Biography
Biography: Disha Jaggi
Abstract
Chemical peeling is a widely used procedure in the management of acne and acne scars. Acne vulgaris is the most common skin disorder in adolescents and young adults. It carries a significant psychological and economic burden to patients and society. Salicylic acid has been used to treat various skin disorders for more than 2,000 years. The ability of salicylic acid to exfoliate the stratum corneum makes it a good agent for peeling. This report entitles the young adult female with acne and was treated with Salycylic acid and glycolic acid peel and the desired outcome was assessed.
Introduction
Acne is a common chronic inflammatory skin disease experienced by most adolescents and young adults and the pathogenesis of acne vulgaris is a multifactorial. The major identified factors that are involved in pathogenesis of active acne lesion formation and scarring are: excess sebum production, follicular epidermal hyper keratinization, the proinflammatory effects of Propionibacterium acnes and other normal skin flora, and immunological reactions.
The estimated life-time prevalence is ~80%. Patients experience high levels of anxiety, depression, and low self-esteem which lead to impaired quality of life. Therefore, treatment should focus on early intervention & prevention to decrease the physical and esthetic burden of the disease. The treatment of acne is based on a combination of topical therapies, systemic treatments, chemical peels, dermabrasion, laser & oral medication.
Chemical peeling is one of the most common cosmetic procedures in medical practice and has been used for decades. It is defined as the application of chemical agents, of variable strength, on the skin that results in controlled destruction of the epidermis and dermis. The induced exfoliation is followed by dermal and epidermal regeneration from adjacent epithelium and skin adnexa, which results in improved surface texture and appearance of the skin.
Technique
Superficial peel i.e. salicylic acid peel 30% with combination of oral antibiotics has been started for the patient. Patient was prepared by cleansing and degreasing the whole face by using acetone or 70% alcohol soaked-gauze. Peak results are visible after a series of 3–6 chemical peels depending on the severity of the condition being treated and skin type. Then the whole face was coated with salicylic acid 30% by using cotton-tipped applicator and number of coating ranged from 2-3 application in one sitting, until fine frosting occurred.
At every 2-4 weeks interval, session of peel was done to the patient for around 5 months with 2 sessions of glycolic acid peel are also given in combination for resurfacing of the skin and maintain good texture of skin.
Result
Salicylic acid peeling used 8 times 2 weeks apart in patient with acne vulgaris and in combination with 2 times 2 weeks apart session of glycolic acid peeling used for resurfacing of skin. Active acne vulgaris included papules and pustules showed significant reduction within 1 month of therapy. After 5 months, remarkable reduction in acne vulgaris and acne scar seen with tightening and whitening of the skin of whole face. Patient was fully satisfied regarding response to therapy. Follow up for three months after peeling showed no relapse in active acne vulgaris and the reduction in scarring was permanent. For maintenance therapy patient was allowed to visit at least once in every 6 months.
Conclusion
SA peel is a safe peeling agent and can be used in different cases of cosmetology procedure e.g. acne vulgaris, melasma, photodamage, freckles, and lentigines. It can be safely used on dark skin type. Equally glycolic acid has also shown to be safe in the treatment of acne even in darker skin types as well as adjunctive therapy for the treatment of acne scars. With this SA also has the added advantage of having a whitening effect, which is favourable darker skin types, as well as those with co-existing hyper pigmentation. Compared to newer technologies for acne and acne scars removal, chemical peeling is affordable and with minimal downtime, and can be performed easily.