Introduction: Classification of Peels



Many chemical peels and combination modalities are currently available for different clinical goals. The classification of chemical peels is defined by the depth of penetration into the skin, which can be superficial peels (corneal layer, epidermis, superficial papillary dermis only), medium-depth peels (past papillary dermis, up to upper reticular dermis), or deep peeling (all of the above but also reaching mid reticular dermis and extensive inflammation). The success of the procedure depends on the artistic hands of the surgeon and the right understanding of specific characteristics of the wounding agent. This chapter will provide important information for dermatologists and plastic surgeons with interest in chemical peels.


  1. 1.
    Ayres S. Dermal changes following application of chemical cauterants to aging skin. Arch Dermatol. 1960;82:578.CrossRefPubMedGoogle Scholar
  2. 2.
    Baker T, Gordon H. The ablation of rhytides by chemical means: a preliminary report. J Fla Med Assoc. 1961;48:541.Google Scholar
  3. 3.
    Beeson WH, McCollough EG. Chemical face peeling without taping. J Dermatol Surg Oncol. 1985;11(10):985–90.CrossRefPubMedGoogle Scholar
  4. 4.
    Brody HJ. Chemical peeling and resurfacing [Internet]. 3rd ed. Atlanta: Emory University Digital Library Publications; 2009. p. 1–267. Available from: Google Scholar
  5. 5.
    Brody HJ, Hailey CW. Medium-depth chemical peeling of the skin: a variation of superficial chemosurgery. J Dermatol Surg Oncol. 1986;12(12):1268–75.CrossRefPubMedGoogle Scholar
  6. 6.
    Brody HJ, Monheit GD, Resnik SS, Alt TH. A history of chemical peeling. Dermatol Surg. 2000;26(5):405–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Brown AM, Kaplan LM, Brown ME. Phenol induced histological skin changes: hazards, techniques, and uses. Br J Plast Surg. 1960;13:158.CrossRefPubMedGoogle Scholar
  8. 8.
    Coleman WP, Futrell JM. The glycolic acid trichloroacetic acid peel. J Dermatol Surg Oncol. 1994;20(1):76–80.CrossRefPubMedGoogle Scholar
  9. 9.
    Combes FC, Sperber PA, Reisch M. Dermal defects: treatment by a chemical agent. NY Physician Am Med. 1960;56:36.Google Scholar
  10. 10.
    Cucé LC, Bertino MCM, Scattone L, Birkenhauer MC. Tretinoin peeling. Dermatol Surg. 2001;27(1):12–4.PubMedGoogle Scholar
  11. 11.
    Dainichi T, Ueda S, Imayama S, Furue M, Ainichi TED, Eda ÃSEU, et al. Excellent clinical results with a new preparation for chemical peeling in acne: 30% salicylic acid in polyethylene glycol vehicle. Dermatol Surg. 2008;34(7):891–9; discussion 899.PubMedGoogle Scholar
  12. 12.
    Eller J, Wolff S. Skin peeling and scarification. JAMA J Am Med Assoc. 1941;116:934–8.CrossRefGoogle Scholar
  13. 13.
    Fox G. Photographic atlas of the diseases of the skin, vol. 2. Philadelphia: Lippincott; 1905.Google Scholar
  14. 14.
    Gordon JRS, Brieva JC. Unilateral dermatoheliosis. N Engl J Med. 2012;366(16):e25.CrossRefPubMedGoogle Scholar
  15. 15.
    Griffin T, Van Scott E, Maddin S. The use of pyruvic acid as a chemical peeling agent. J Dermatol Surg Oncol. 1989;15:1316.Google Scholar
  16. 16.
    Hetter GP. An examination of the phenol-croton oil peel: part II. The lay peelers and their croton oil formulas. Plast Reconstr Surg. 2000a;105(1):240–8-51.CrossRefPubMedGoogle Scholar
  17. 17.
    Hetter GP. An examination of the phenol-croton oil peel: part IV. Face peel results with different concentrations of phenol and croton oil. Plast Reconstr Surg. 2000b;105(3):1061–83; discussion 1084-7.CrossRefPubMedGoogle Scholar
  18. 18.
    Larson DL, Karmo F, Hetter GP. Phenol-croton oil peel: establishing an animal model for scientific investigation. Aesthet Surg J. 2009;29(1):47–53.CrossRefPubMedGoogle Scholar
  19. 19.
    Litton C. Chemical face lifting. Plast Reconstr Surg. 1962;29:371.CrossRefGoogle Scholar
  20. 20.
    Mackee G, Karp F. The treatment of post acne scars with phenol. Br J Dermatol. 1952;64:456–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Monash S. The uses of diluted trichloroacetic acid in dermatology. Urol Cutan Rev. 1945;49:119.Google Scholar
  22. 22.
    Monheit GD. The Jessner’s + TCA peel: a medium depth chemical peel. Dermatol Surg Oncol. 1989;15:945–50.CrossRefGoogle Scholar
  23. 23.
    Orekoya O, Oremule B, Hanna T. Historical abstracts. Br J Dermatol. 2016;175:191–8.Google Scholar
  24. 24.
    Resnik SS, Lewis LA, Cohen BH. Trichloroacetic acid peeling. Cutis. 1976;17(1):127–9.PubMedGoogle Scholar
  25. 25.
    Safoury OS, Zaki NM, El Nabarawy EA, Farag EA. A study comparing chemical peeling using modified Jessner’s solution and 15% trichloroacetic acid versus 15% trichloroacetic acid in the treatment of melasma. Indian J Dermatol India. 2009;54(1):41–5.CrossRefGoogle Scholar
  26. 26.
    Van Scott EJ, Yu RJ. Hyperkeratinization, corneocyte cohesion, and alpha hydroxy acids. J Am Acad Dermatol. 1984;11(5):867–79.CrossRefPubMedGoogle Scholar
  27. 27.
    Stegman SJ. A comparative histologic study of the effects of three peeling agents and dermabrasion on normal and sundamaged skin. Aesthet Plast Surg. 1982;6(3):123–35.CrossRefGoogle Scholar
  28. 28.
    Stuzin JM, Baker TJ, Gordon HL. Chemical peel: a change in the routine. Ann Plast Surg. 1989;23(2):166–9.CrossRefPubMedGoogle Scholar
  29. 29.
    Sumita JM, Leonardi GR, Bagatin E. Tretinoin peel: a critical view. An Bras Dermatol Sociedade Brasileira de Dermatologia. 2017;92(3):363–6.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Unna P. Therapeutiques generales des maladies de la peau. 1882.Google Scholar
  31. 31.
    Urkov J. Surface defects of skin: treatment by controlled exfoliation. Ill Med J. 1946;89:75.PubMedGoogle Scholar
  32. 32.
    Vagotis FL, Brundage SR. Histologic study of dermabrasion and chemical peel in an animal model after pretreatment with Retin-A. Aesthet Plast Surg. 1995;19(3):243–6.CrossRefGoogle Scholar
  33. 33.
    Vasconcelos B, Figueira G, Fonseca J, Mendonça L, Fonseca C. A splitface comparative study between two phenolbased peelings (BakerGordon and Hetter formulas) in the treatment of facial rhytids. Surg Cosmet Dermatol. 2013;5:40–4.Google Scholar
  34. 34.
    Wambier CG. My personal experience with peelings. In: Issa MCA, Tamura B, editors. Chemical and physical procedures. Cham: Springer International Publishing; 2017. p. 1–9.Google Scholar
  35. 35.
    Wambier CG, Brody HJ, Hetter GP. Comments: Hemiface comparative study of two phenol peels (Baker-Gordon and Hetter formulas) for the correction of facial rhytids. Surg Cosmet Dermatol. 2017;9(2):190–1.Google Scholar
  36. 36.
    Wambier CG, de Freitas FP. Combining phenol-croton oil peel. In: Issa MCA, Tamura B, editors. Chemical and physical procedures. Cham: Springer International Publishing; 2017. p. 1–13.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Yale University School of MedicineNew HavenUSA
  2. 2.Emory University School of MedicineAtlantaUSA

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