SALICYCLIC ACID PEELS

CONTENTS
• Introduction
• Peel formulations
• Equipments and Reagents
• Indications
• Contraindications
• Priming and Prepeel preparation
• Procudure
• Postpeel care
• Complications

INTRODUCTION
• Salicylic acid is a beta hydroxy acid derived
from the willow bark, wintergreen leaves
and sweet birch (hydroxyl derivative of
benzoic acid.)
• It is lipophilic and acts as a keratolytic
agent by dissolving the intercellular lipids,
surrounding the keratinized epithelial
cells.
• Due to its lipophilic nature, it
preferentially acts on the sebaceous
follicle, has excellent comedolytic activity
and hence is very useful for acne.

• It also has anti-inflammatory and
antimicrobial properties.
• It is safe for all skin types.
• It has limited penetration and is
effective for superficial epidermal
conditions like oily, rough skin,
epidermal melisma and mild
photoaging.

PEEL FORMULATION
• It is available as Salicylic acid powder, slightly soluble
in water, but highly soluble in 95% ethanol, ether or
methanol (common spirit).
• On application, the alcohol evaporates and the salt
crystallizes on the skin forming a white precipitate,
this appears like a frost and is called ‘pseudofrost”.
• 1. Hydroethanolic solution
• 2. 2% solution as skin cleaner- acne washes.
• 3. salicylic acid peels kits (beta lift, bioglan pharma).
• 4. salicylic acid paste.

EQUIPMENTS AND REAGENTS
• 1. SA solution 20%, 30%, 40%, 50%.
• 2. Alcohol
• 3. Acetone
• 4. Cold water
• 5. Petrolatum or Vaseline.
• 6. Syringes
• 7. Glass cup or Beaker.
• 8. Cotton tipped applicators
• 9. Cotton gauge pieces.
• 10. Gloves
• 11. Head band or cap for patient.
• 12. Fan.

INDICATIONS
• SA Peels used for all skin types 1-IV.
• 1. ACNE
• Comedonal Acne
• Inflammatory Acne
• Pigmented Acne Scars
• Superficial Acne Scars
• 2. HYPER PIGMENTATION
• Epidermal melisma
• Postinflammatory hyperpigmentation
• Freckles
• Lentigines

• 3. PHOTOAGING
• Fine wrinkles
• Dyschromias
• 4. TEXTURAL CHANGES
• Oily skin
• Rough uneven skin
• Dilated pores
• 5. KERATOTIC LESIONS
• Keratosis pilaris
• Warts
• 6. ACNE ROSACEA

CONTRAINDICATIONS
• Pregnancy
• Aspirin hyper sensitive
• Lactation
• Unrealistic patient expectations
• Dermatitis at the peeling site

PREPEEL PREPARATION
• Patient selection and counseling , detailed history and examination , informed
consent and photographiv documentation are mandatory before peeling.
Darker pigmented skins
( Priming )
Hypo pigmenting agents - intended to use post peeling ( such
as hydroquinone, kojic acid, azelaic acid or arbutin)
• Proper use of broad spectrum sunscreens and safe sun protection.
• Retinoids should stoped 1 week before peeling

PROCEDURE
Face wash
Hairband to cover hair
Head elevated to 45degrees
2”x2” cotton gauze
Cleanser and degreased
Sensitive areas covered with petrolactum
Peeling agent in a glass cup 20%
Wash the face and dry it
Instructed to limit sun exposure & use sunscreens appropriately

Before After
Pseudofrosting seen in salipeels

POSTPEEL CARE
• Feel tightness of skin after peel.
• Post peel till desquamation subsides sunscreens
and moisturizers are used.
• Topical antibacterial ointments- prevent bacterial
infection.
• Total skin regimen of Hypopigmenting agents,
acne medications, glycolic acid and retinoids
should use till the next peel.

COMPLICATIONS
• Uncommon, usually mild and
transient.
• Excessive crusting, desquamation,
inflammation and erythema.
• Salicylism observed when 50% SA
paste are applied to 50% of the body
surface- characterized by tinnitus,
dizziness, abdominal cramps and
deafness. ( patient is asked to drink
copious water to prevent salicylism )