title: Chemical peel of nonfacial skin using glycolic acid gel augmented with TCA and neutralized based on visual staging.
abstract: BACKGROUND
  Until recently, standard techniques for laser or chemical peeling have not always provided consistent results when applied to the nonfacial skin.
  
  
  OBJECTIVE
  The author describes a more controlled chemical peel technique for nonfacial skin using 70% glycolic acid gel combined with 40% trichloroacetic acid (TCA). The method has given consistently good results on the skin of the neck, chest, arms, hands, back, and other nonfacial skin.
  
  
  METHODS
  More than 3100 patients were given skin peels of the neck, chest, and other areas of the body as indicated. Seventy percent glycolic acid gel was applied to the areas to be peeled, then immediately augmented with 40% TCA. Each area was carefully monitored for the end point and then neutralized with copious amounts of 10% sodium bicarbonate solution. The end point was determined by visual observation using a six-stage classification to determine the degree of peeling.
  
  
  RESULTS
  Clinical results were excellent, with smoother skin texture, decreased wrinkling and striae, and fading of lentigines and other pigmentary abnormalities. There was excellent blending into peeled facial skin and into adjacent areas of nonpeeled skin. Complications were minimal.
  
  
  CONCLUSIONS
  This technique can provide the benefits of skin peeling to nonfacial skin with excellent cosmetic results and minimal complications.
authors.affiliation: Coronado Skin Medical Center, Inc., California 92118, USA.
authors.forename: K K
authors.initials: KK
authors.lastname: Cook
authors.forename: W R
authors.initials: WR
authors.lastname: Cook
mesh_terms: D002615:Chemexfoliation / Q000379:methods*; D062109:Dermatologic Surgical Procedures; D005260:Female; D005782:Gels; D006016:Glycolates / Q000008:administration & dosage*; D006801:Humans; D007641:Keratolytic Agents / Q000008:administration & dosage*; D008297:Male; D011182:Postoperative Care; D012880:Skin Pigmentation / Q000187:drug effects*; D013997:Time Factors; D014238:Trichloroacetic Acid / Q000008:administration & dosage*
chemical_list: D005782:Gels; D006016:Glycolates; D007641:Keratolytic Agents; C031149:glycolic acid; D014238:Trichloroacetic Acid