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Salicylic acid solution
Salicylic acid solution
Salicylic acid is the most popular ฮฒ-hydroxy acid used in chemical peeling.Unlike other chemical solutions, its lipophilic nature allows it to penetrate into sebaceous glands and hair follicles. It is keratolytic and comedolytic, removing intercellular lipids and desmosomes, thereby decreasing the cohesiveness between corneocytes and keratinocytes.2 As a superficial peel, this solution is well tolerated even in patients with Fitzpatrick skin types IV to VI.3
There are numerous formulations for salicylic acid peels but the most common is a 20% to 30% salicylic acid solution in an ethanol base. The skin should first be prepped with acetone to degrease the skin. The peel can then be applied in two to three coats and left on for 3 to 5 minutes starting with the forehead, then the cheeks, nose, cutaneous lip, and chin. There is no need for neutralization. The skin will develop a light frost as the ethanol evaporates and salicylic acid precipitates, signaling completion of the peel. To achieve an even peel, more solution can be applied until the faint frost is evenly distributed. The patient can then rinse and cleanse the face with a gentle and bland facial cleanser.
Patients will experience an initial mild stinging sensation, lasting around 3 minutes, which can be alleviated with a cool fan.4 This discomfort is transient since the peel has anesthetic properties. Side effects are generally mild and transient, with the most common being dryness. While postinflammatory hypo- and hyperpigmentation have been reported in patients, particularly in areas of inflamed skin, this is transient, even in patients with Fitzpatrick skin type IV and greater.3 While salicylic acid is generally well tolerated it should not be used in patients who are pregnant or breastfeeding as it is pregnancy category C. Care should also be taken to avoid using this peel with lasers or dermabrasion given the flammable ethanol base.