salicylates and Facial-Dermatoses

Chemical peeling is a common treatment in cosmetic dermatology. A peel that has been used for many years is trichloroacetic acid. Its adverse effects have for a long time been a major limitation. We present a practical review of the characteristics, mechanisms of action, indications, and complications of superficial chemical peels and of peeling with trichloroacetic acid.

Topics: Acids; Animals; Chemexfoliation; Collagen Type I; Drug Combinations; Elastin; Epidermis; Ethanol; Facial Dermatoses; Humans; Hyperpigmentation; Keratolytic Agents; Lactic Acid; Mice; Pigmentation Disorders; Precancerous Conditions; Resorcinols; Salicylates; Skin Aging; Skin Neoplasms; Trichloroacetic Acid

The hydroxy acids are widely used in skin creams because of their exfoliating and rejuvenating effect on photoaged skin. As a member of this family, the salicylic acid derivative known in the literature as 2-hydroxy-5-octanoyl benzoic acid or beta-lipohydroxy acid has also been proposed as an exfoliant and as a treatment of photoaged skin and acne. This article reviews the effects of the hydroxy acids and compares them to those of the salicylic acid derivative. We propose the name C(8)-lipohydroxy acid (C8-LHA) for this derivative to differentiate it from other related compounds. The lipophilic nature of C8-LHA and its relatively slow penetration in the skin afford it an exfoliating effect that is efficient at low concentrations. It appears to have antimicrobial, anti-inflammatory, and anticomedogenic properties, which make it effective against acne. Its antifungal and exfoliating properties are also likely to prove useful in combating dandruff.

Topics: Administration, Cutaneous; Facial Dermatoses; Female; Follow-Up Studies; Humans; Hydroxy Acids; Male; Risk Assessment; Salicylates; Sensitivity and Specificity; Skin Absorption; Skin Aging; Skin Diseases; Skin Irritancy Tests; Treatment Outcome

The Jessner's-trichloroacetic acid (TCA) peel is a procedure developed by Monheit to produce a safe, effective medium-depth chemical peel for the treatment of photoaged skin, actinic keratoses, and superficial acne scars. The technique of pretreatment degreasing and combination chemicals allow a deeper penetration for the 35% TCA, increasing its efficacy while preserving its safety. Technique and methods are reviewed.

Topics: Acne Vulgaris; Chemexfoliation; Cicatrix; Drug Combinations; Ethanol; Face; Facial Dermatoses; Humans; Keratosis; Lactates; Lactic Acid; Resorcinols; Salicylates; Skin Aging; Trichloroacetic Acid

Antibiotics and retinoids have been used for acne vulgaris for decades. Though effective, each has its own drawbacks. Chemical peels have been used for treatment of acne vulgaris with inadequate clinical evidence. We sought to determine the efficacy and safety of Jessner's solution (JS) in comparison with salicylic acid (SA) 30% in the management of acne vulgaris and postacne hyperpigmentation in patients with colored skin.. A total of 36 subjects (94.5% Fitzpatick Type IV-V) were recruited in this randomized double-blinded, split-face, controlled trial. Each side of the face was randomly assigned for treatment with either JS or SA. Subjects were treated once fortnightly for a total of three sessions. Lesion counting, Michaelsson acne score (MAS), photographs, and postacne hyperpigmentation index (PAHPI) were used to objectively assess the improvement. Complications were assessed during each visit. Statistical analysis was conducted using SPSS v22.0. Significance was set at P = 0.05.. At the end of therapy, significant reduction in inflammatory, noninflammatory lesions, MAS, and PAHPI scores (P < 0.001, respectively) were noted in comparison to baseline. Mixed model analysis revealed no significant outcome difference between the two groups. Patients who reported good and very good outcome were 76.4% (JS) and 85.3% (SA). Burning, stinging sensation, and exfoliation were the common complications reported. Postinflammatory hyperpigmentation was reported only once in the JS arm.. Both JS and SA were equally effective in the treatment of acne vulgaris and reducing postacne hyperpigmentation in patients with colored skin.

Topics: Acne Vulgaris; Adult; Chemexfoliation; Double-Blind Method; Drug Combinations; Ethanol; Facial Dermatoses; Female; Humans; Hyperpigmentation; Keratolytic Agents; Lactic Acid; Male; Pain; Resorcinols; Salicylates; Salicylic Acid; Severity of Illness Index; Skin Pigmentation; Treatment Outcome; Young Adult

Chemical peeling is a well-identified therapeutic modality for acne vulgaris (AV). Jessner's solution (JS) is a known peeling agent for acne since more than 100 years. Salicylic acid (SA) peel is a well-established peeling agent for acne. There is paucity of literature comparing the current peeling agents of choice, that is, SA with the older peeling agents, that is, JS for acne.. To compare the efficacy and safety of 30% SA vs. JS peels in treatment of mild-to-moderate facial acne in Indian patients.. A total of 40 patients with mild-to-moderate AV were enrolled for 12 weeks and were randomly divided into two groups: group 1, 30% SA peels and group 2, JS peels were performed 2 weeks apart with total of six peels in 12-week duration. Clinical improvement was assessed objectively using Michaelsson acne scores (MAS) and clinical photographs. Side effects were observed at each visit.. At the end of therapy, improvement in MAS and percentage decrease in MAS were significantly higher in group 1 as compared to group 2. Likewise, decrease in mean comedone counts in group 1 was significantly higher as compared to group 2. However, there was no statistically significant difference in the decrease in mean papule and pustule counts between the two groups. Both the groups tolerated the peels well.. Thus, 30% SA peels were more effective than JS peels in treatment of noninflammatory lesions, that is, comedones and in overall improvement of mild-to-moderate facial acne vulgaris.

Topics: Acne Vulgaris; Adolescent; Chemexfoliation; Drug Combinations; Ethanol; Facial Dermatoses; Female; Humans; Keratolytic Agents; Lactic Acid; Male; Photography; Resorcinols; Salicylates; Salicylic Acid; Severity of Illness Index; Young Adult

Many clinicians perform glycolic acid peels for facial acne patients, but there has not been a well-controlled study to compare this new therapy with other conventional modalities.. To compare the effectiveness of treatment and side effects in the treatment of facial acne by two agents, 70% glycolic acid and Jessner's solution.. Twenty-six patients with facial acne were treated simultaneously with 70% glycolic acid and Jessner's solution biweekly on each side of the face. The treatment sides were randomized and the evaluation of treatment was done biweekly by a blinded evaluator who did not know the randomization code. Dr. Cunliffe's acne grading system was used for objective comparison. All patients were also asked about the improvement of facial acne and about the side effects experienced. Finally, the patients answered the preference test between the 2 peeling methods.. Acne grading of both treatments improved after 3 treatment sessions. However, there were no significant differences in treatment effects between the 2 methods. As far as side effects were concerned, sites treated with Jessner's solution showed a significantly increased degree of exfoliation compared to glycolic acid (p < 0.01).. Glycolic acid is less widely used than Jessner's solution due to its inconvenient application technique. But considering the equal treatment effect and lesser degree of exfoliation in glycolic acid, we would recommend the use of glycolic acid over Jessner's solution for acne patients.

Topics: Acne Vulgaris; Adolescent; Adult; Chemexfoliation; Drug Combinations; Ethanol; Facial Dermatoses; Female; Glycolates; Humans; Keratolytic Agents; Lactic Acid; Male; Prospective Studies; Resorcinols; Salicylates; Single-Blind Method; Skin; Treatment Outcome

Melasma can be resistant to topical therapy.. Our purpose was to evaluate the efficacy of superficial peels in conjunction with topical tretinoin and hydroquinone in patients with melasma and to evaluate the ability of Wood's light examination to predict response to treatment.. We measured increased light reflectance in melasma areas with a colorimeter. Clinical observations were scored through an index designed to weigh numerically homogeneity, intensity of color, and area of melasma.. Colorimetric analysis showed an average lightening of 3.14 +/- 3.1 on the glycolic acid-treated side and 2.96 +/- 4.84 on the Jessner's solution-treated side. There was no statistically significant difference between the right and left. There was an overall decrease in melasma area and severity of 63%.. Superficial peels hasten the effects of topical therapy in melasma. Wood's light examination did not help predict response to treatment.

Topics: Chemexfoliation; Colorimetry; Drug Combinations; Ethanol; Facial Dermatoses; Female; Glycolates; Humans; Keratolytic Agents; Lactic Acid; Melanosis; Resorcinols; Salicylates; Tretinoin

We compared the efficacy and safety of a medium-depth chemical peel with those of the standard regimen of topical fluorouracil in the treatment of widespread facial actinic keratoses (AK). Fifteen patients with severe facial actinic damage and similar numbers of AK on both sides of the face were treated on the left side with a single application of Jessner's solution and 35% trichloroacetic acid and on the right side with twice daily applications of 5% fluorouracil cream for 3 weeks. Evaluations were conducted before treatment and at 1, 6, and 12 months after treatment. Visible AK were counted, random skin biopsies performed, adverse effects monitored, and patients questioned about preference and perception of efficacy.. Both treatments reduced the number of visible AK by 75% and produced equivalent reductions in keratinocyte atypia, hyperkeratosis, parakeratosis, and inflammation, with no significant alteration of preexisting solar elastosis and telangiectasia. Except for erythema that lasted 3 months in one patient, no untoward side effects were observed with the chemical peel. The majority of patients preferred the peel over fluorouracil because of the single application and less morbidity.. The medium-depth peel induced by Jessner's solution and 35% trichloroacetic acid is a useful alternative therapeutic option for widespread facial AK, particularly for poorly compliant patients, because it equals fluorouracil in efficacy while being superior in terms of the convenience of a single application with little associated morbidity.

Topics: Drug Combinations; Ethanol; Facial Dermatoses; Fluorouracil; Follow-Up Studies; Humans; Keratosis; Lactates; Lactic Acid; Male; Resorcinols; Salicylates; Sunlight; Trichloroacetic Acid

Topics: Aged; Dermatitis, Allergic Contact; Facial Dermatoses; Female; Hair Preparations; Humans; Patch Tests; Salicylates

Topics: Chronic Disease; Cosmetics; Dermatitis, Allergic Contact; Edema; Erythema; Eyelid Diseases; Facial Dermatoses; Female; Humans; Middle Aged; Pruritus; Salicylates

Topics: Adult; Dermatitis, Allergic Contact; Facial Dermatoses; Female; Humans; Patch Tests; Salicylates; Skin Cream

Topics: Aged, 80 and over; Facial Dermatoses; Humans; Male; Photosensitivity Disorders; Platelet Aggregation Inhibitors; Salicylates; Skin Tests

Topics: Cosmetics; Dermatitis, Allergic Contact; Facial Dermatoses; Female; Humans; Salicylates

Topics: Adult; Cosmetics; Dermatitis, Allergic Contact; Facial Dermatoses; Female; Humans; Middle Aged; Perfume; Salicylates

Glycolic acid and Jessner's solution are popular superficial chemical peel agents for the treatment of facial acne, and increased sebum secretion is one of the major aetiological factors of acne.. To compare the effects of 30% glycolic acid peels and Jessner's solution peels on sebum secretion in facial acne patients.. Thirty-eight patients with mild to moderate facial acne were included. Twenty-seven patients were treated with 30% glycolic acid peels and 11 patients with Jessner's solution peels. Each peel was performed twice with an interval of 2 weeks. Before and 2 weeks after each peel, sebum levels of forehead, nose, chin and cheeks were measured by using a Sebumeter (SM810 Courage & Khazaka, Cologne, Germany).. The sebum levels were not significantly changed by two peels treatments of 30% glycolic acid peels or Jessner's solution peels on the facial skins of patients with facial acne.. The two types of peels, 30% glycolic acid peels and Jessner's solution peels, did not affect sebum secretion of the facial skins of patients with facial acne after the two peels treatments. The accumulative effects of more than two peels treatments using these modalities need further evaluation.

Topics: Acne Vulgaris; Adolescent; Adult; Chemexfoliation; Drug Combinations; Ethanol; Facial Dermatoses; Female; Glycolates; Humans; Lactic Acid; Male; Resorcinols; Salicylates; Sebum

Few studies have examined the long-term efficacy of fluorouracil (FU) or chemical peels for the treatment of actinic keratoses (AK). Our earlier work examined the efficacy and safety of a medium-depth chemical peel compared with the standard regimen of topical FU in the treatment of widespread facial AK through 12 months.. To determine long-term efficacy of both treatments by extending our observations through 32 months.. Fifteen patients with severe facial actinic damage were treated on the left side with a single application of Jessner's solution and 35% trichloroacetic acid and on the right side with twice daily applications of 5% FU cream for 3 weeks. Parameters evaluated at 1, 6, 12, and 32 months included counts of visible AK, random skin biopsies from both treatment areas, development of intercurrent neoplasms, and surveys assessing sun exposure.. Eight patients were available for reevaluation at 32 months. Both treatment sides showed a reduction in mean number of AK at 12 months followed by an increase in mean AK number between 12 and 32 months. Improvements in biopsies of clinically actinically damaged skin were seen in keratinocytic atypia, hyperkeratosis, parakeratosis, and inflammation at all treatment times during the study with both treatments. Three squamous cell carcinomas developed in the patients after initial treatment; one developed on the side treated with the peel, and two developed on the side treated with fluorouracil. Surveys failed to demonstrate an association between sun exposure and clinical response.. Based on these findings, patient with widespread actinic keratoses treated with medium-depth chemical peel or with 5% FU should be reevaluated yearly or every 1.5 years for reappearance of AK and retreatment.

Topics: Administration, Topical; Chemexfoliation; Drug Combinations; Ethanol; Facial Dermatoses; Fluorouracil; Follow-Up Studies; Humans; Keratosis; Lactic Acid; Male; Resorcinols; Salicylates; Sunlight; Trichloroacetic Acid

Topics: Administration, Cutaneous; Adolescent; Adult; Child; Child, Preschool; Dermatitis, Irritant; Dermatologic Agents; Facial Dermatoses; Female; Humans; Irritants; Ointments; Salicylates; Salicylic Acid; Tretinoin; Warts

One hundred patients with facial seborrheic dermatitis and 42 control subjects were studied. The number of periodic acid-Schiff-positive Pityosporum ovale yeast cells in skin scrapings per high-power field were counted and designated 1 + to 4 +. Our data indicate a correlation between the density of P. ovale and the clinical severity of seborrheic dermatitis, both before and after therapy with a precipitated sulfur/salicyclic acid shampoo. The data support the concept that yeast contributes to the pathogenesis of seborrheic dermatitis.

Topics: Administration, Cutaneous; Adult; Aged; Aged, 80 and over; Dermatitis, Seborrheic; Facial Dermatoses; Follow-Up Studies; Humans; Malassezia; Male; Middle Aged; Salicylates; Staining and Labeling; Sulfur

Two effective methods in chemical peeling, solid carbon dioxide plus trichloroacetic acid and Jessner's solution plus trichloroacetic acid, were compared clinically with photographs and histologically with serial biopsies. Carbon dioxide produced a deeper wound than Jessner's solution, and CO2 + TCA was slightly deeper than Jessner's + TCA but was probably not significantly deeper from a clinical standpoint except in correcting scarring. Triple consecutive applications of TCA can substantially increase wound depth with both combination peels.

Topics: Administration, Topical; Adult; Carbon Dioxide; Chemexfoliation; Drug Combinations; Epidermis; Ethanol; Facial Dermatoses; Female; Humans; Lactates; Lactic Acid; Necrosis; Pigmentation Disorders; Resorcinols; Salicylates; Trichloroacetic Acid; Wound Healing

Topics: Adrenal Cortex Hormones; Dermatitis, Seborrheic; Facial Dermatoses; Hair; Humans; Male; Salicylates; Sulfur; Tars