Eyelid Phenol Peeling as a Potential Alternative to Surgical Blepharoplasty: A Case Series

Phenol peel is a deep peel used to treat conditions involving the reticular dermis such as scars, deep wrinkles, and lentigos and is an attractive alternative to surgical interventions for the rejuvenation of the eyelids and face. Patients who wish to undergo this procedure should be screened for the presence of any contraindications and should be counseled on the possible complications, which include arrhythmia, skin atrophy, scarring, acne eruption, and infection. We describe the cases of four women who underwent deep phenol peeling for the improvement of wrinkles and aging features around the eyelid area as a conservative alternative to surgical blepharoplasty. Patients were previously healthy with no absolute contraindication for the procedure. They were instructed to use the Kligman formula for 1 month prior to peeling. A nonsteroidal anti-inflammatory medication was given to the patient 30 mins before starting the procedure. The skin was cleansed with urea foam for 1 min, and excess product was removed with a dry and then a moistened gauze until the skin was clean. A 70% alcohol solution was then used to clean the skin area in which the peeling was desired. Phenol concentrated at 88% was applied using a damp cotton swab over multiple layers, until peeling was achieved. At the end of the procedure, a plastic occlusive mask was used to seal the area, and a postphenol occlusive ointment was applied over the periorbital region. Patients were instructed not to wash the area for 7-10 days and were prescribed Hyabak eye drops for dryness as well as oral analgesics as needed. No complications were reported in all cases. Phenol peeling is an easy, relatively safe and effective deep peeling technique that can be used to achieve the desired aesthetic outcomes in patients who wish to improve aging features and minimize the appearance of deep wrinkles without undergoing surgical intervention.