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Published in: Aesthetic Plastic Surgery 2/2018

01-04-2018 | Original Article

Chemical Peeling with a Modified Phenol Formula for the Treatment of Facial Freckles on Asian Skin

Authors: Hua-Feng Sun, Hai-Shan Lu, Le-Qi Sun, Wei-Dong Ping, Dong-Sheng Mao, Dan Li

Published in: Aesthetic Plastic Surgery | Issue 2/2018

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Abstract

Background

Chemical peeling is an efficient method for the treatment of pigment disorders. For freckles, medium-depth to deep peeling using a phenol solution is one of the most effective chemical peels, and modifications of facial skin can be observed up to 20 years after peeling. However, applying phenol to the skin may cause serious side effects. Phenol peeling has been rarely used in Asia due to its tendency to cause permanent pigmentary changes and hypertrophic scars.

Methods

In total, 896 Chinese inpatients with facial freckles were enrolled in this study. The phenol formula was modified with crystalline phenol, dyclonine, camphor, anhydrous alcohol and glycerin and adjusted to a concentration of 73.6–90.0%. The entire peeling treatment was divided into two procedures performed separately on 2 days.

Results

All patients exhibited 26% or greater improvement, and 99.66% of patients exhibited 51% or greater improvement (good and excellent). Scarring and systemic complications were not observed in any patient.

Conclusions

The modified phenol formula is very effective and safe for the treatment of facial freckles in Asian patients.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literature
1.
go back to reference Huang YL, Liao YL, Lee SH, Hong HS (2002) Intense pulsed light for the treatment of facial freckles in Asian skin. Dermatol Surg 28(11):1007–1012 (discussion 1012) PubMed Huang YL, Liao YL, Lee SH, Hong HS (2002) Intense pulsed light for the treatment of facial freckles in Asian skin. Dermatol Surg 28(11):1007–1012 (discussion 1012) PubMed
2.
go back to reference Ezzedine K, Mauger E, Latreille J, Jdid R, Malvy D, Gruber F et al (2013) Freckles and solar lentigines have different risk factors in Caucasian women. J Eur Acad Dermatol Venereol 27(3):e345–e356CrossRefPubMed Ezzedine K, Mauger E, Latreille J, Jdid R, Malvy D, Gruber F et al (2013) Freckles and solar lentigines have different risk factors in Caucasian women. J Eur Acad Dermatol Venereol 27(3):e345–e356CrossRefPubMed
3.
go back to reference El Zawahry B, Zaki N, Hafez V, Hay RA, Fahim A (2014) Efficacy and safety of fractional carbon dioxide laser for treatment of unwanted facial freckles in phototypes II–IV: a pilot study. Lasers Med Sci 29(6):1937–1942CrossRefPubMed El Zawahry B, Zaki N, Hafez V, Hay RA, Fahim A (2014) Efficacy and safety of fractional carbon dioxide laser for treatment of unwanted facial freckles in phototypes II–IV: a pilot study. Lasers Med Sci 29(6):1937–1942CrossRefPubMed
4.
go back to reference Ho SG, Chan NP, Yeung CK, Shek SY, Kono T, Chan HH (2012) A retrospective analysis of the management of freckles and lentigines using four different pigment lasers on Asian skin. J Cosmet Laser Ther 14(2):74–80CrossRefPubMed Ho SG, Chan NP, Yeung CK, Shek SY, Kono T, Chan HH (2012) A retrospective analysis of the management of freckles and lentigines using four different pigment lasers on Asian skin. J Cosmet Laser Ther 14(2):74–80CrossRefPubMed
5.
go back to reference Bastiaens M, ter Huurne J, Gruis N, Bergman W, Westendorp R, Vermeer BJ et al (2001) The melanocortin-1-receptor gene is the major freckle gene. Hum Mol Genet 10(16):1701–1708CrossRefPubMed Bastiaens M, ter Huurne J, Gruis N, Bergman W, Westendorp R, Vermeer BJ et al (2001) The melanocortin-1-receptor gene is the major freckle gene. Hum Mol Genet 10(16):1701–1708CrossRefPubMed
6.
go back to reference Mradula PR, Sacchidanand S (2012) A split-face comparative study of 70% trichloroacetic acid and 80% phenol spot peel in the treatment of freckles. J Cutan Aesthet Surg 5(4):261–265CrossRefPubMedPubMedCentral Mradula PR, Sacchidanand S (2012) A split-face comparative study of 70% trichloroacetic acid and 80% phenol spot peel in the treatment of freckles. J Cutan Aesthet Surg 5(4):261–265CrossRefPubMedPubMedCentral
7.
go back to reference Park JH, Choi YD, Kim SW, Kim YC, Park SW (2007) Effectiveness of modified phenol peel (Exoderm) on facial wrinkles, acne scars and other skin problems of Asian patients. J Dermatol 34(1):17–24CrossRefPubMed Park JH, Choi YD, Kim SW, Kim YC, Park SW (2007) Effectiveness of modified phenol peel (Exoderm) on facial wrinkles, acne scars and other skin problems of Asian patients. J Dermatol 34(1):17–24CrossRefPubMed
8.
go back to reference Monheit GD, Chastain MA (2001) Chemical peels. Facial Plast Surg Clin N Am 9(2):239–255 Monheit GD, Chastain MA (2001) Chemical peels. Facial Plast Surg Clin N Am 9(2):239–255
9.
go back to reference Jang KA, Chung EC, Choi JH, Sung KJ, Moon KC, Koh JK (2000) Successful removal of freckles in Asian skin with a Q-switched alexandrite laser. Dermatol Surg 26(3):231–234CrossRefPubMed Jang KA, Chung EC, Choi JH, Sung KJ, Moon KC, Koh JK (2000) Successful removal of freckles in Asian skin with a Q-switched alexandrite laser. Dermatol Surg 26(3):231–234CrossRefPubMed
10.
go back to reference Hetter GP (2000) An examination of the phenol-croton oil peel: Part I. Dissecting the formula. Plast Reconstr Surg 105(1):227–239 (discussion 249–251) CrossRefPubMed Hetter GP (2000) An examination of the phenol-croton oil peel: Part I. Dissecting the formula. Plast Reconstr Surg 105(1):227–239 (discussion 249–251) CrossRefPubMed
11.
go back to reference Hetter GP (2000) An examination of the phenol-croton oil peel: Part II. The lay peelers and their croton oil formulas. Plast Reconstr Surg 105(1):240–248 (discussion 249–251) CrossRefPubMed Hetter GP (2000) An examination of the phenol-croton oil peel: Part II. The lay peelers and their croton oil formulas. Plast Reconstr Surg 105(1):240–248 (discussion 249–251) CrossRefPubMed
12.
go back to reference Hetter GP (2000) An examination of the phenol-croton oil peel: part III. The plastic surgeons’ role. Plast Reconstr Surg 105(2):752–763CrossRefPubMed Hetter GP (2000) An examination of the phenol-croton oil peel: part III. The plastic surgeons’ role. Plast Reconstr Surg 105(2):752–763CrossRefPubMed
13.
go back to reference Hetter GP (2000) An examination of the phenol-croton oil peel: part IV. Face peel results with different concentrations of phenol and croton oil. Plast Reconstr Surg 105(3):1061–1083 (discussion 1084–1067) CrossRefPubMed Hetter GP (2000) An examination of the phenol-croton oil peel: part IV. Face peel results with different concentrations of phenol and croton oil. Plast Reconstr Surg 105(3):1061–1083 (discussion 1084–1067) CrossRefPubMed
15.
go back to reference Fischer TC, Perosino E, Poli F, Viera MS, Dreno B (2010) Chemical peels in aesthetic dermatology: an update 2009. J Eur Acad Dermatol Venereol 24(3):281–292CrossRefPubMed Fischer TC, Perosino E, Poli F, Viera MS, Dreno B (2010) Chemical peels in aesthetic dermatology: an update 2009. J Eur Acad Dermatol Venereol 24(3):281–292CrossRefPubMed
16.
go back to reference Stone PA (1998) The use of modified phenol for chemical face peeling. Clin Plast Surg 25(1):21–44PubMed Stone PA (1998) The use of modified phenol for chemical face peeling. Clin Plast Surg 25(1):21–44PubMed
17.
go back to reference Han SH, Kim HJ, Kim SY, Kim YC, Choi GS, Shin JH (2011) Skin rejuvenating effects of chemical peeling: a study in photoaged hairless mice. Int J Dermatol 50(9):1075–1082CrossRefPubMed Han SH, Kim HJ, Kim SY, Kim YC, Choi GS, Shin JH (2011) Skin rejuvenating effects of chemical peeling: a study in photoaged hairless mice. Int J Dermatol 50(9):1075–1082CrossRefPubMed
18.
go back to reference Obagi ZE (ed) (2000) Endpoints. In: Obagi skin health restoration and rejuvenation. Springer, New York, pp 203–211 Obagi ZE (ed) (2000) Endpoints. In: Obagi skin health restoration and rejuvenation. Springer, New York, pp 203–211
20.
go back to reference Goodman LS, Gilman A (1965) The pharmacological basis of therapeutics. Macmillan Publishing Co., New York, pp 982–983 Goodman LS, Gilman A (1965) The pharmacological basis of therapeutics. Macmillan Publishing Co., New York, pp 982–983
21.
go back to reference Miller C, King E, Frere J (1778) An account of the Island of Sumatra. Philos Trans R Soc Lond 68:121CrossRef Miller C, King E, Frere J (1778) An account of the Island of Sumatra. Philos Trans R Soc Lond 68:121CrossRef
22.
go back to reference Larson DL, Karmo F, Hetter GP (2009) Phenol-croton oil peel: establishing an animal model for scientific investigation. Aesthet Surg J. 29(1):47–53CrossRefPubMed Larson DL, Karmo F, Hetter GP (2009) Phenol-croton oil peel: establishing an animal model for scientific investigation. Aesthet Surg J. 29(1):47–53CrossRefPubMed
23.
go back to reference Isoda M, Ueda S, Imayama S, Tsukahara K (2001) New formulation of chemical peeling agent: histological evaluation in sun-damaged skin model in hairless mice. J Dermatol Sci 27(Suppl 1):S60–S67CrossRefPubMed Isoda M, Ueda S, Imayama S, Tsukahara K (2001) New formulation of chemical peeling agent: histological evaluation in sun-damaged skin model in hairless mice. J Dermatol Sci 27(Suppl 1):S60–S67CrossRefPubMed
24.
go back to reference Omi T, Sato S, Numano K, Kawana S (2010) Ultrastructural observations of chemical peeling for skin rejuvenation (ultrastructural changes of the skin due to chemical peeling). J Cosmet Laser Ther 12(1):21–24CrossRefPubMed Omi T, Sato S, Numano K, Kawana S (2010) Ultrastructural observations of chemical peeling for skin rejuvenation (ultrastructural changes of the skin due to chemical peeling). J Cosmet Laser Ther 12(1):21–24CrossRefPubMed
25.
go back to reference Fitzpatrick RE, Tope WD, Goldman MP, Satur NM (1996) Pulsed carbon dioxide laser, trichloroacetic acid, Baker–Gordon phenol, and dermabrasion: a comparative clinical and histologic study of cutaneous resurfacing in a porcine model. Arch Dermatol 132(4):469–471CrossRefPubMed Fitzpatrick RE, Tope WD, Goldman MP, Satur NM (1996) Pulsed carbon dioxide laser, trichloroacetic acid, Baker–Gordon phenol, and dermabrasion: a comparative clinical and histologic study of cutaneous resurfacing in a porcine model. Arch Dermatol 132(4):469–471CrossRefPubMed
26.
go back to reference Kligman AM, Baker TJ, Gordon HL (1985) Long-term histologic follow-up of phenol face peels. Plast Reconstr Surg 75(5):652–659CrossRefPubMed Kligman AM, Baker TJ, Gordon HL (1985) Long-term histologic follow-up of phenol face peels. Plast Reconstr Surg 75(5):652–659CrossRefPubMed
27.
go back to reference Deprez P (2007) Textbook of chemical peels. Superficial, medium, and deep peels in cosmetic practice. Informa, LondonCrossRef Deprez P (2007) Textbook of chemical peels. Superficial, medium, and deep peels in cosmetic practice. Informa, LondonCrossRef
28.
go back to reference Wu S, Shi H, Wu H, Yan S, Guo J, Sun Y et al (2012) Treatment of melasma with oral administration of tranexamic acid. Aesthetic Plast Surg 36(4):964–970CrossRefPubMed Wu S, Shi H, Wu H, Yan S, Guo J, Sun Y et al (2012) Treatment of melasma with oral administration of tranexamic acid. Aesthetic Plast Surg 36(4):964–970CrossRefPubMed
29.
go back to reference Tan AW, Sen P, Chua SH, Goh BK (2017) Oral tranexamic acid lightens refractory melasma. Australas J Dermatol 58(3):e105–e108CrossRefPubMed Tan AW, Sen P, Chua SH, Goh BK (2017) Oral tranexamic acid lightens refractory melasma. Australas J Dermatol 58(3):e105–e108CrossRefPubMed
30.
go back to reference Lee HC, Thng TG, Goh CL (2016) Oral tranexamic acid (TA) in the treatment of melasma: a retrospective analysis. J Am Acad Dermatol 75(2):385–392CrossRefPubMed Lee HC, Thng TG, Goh CL (2016) Oral tranexamic acid (TA) in the treatment of melasma: a retrospective analysis. J Am Acad Dermatol 75(2):385–392CrossRefPubMed
31.
go back to reference Li D, Shi Y, Li M, Liu J, Feng X (2010) Tranexamic acid can treat ultraviolet radiation-induced pigmentation in guinea pigs. Eur J Dermatol 20(3):289–292PubMed Li D, Shi Y, Li M, Liu J, Feng X (2010) Tranexamic acid can treat ultraviolet radiation-induced pigmentation in guinea pigs. Eur J Dermatol 20(3):289–292PubMed
32.
go back to reference Maeda K, Naganuma M (1998) Topical trans-4-aminomethylcyclohexanecarboxylic acid prevents ultraviolet radiation-induced pigmentation. J Photochem Photobiol B 47(2–3):136–141CrossRefPubMed Maeda K, Naganuma M (1998) Topical trans-4-aminomethylcyclohexanecarboxylic acid prevents ultraviolet radiation-induced pigmentation. J Photochem Photobiol B 47(2–3):136–141CrossRefPubMed
33.
go back to reference Reichel CA, Lerchenberger M, Uhl B, Rehberg M, Berberich N, Zahler S et al (2011) Plasmin inhibitors prevent leukocyte accumulation and remodeling events in the postischemic microvasculature. PLoS ONE 6(2):e17229CrossRefPubMedPubMedCentral Reichel CA, Lerchenberger M, Uhl B, Rehberg M, Berberich N, Zahler S et al (2011) Plasmin inhibitors prevent leukocyte accumulation and remodeling events in the postischemic microvasculature. PLoS ONE 6(2):e17229CrossRefPubMedPubMedCentral
34.
go back to reference Bastaki M, Nelli EE, Dell’Era P, Rusnati M, Molinari-Tosatti MP, Parolini S et al (1997) Basic fibroblast growth factor-induced angiogenic phenotype in mouse endothelium. A study of aortic and microvascular endothelial cell lines. Arterioscler Thromb Vasc Biol 17(3):454–464CrossRefPubMed Bastaki M, Nelli EE, Dell’Era P, Rusnati M, Molinari-Tosatti MP, Parolini S et al (1997) Basic fibroblast growth factor-induced angiogenic phenotype in mouse endothelium. A study of aortic and microvascular endothelial cell lines. Arterioscler Thromb Vasc Biol 17(3):454–464CrossRefPubMed
35.
go back to reference Na JI, Choi SY, Yang SH, Choi HR, Kang HY, Park KC (2013) Effect of tranexamic acid on melasma: a clinical trial with histological evaluation. J Eur Acad Dermatol Venereol 27(8):1035–1039CrossRefPubMed Na JI, Choi SY, Yang SH, Choi HR, Kang HY, Park KC (2013) Effect of tranexamic acid on melasma: a clinical trial with histological evaluation. J Eur Acad Dermatol Venereol 27(8):1035–1039CrossRefPubMed
36.
go back to reference Chung BY, Choi SR, Moon IJ, Park CW, Kim YH, Chang SE (2016) The glutathione derivative, GSH monoethyl ester, may effectively whiten skin but GSH does not. Int J Mol Sci 17(5):629CrossRefPubMedCentral Chung BY, Choi SR, Moon IJ, Park CW, Kim YH, Chang SE (2016) The glutathione derivative, GSH monoethyl ester, may effectively whiten skin but GSH does not. Int J Mol Sci 17(5):629CrossRefPubMedCentral
37.
go back to reference Landau M (2005) Advances in deep chemical peels. Dermatol Nurs 17(6):438–441PubMed Landau M (2005) Advances in deep chemical peels. Dermatol Nurs 17(6):438–441PubMed
38.
go back to reference Clark E, Scerri L (2008) Superficial and medium-depth chemical peels. Clin Dermatol 26(2):209–218CrossRefPubMed Clark E, Scerri L (2008) Superficial and medium-depth chemical peels. Clin Dermatol 26(2):209–218CrossRefPubMed
Metadata
Title
Chemical Peeling with a Modified Phenol Formula for the Treatment of Facial Freckles on Asian Skin
Authors
Hua-Feng Sun
Hai-Shan Lu
Le-Qi Sun
Wei-Dong Ping
Dong-Sheng Mao
Dan Li
Publication date
01-04-2018
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 2/2018
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-017-1048-z

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