Chemical peels.

With so many new peel preparations on the market today, the dermatologist must ask himself basic questions concerning the products. The most important question is directed to the medical literature rather than the advertising or marketing campaign so common among market-driven cosmetic products. Since all peeling agents--superficial, medium depth and deep--are derived from basic chemicals known to cause exfoliation, destruction and/or inflammation of skin in a controlled manner, the clinician must ask what is new and better about the product. Peeling agents, regardless of their proprietary new name, fall into chemical families. The clinical evaluation of these generic agents is well documented in our literature as to efficacy, technical care and safety. In addition, combinations of peeling agents have been presented in the dermatologic cosmetic literature with scientific clinical trials and histology. These include: 1) The Gordon-Baker phenol peel; 2) Combination medium depth peeling; 3) Glycolic acid formulations. It is the responsibility of the dermatologic surgeon to be in control of his chemicals and his products. It is thus necessary for him to understand all the products and the peel formulation and be sure it has undergone the test of objective scientific study with clear clinical evaluations and histology. Only then will we truly know the effectiveness of the agents we are using for exfoliating and resurfacing.