Stone P A, Lefer L G
Aesthetic Plastic Surgery Center, Springfield, Massachusetts 01105, USA.
Clin Plast Surg. 2001 Jan;28(1):13-36.
To determine the relative roles of phenol concentration, croton oil concentration, and application techniques, the authors obtained three additional human biopsy studies. The last study was a randomized, controlled, prospective study with surgeon, pathologist, and third-party evaluators blinded during the application process and during the gross and histologic evaluations. Conclusions drawn from the findings of the studies included the following: Rubbing more coats of phenol, with or without croton oil, produces more inflammation and fibrosis. Adding croton oil reduces the threshold of injury from 20 to 50 coats to 5 to 20 coats applied with a cotton tip applicator, confirming the clinical impression that croton oil resin facilitates injury pattern of wounding when used with phenol in 35% to 88% concentrations. 48% phenol without croton oil can provide the same long-term results as 48% phenol with croton oil. The data suggest that the application technique is more important than the concentration of phenol or croton oil alone.
