretinoin peels, 189 Peeling techniques advantages, 14 atrophic acne scars, 13 comedonic-inflammatory acne, cotton tips, 45, 46 low-strength products, marking treatment area, 45, 46 melasma, forehead, 12 papulo-pustolar acne, 13 peeling solution application, 45, 46 SA acne rosacea, 20, 22 acne vulgaris, 20, 21 frosting, 19, 20 melasma, 20, 21 TCA adjunctive agents, 37 application, 37 level 1 frost, 37 level 11 frost, 38 level 111 frost, 38 waterproof zinc oxide non-permeable tape, 45, 47 Percutaneous collagen induction (PCI), 87 Permethrin, 162 Peroxidase inhibitors mexameter readings, 129 topical indomethacin, 128 PHAs. See Polyhydroxy acids Photoaging biopsies, 118 clinical and histological assessment, 115, 116 combination, before and after, 117 improvement, 5 salicylic acid, 117 improvement, TCA, 116 pigmentation, TCA, 116 pyruvic acid, 118 superficial agents, 115 TCA and phenol, 115 clinical and histological features, intrinsic and extrinsic aging, 107, 108 clinical types ablative resurfacing procedure, 109 Glogau s classifiation, 108, 110 series, patients, 108, 111 severity, 108 epidemiology biopsy, African American woman, 108, 109 clinical photodamage, 108 genetics, 107 mottled hyperpigmentation, Caucasian woman, 108 signs, 107 textural irregularities, African American woman, 108 therapeutic intervention, Photodynamic therapy (PDT), Point strategy, melasma therapy description, 125 disruption, melanin granules, 127 inhibition, melanin synthesis, 126 optimal treatment, 126 reduction, melanocyte activity, 126 removal, melanin, 126 sun protection, 126 Polyhydroxy acids (PHAs), 114 Post-acne scarring, advantages, 152 aftercare, 152 contra, disadvantages, history and classification Boxcar scars, depressed distensible scars, 149, 150 icepick scars, 149, 150 peeling technique skin dermabrasion, 152 tipolisher, 152 pre-peeling preparation, 151 rolling acne scars, 152, 153 skin abrasion, 152, 153 Postinflammatory hyperpigmentation acne excorians, 146 Pseudofolliculitis barbae, 147 salicylic acid peels, 145 clinical types, 144 definition, 143 diagnostic criteria, 144 differential diagnosis, 144 epidemiology, 143 etiology arachidonic acid, 144 skin disorders, 143 laser therapy, 147 therapy, 144 topical agents hydroquinone, 145 monotherapy, 144 Pycnogenol, 129 Pyruvic acid advantages, 30 contra acne, oily skin and photoaging, 26 photoaging and melasma, 26 rosacea, 26 description, 25 disadvantages, 30 effects, 25 formulations, 25 chemical peeling, 25, 29 microcystic acne, 25, 26 wrinkles and solar lentigo, 25,
6 210 Index Pyruvic acid (cont.) peeling technique liquid formulations, 26 microcystic acne, 26, 27 neutralization, sodium bicarbonate, 26, 28 pigmentation, 30 post-peeling Care, 26, 30 properties, 25 side effects, 30 R Retinoic acid, 130 Rosacea clinical picture, 161 differential diagnosis, 161 epidemiology, 159 etiopathogenesis Demodex folliculorum, 160 diet and alcohol, 160 drugs, 160 heat, 159 Helicobacter pylori, 160 psychological factors, 160 race, 159 vascular abnormalities, 159 peelings, 162 systemic therapy, 162 topical therapy azelaic acid, 161 benzoyl peroxide, metronidazole, 161 permethrin, 162 sulfur, 162 topical antibiotics, 161 tretinoin, 162 Ros scavengers/reduction agents, melasma ascorbic acid, 129 pycnogenol, 129 THC, 129 Rucinol, 128 S SA. See Salicylic acid Salicylic acid (SA) advantages, 4, 22 chemical background/properties, 17 contra, description, 17 disadvantages, 4, 22 formulations description, 17, 18 solutions, 17, 18 colorimetry, 18 GA and LHA, 18 ointment, minimal to mild side effects, 179 patient preparation, 19 peeling technique acne rosacea, 20, 22 acne vulgaris, 20, 21 frosting, 19, 20 melasma, 20, 21 post-peeling care and complications, 20 side effects, Senile lentigo chemical peeling, definition, 141 diagnosis and differential diagnosis, 141 epidemiology, 141 treatment, 141 Skin turnover accelerators, melasma alpha-hydroxy acids, 130 Systemic therapy, acne hormonal therapy, 104 oral antibiotics, 104 oral retinoids, T Tazarotene, 112 TCA. See Trichloroacetic acid Tetrahydrocurcumin (THC), 129 THC. See Tetrahydrocurcumin Therapeutic intervention, photoaging agents, 115 photoprotection classification, sunscreens, 109 description, 109 mexoryl, 109 physical agents, 110 therapeutic approach, 109, 112 retinoids adapalene, description, 110 postinflammatory hyperpigmentation, 110 receptors and subtypes, 110 tazarotene, 112 tretinoin, tyrosinase inhibitors AHAs, 114 azelaic acid, 113 ellagic acid, 114 hydroquinone, 113 kojic acid, niacinamide, 114 PHAs, 114 safety concern, 114 Tretinoin description, 110 efficacy, 110 papillary dermal collagen I formation, 110 placebo-controlled study, 112 Tretinoin peeling, 181 Trichloroacetic acid (TCA) advantages and disadvantages, 188 chemical background and formulations, 33 chemical peeling, 141
7 211 cleaning, skin defatting, 142 complications, 39 concentration, senile lentigos, 142 duration, treatment, 142 dyschromias, 187 efficacy, 142 facial vs. non-facial skin, 37 formulations, 188 frosting degree and duration, 142 CROSS technique, 36 medium depth chemical peel, melasma, pigmentary dyschromias, 36 treatment efficacy, 36 peel depths, classification, peeling preparation, 37 peeling technique, post-peeling care, treatment, 33 Tyrosinase inhibitors, melasma azelaic acid, 128 HQ, 127 KA, 128 licorice extract, OH-anisole, 128 other compounds, 128 rucinol, 128 V Vitamin C (ascorbic acid) characteristics, efficacies, 114 W Waterproof zinc oxide non-permeable tape, 45, 47 Wood s lamp examination, 125
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