[Chemical peels in aesthetic dermatology]

Chemical peels are classified as very superficial (exfoliation), superficial (epidermal), medium (papillary dermal) and deep (reticular dermal). A successful peel depends upon a number of variables, such as choice of the peeling agent, its concentration, and the pressure and frequency of the applications; all must be adjusted to the patient's skin condition. Through standardization of the peeling agents, the level of injury can be determined pre-operatively and complications minimized. Trichloroacetic acid (TCA) is the most popular peeling agent used in different concentrations. It has the broadest spectrum of indications due to its versatility in combination with other peeling agents. Indications for superficial peels include skin resurfacing, wrinkles, actinically damaged skin, actinic keratoses and benign pigmented lesions. Superficial peels have the advantage that they can be used on most regions of the body. The use of different chemical peels, their varying effects and their potential complications are reviewed. There are at present more than 45 chemical peels with different combinations of agents available on the European market.