Through the patient's history and physical examination, the physicians will identify any specific factor such as medications, prior procedures and medical conditions that can affect the outcome of the peel . Complications of glycolic acid peel like hyperpigmentation and infection are rare. Chemical peel with glycolic acid may cause sensible irritation symptoms, characterized by stinging, burning and itching. A substance capable of counteracting sensory irritation is strontium nitrate at 20 % concentration, which applied topically with 70% gly-colic acid, potently suppresses the sensation of chemically induced irritation .
Moreover, some studies have demonstrated that glycolic acid could cause an increase in the level of skin damage in a dose- and time-dependent manner. Lower doses (1 and 3 mg/cm2) of glycolic acid caused erythema and eschar at most, whereas higher doses (5 and 7 mg/cm2) of glycolic acid caused redness, edema and ne-crotic ulceration.
Glycolic acid also increased the thickness of the epidermal layer, reduced the organization of the stratum corneum and eventually destroyed some parts of the epidermal layer at 7 mg/cm2. UVB caused redness and edema and also reduced the integrity of the stratum corneum. Glycolic acid enhances UVB-induced skin damage without accompanying PGE (2) production or COX-2 protein expression. Therefore, caution should be exercised by those using glycolic acid chronically or in excessive amounts. Moreover, people with photosensitive skins and those particularly exposed to the sun should be particularly careful. However, this photosensitivity could be reversed within a week after terminating treatments .
Laboratory investigations have rarely shown a complex I deficiency in the mitochondrial oxidative phosphorylation of patients who had recurrent episodes characterized by nausea,vom-iting, and signs of dehydration necessitating admission to the hospital. In these patients gly-colic acid was detected in blood and they were diagnosed as having ethylene glycol intoxication .
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