NewBeauty recently wrote an article about the phenol peel. How popular is the phenol peel, and what are its risks and benefits? What is the unique role of in-office chemical peels in dermatology?
For expert advice, I reached out to Seaver L. Soon, MD, FAAD, FACMS, immediate past president of the International Peeling Society and chair of the International Peeling Society-USA. Dr. Soon will lecture on superficial and medium depth chemical peels at the upcoming Pigmentary Disorders Exchange Symposium.
Phenol peels have been around for about a century. How popular are they now?
Our culture is enamored with technology and what is new is often assumed as superior. My experience with chemical peeling is that, although a century old, it is an extremely powerful skill to help our patients for both medical and cosmetic concerns. Consequently, I believe that deep chemical peels, based on the regenerative effects of phenol and croton oil, are experiencing a resurgence in popularity among dermatologists as research published and hands-on training workshops led by the International Peeling Society have demonstrated the safety of properly performed deep chemical peels and the incomparable improvement related to skin quality and wrinkle reduction.
What are the risks and benefits of a phenol peel?
Like all medical procedures, phenol-croton oil peels carry risks and benefits. The most significant risk of full-face phenol croton oil chemical peeling is cardiac toxicity. Those performing full-face deep chemical peels must undertake the appropriate precautions, for example, taking a 10-15 minute safety pause between peeling facial subunits, obtaining cardiology medical clearance, cardiac monitoring during the procedure and ACLS certification. However, segmental deep chemical peels, defined as a phenol croton oil peel applied to 1-2% of the body surface area (for example, the perioral or periocular region) and medium depth peels to blend the remainder of the face, are not associated with cardiac risk based on our clinical research. Other risks of deep chemical peels include infection, scar, persistent erythema, hypopigmentation and line of demarcation. These can be avoided or managed with proper training. The benefits of this procedure are durable improvement in skin quality and wrinkle reduction lasting approximately a decade.
In what patient population would you consider recommending a phenol peel?
I recommend phenol peels in Fitzpatrick skin types I-II with coarse, static rhytids on the face. However, recent research suggests this peel may be safe and effective in Fitzpatrick skin types III-VI for indications such as acne scarring, melasma and constitutional periorbital dark circles.
What’s changed in the world of in-office chemical peels in recent years?
There is a resurgence of interest in chemical peeling, and dermatologists are interested not only in proprietary peels but also in mixing their own formulations.
With all the available treatments, what is the unique role of in-office chemical peels in dermatology?
What is unique about in-office chemical peels is the tremendous benefit dermatologists can provide their patients not only for cosmetic indications, such as wrinkling or lentigines, but also for medical indications, such as acne, melasma and field precancerization with actinic keratosis. Chemical peels may be offered at a very reasonable overhead cost to the practice. The International Peeling Society partners with such industry leaders as Delasco, Dermaceutic, PCA Skin, Skinceuticals and Young Pharmaceuticals.
What is your advice for dermatology clinicians in using chemical peels in dermatologic treatment?
Get hands on training with the International Peeling Society! The website, www.chemicalpeeling.org, lists upcoming opportunities for hands-on training, which I believe is crucial to learn this procedural skill for both medical and cosmetic indications, ranging from patient preparation, clinical endpoints for different peeling solutions, as well as optimal aftercare and complication management. International Peeling Society membership may be obtained at: www.peelingsociety.com.
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