We have located links that may give you full text access.
TCA-based blue peel: a standardized procedure with depth control.
Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.] 1999 October
BACKGROUND: Trichloroacetic acid (TCA) peels are popular, well known, and widely utilized to correct a variety of skin problems. Different methods exist, ranging from the use of plain TCA to augmented or modified TCA at concentrations ranging from 30% to 50%. However, peel results vary depending upon the physician skill level, patient selection, and patient management.
OBJECTIVES: The purpose of this article is to fill the gap for a peel that is deeper than superficial exfoliative procedures yet lighter than a medium-depth peel, to simplify and standardize the TCA peel, to define depth properly based on intraoperative clinical signs, to implement a color guide that facilitates even application of TCA and avoids skip areas, and to identify and minimize variables that may contribute to inconsistent outcomes.
METHODS: A coating system for TCA application is created by selecting a specific TCA concentration (15% or 20%), TCA volume (4 or 6 ml, respectively), and a standardized body surface area to be peeled (5%), taking into consideration skin thickness and fragility. Multiple coats of TCA are applied to reach the desired endpoints: papillary dermis (light Blue Peel) or the immediate upper reticular dermis (light/medium Blue Peel). Clinical signs guide the depth achieved (frost quality, even blue, pink sign, epidermal sliding) and correlate retrospectively with healing time (7-10 days).
RESULTS: The TCA Blue Peel was found to be a simple and consistent treatment approach for problems related to the epidermis, papillary dermis, and immediate upper reticular dermis. An unexpected benefit was the appearance of skin tightening and a reduction of skin laxity in many cases. This suggests that the papillary dermis and the immediate upper reticular dermis play a significant role in skin tightness.
CONCLUSION: A simple coating system for achieving depth-controlled TCA peels is presented with correlation to intraoperative clinical signs. This method makes it easier to peel skin of all racial backgrounds, including nonfacial skin. This is especially useful for many patients previously excluded from having procedures that penetrate beneath the papillary dermis. Commonly encountered variables in chemical peels are presented which may affect outcome.
OBJECTIVES: The purpose of this article is to fill the gap for a peel that is deeper than superficial exfoliative procedures yet lighter than a medium-depth peel, to simplify and standardize the TCA peel, to define depth properly based on intraoperative clinical signs, to implement a color guide that facilitates even application of TCA and avoids skip areas, and to identify and minimize variables that may contribute to inconsistent outcomes.
METHODS: A coating system for TCA application is created by selecting a specific TCA concentration (15% or 20%), TCA volume (4 or 6 ml, respectively), and a standardized body surface area to be peeled (5%), taking into consideration skin thickness and fragility. Multiple coats of TCA are applied to reach the desired endpoints: papillary dermis (light Blue Peel) or the immediate upper reticular dermis (light/medium Blue Peel). Clinical signs guide the depth achieved (frost quality, even blue, pink sign, epidermal sliding) and correlate retrospectively with healing time (7-10 days).
RESULTS: The TCA Blue Peel was found to be a simple and consistent treatment approach for problems related to the epidermis, papillary dermis, and immediate upper reticular dermis. An unexpected benefit was the appearance of skin tightening and a reduction of skin laxity in many cases. This suggests that the papillary dermis and the immediate upper reticular dermis play a significant role in skin tightness.
CONCLUSION: A simple coating system for achieving depth-controlled TCA peels is presented with correlation to intraoperative clinical signs. This method makes it easier to peel skin of all racial backgrounds, including nonfacial skin. This is especially useful for many patients previously excluded from having procedures that penetrate beneath the papillary dermis. Commonly encountered variables in chemical peels are presented which may affect outcome.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app