In contrast to the previous decade, chemical peels are commonly performed in darker racial-ethnic groups, individuals comprising skin types IV-VI (Asians,Hispanics,Blacks,and Native Americans). Serial superficial glycolic acid, salicylic acid, Jessner's solution, and TCA peels (when appropriate) offer substantial benefits for post-inflammatory hyperpigmentation, melasma, acne, pseudofolliculitis barbae, oily skin, and texturally rough skin. When selecting a peeling agent, the benefits of the procedure should always substantially outweigh any associated risks or complications. Superficial peels with appropriate titration of concentrations are generally safe and efficacious for darker-skinned patients. However, given the labile nature of melanocytes of darker complexioned individuals, medium-depth and deep peels are more likely to induce substantial complications and side effects.
Fig. 13.6. Post-peel persistent hypopigmentation following a 35% TCA peel
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