Contraindications

■ History of recurrent herpes simplex virus infection

■ Daily sun exposure

■ Degrease the skin with alcohol

■ Solution application:

- Apply the solution with a brush (for a light and uniform peel) in two to three layers and keep the acid on the skin until erythema appears

- Apply the solution with gauze, scrub gently and continuously for 1-3 min to obtain a deeper penetration

■ Apply the solution to small areas (forehead, one cheek at a time, chin, nose and upper lip) and neutralize each area with sodium bicarbonate before progressing to the next area

■ A small fan should be used during the application of pyruvic acid to avoid inhaling the vapors

■ Moisturizing creams and sunscreens must be applied after the peel

■ Three to five peeling sessions are needed at 4-week intervals (Figs. 4.9a, b, 4.10a, b and 4.11a, b)

Fig. 4.2. Peeling procedure in a patient with microcystic Fig. 4.3. Peeling procedure in a patient with microcystic acne: the microcysts are broken with a 30 */2 gaube acne: Toelette with a surgical spoon needle

Fig. 4.2. Peeling procedure in a patient with microcystic Fig. 4.3. Peeling procedure in a patient with microcystic acne: the microcysts are broken with a 30 */2 gaube acne: Toelette with a surgical spoon needle

Microcystic Acne

Fig. 4.5. Peeling procedure in a patient with microcystic acne

Fig. 4.4. Peeling procedure in a patient with microcystic acne: application of the formulation

Fig. 4.5. Peeling procedure in a patient with microcystic acne

Fig. 4.6a. Neutralization with sodium bicarbonate

Microcystic Acne
Fig. 4.6b. Uniformity of erythema after neutralization
Erythema From Chemical PeelMicrocystic Acne

■ Desquamation

■ Crusting in areas of thinner skin

Fig. 4.7. The fan used during the procedure

Fig. 4.7. The fan used during the procedure

Chemical Peel During And After
Fig. 4.8. The patient after peeling

4.8 Post-peeling Care

■ Daily use of moisturizing facial cream and sunscreens

■ Cease the use of retinoid creams, a-hy-droxy acid and pyruvic acid creams for a week after the peel

Side Effects

■ Desquamation

■ Crusting in areas of thinner skin

4.10 Advantages

■ Very mild erythema

■ Mild desquamation

■ Short post-operative period

■ Can be used in Fitzpatrick skin type III and IV

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