Advanced chemical peels: Phenol-croton oil peel

Comment on “Anti-aging effects of ingenol mebutate for patients with actinic keratosis” and phenol-croton oil peelings

“…This topical procedure also promotes an appealing dermal effect by producing a neocollagenesis band and erasing elastosis. 2 Compared with the phenol-croton oil chemical peel, ingenol mebutate peels have mild antiaging effects even at concentrations of 0.05% (Figs 2 and 3). One hypothesis for this difference in efficacy is the fact that in this commercial presentation, ingenol mebutate might be unable to reach the reticular dermis.…”

“…Essential phytochemical insights are presented in this letter to link such treatment with an established dermatologic resurfacing procedure for chronic photodamage, the phenol-croton oil peel. 2 Croton tiglium (Euphorbiaceae) oil has been used in Western medicine since the 1800s 3 and in Eastern medicine for millennia. In the 1920s, phorbol esters, a class of toxic diterpenes, were discovered in croton oil 4 and were later found in other species of the genera Croton, Sapium, and Euphorbia.…”

“…5 In the 1960s the medical technique of mixing drops of croton oil with phenol was developed to create a deep chemical peel for treatment of extremely photodamaged facial skin, with long-lasting impressive results. 2 Croton oil is a rich natural matrix of phorbol esters that have the same general structure yet vary in their composition by ester bonding to hydroxyl groups. 6 (Fig 1, A-C ).…”

Reply to: “Comment on ‘Anti-aging effects of ingenol mebutate for patients with actinic keratosis' and phenol-croton oil peelings”

“…After reviewing the article by Wambier et al on the phenol peel, 3 we were fascinated by the persisting effect of phenol on pigmentation, as well as by its dramatic renovation against wrinkles, because unlike ingenol mebutate, phorbol esters (which contain phenol as an adjuvant agent) can reach the reticular dermis. Such deeper penetration into the dermis during chemical peels may result in both long-lasting and rejuvenating effects for chronically photodamaged facial skin.…”

“…However, in the case of an Asian with a darker skin tone (Fitzpatrick skin types of III or IV), phenol peels might induce hypertrophic scar and postinflammatory hyperpigmentation. 3,4 Therefore, to prevent postinflammatory hyperpigmentation in Asian patients, careful attention should be paid to the doctor's instructions before, during, and after the procedure.…”