In 1982, Stegman reported the histologic effects of three peeling agents, including TCA, full strength phenol, Baker's phenol, and derma-brasion on normal and sun-damaged skin of the neck. This study demonstrated that 40-60% TCA caused epidermal necrosis, papillary dermal edema, and homogenization to the midre-ticular dermis 3 days after peeling. Findings were similar in sun-damaged compared with non sun-damaged skin. Ninety days after peeling, he observed an expanded papillary dermis, which he defined as the Grenz zone. The thickness of the Grenz zone increased as the depth of peeling increased. The investigative work of Stegman and others facilitated our understanding of the capacity of medium-depth and deep peeling agents to improve photodamage [50,51, 52]. Superficial, medium-depth, and deep-peeling agents are currently utilized according to the degree of photodamage.
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