Chemical Peeling
History
Vanity has always been the core of existence of women and men (whether they admit it or not) across the centuries. In an attempt to fight wrinkles and other harbingers of aging as well as attain a clear, smooth complexion, man has experimented since time immemorial and it is this comprehensive experimentation that has laid the foundation for modern day chemical rejuvenation.
Tracing a medical procedure is often an uphill and deterring task, there are many reason for this. No written records exist from the prehistoric era, interpretation of medical terminology is often confusing. With the passage of time operative and medical procedures are lost and only to be discovered and rediscovered many times over.
1600-1700 BC
during the Elizabeth times, cosmesis became very fashionable. Elizabeth 1 of England herself, painted lines on her face following outlines of superficial veins preserve the appearance of youth. Ladies of the haute monde like the Romans before them, employed cloth patches followed by minute wax prostheses on their wrinkles and scars. Of course should the Elizabethan lady become over heated for some reason, her wax prostheses would melt!!
1750 BC
There were many attempts in this period cover cosmetic influenced by disease and age with substances such as lead carbonate face powders. It become apparent in due course that leaded face masks could lead to death but nevertheless their popularity continued with periodic withdrawals and reintroductions.
1834-1867
Phenol face peels began with the famous German chemist Friedrich Ferdinand Runge who discovered carbolic acid(phenol) by mixing cresols obtained from coal tar.
1841
Charles F Gerhardt coined the term phenol.
1842
French chemist Auguste Laurence prepared phenol in a pure form from coal tar which he named phenolic acid.
1816-1888
The era of master dermatologist Ferdinand Hebra, from Veinna, considered the father of modern dermatology by many. There is no documented evidence that Hebra treated wrinkles but he used various original combinations of exfoliating agents to treat freckles and even melasma.
1866
Arnold J Cooley, an English pharmacist published a book curiously labeled ‘The Toilet in Ancient and Modern Times’. In this book he had extensive literature on removal of old scars. He used a gentle massage with warm iodized oils, a glycerinated solution of bichloride of mercury and warm sea water baths. He did not however mention the use of phenol. He interestingly and uniquely presented plans to prevent permanent skin disfigurement by small pox. He insisted that the way to do this was to exclude light and air. On the third day he applied a facial mask in which holes were cut for the nostrils, eyes and mouth after it had been thickly covered with mercurial ointment. The procedure was repeated daily or every third day, always by candlelight and continued till the pustules disappeared. He was however pessimistic about treating wrinkles and loose skin.
1871-1881
Two landmark dermatological works were published. Tilbury Fox’s formulary comprised 190 prescriptions:cantharides, almond oil, glycerine, borax.Piffard’s book ‘A Treatise on the Materia Medica and therapeutics of the skin’- the first dermatological book published in America that was limited to therapy.
1927
H.O. Bames in the Medical Journal and Record published the first article on cosmetic phenol peeling. He described a light peel using resorcin in alcohol and a dry peel using 50% to 80% phenol. He spoke at length on phenol toxicity as well as it’s virtues as a plastic surgery peel.
1960
Maxillofacial surgeon Adolph M Brown and his dermatologist wife Martha Brown published an in depth account of phenol induced histological skin changes.
1960
Thomas J. Baker and Howard L Gordon established the modern day procedure of cosmetic phenol peeling. Over the years Baker and Gordon’s formula and technique have maintained their popularity and it is largely their work which removed the technique of phenol peeling from semi obscurity to a respectable position in aesthetic surgery. Samuel Ayres, Litton and others debated as well as contributed to this literature along the way.
1970s
This era witnessed a rebirth in interest in TCA peeling primarily by dermatologists. Resnik, Lewis, Cowan and Howarth reviewed their work with TCA peels. Simultaneously Vanscott and yu worked on alpha hydroxyl acids which culminated in it’s wide spread usage in the 1980s and 1990s.
1980s
Stegman published his work on the histologic study of the effect of various peeling agents, thereby providing a scientific approach to chemical peeling. His work amongst others influenced Brody and Hailey.
1986
Brody and Hailey combined two superficial agents, solid carbon dioxide and TCA to produce a medium depth peel.
1989
Monheit employed another medium depth technique utilizing resorcinol, salicylic acid lactic acid (jessner’s solution) followed by TCA.
1994
Coleman and Futrell worked on the concept of combination peel using both glycolic acid and TCA.
2007
Sachin Maurya, Behl’s skin institute, New Delhi, also worked on combination peel using 70% glycolic acid, 30% salicylic acid and Jessner’s solution for acne scars and has very well appreciated.
Chemical peels thrive today with continuing experimentation with superficial, medium depth, combination peels and so forth. Alpha hydroxyl acids are present in OTC preparations. Beta hydroxyl acid is the new kid on the block, now available in many OTC preparations and the future probably holds many more exciting discoveries.
Cornelius celsus in as early as 25 BC amidst this flutter of excitement stated his disinterest and disdain in cosmetology, a feeling palpable even today in certain sections but it is becoming increasingly hard to ignore as long as vanity remains an integral part of the human psyche chemical peeling will flourish, in different forms and various adaptations, but it will.
