Phenol peeling: new standards of excellence

Phenol peeling remains the gold standard of chemical peeling because no other agent can compare in the treatment of patients with moderate and deep rhytids. However, phenol peeling can be very painful and is associated with many tradeoffs. Plastic surgeons have boldly modified their approach to TCA peeling to improve their results and we would like to see the same applied to phenol peeling. The purpose of this article is to initiate new thinking about phenol peeling and to correct misconceptions that commonly appear in the literature. By modifying our technique we have been able to perform virtually painless phenol peels and to reduce the tradeoffs commonly seen. Our modifications are discussed in detail along with a discussion of the new concepts we feel are supported by our experience.