Obagiʼs Modified Trichloroacetic Acid (TCA)-Controlled Variable-Depth Peel

Johnson, James B.; Ichinose, Herbert; Obagi, Zein E.; Laub, Donald R.

doi:10.1097/00000637-199603000-00001

Cited by 41 publications

(18 citation statements)

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“…Fanous et al recommended varying depths of peel based on their proposed genitico-racial skin classification to limit complications, whereas the studies of Obagi et al and Johnson et al emphasized clinical signs of peeling depth. 6,43 Although with great clinical implications, these studies were not comparative, with low level of evidence. Moreover, evaluating changes in Langerhans cells following 40% and 60% TCA peels compared to control liquid nitrogen, concerns were raised about potential carcinogenesis following repeated TCA peels due to temporary impairment of the skin defense system.…”

Section: Trichloroacetic Acid Peelmentioning

confidence: 99%

“…As with any therapeutic resurfacing technique, a reliable clinical endpoint is essential. With TCA peels, visual determination of frosting and epidermal sliding as described and histologically elucidated by Obagi et al are reliable indicators for determination of peel depth penetrance 6,26 . Epidermal sliding indicates a medium peel penetrance to the level of the papillary dermis.…”

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confidence: 99%

“…Chemical peeling has a longstanding and widespread acceptance as an efficient and valuable treatment modality for rhytids, actinic damage, lentigos, and dyschromias, and is the standard by which other resurfacing methods are measured. [5][6][7] Chemical peels date back to ancient Egypt and likely are the oldest esthetic procedure performed; animal oils, salt, and alabaster mixtures for ''improving beauty of the skin" and ''removing wrinkles" have been mentioned as early as 1550 BC in the Ebers Papyrus. 5,[7][8][9] Ancient Greeks and Romans used plasters made of mustard, sulfur, and corrosive limestone for chemexfoliation and 27 agents for cleansing, brightening, darkening, softening, and esthetical improvement of the skin were known since antiquity.…”

mentioning

confidence: 99%

“…With TCA peels, visual determination of frosting and epidermal sliding as described and histologically elucidated by Obagi et al are reliable indicators for determination of peel depth penetrance. 6,26 Epidermal sliding indicates a medium peel penetrance to the level of the papillary dermis. It is observed when the coagulated epidermis becomes separated from the underlying reticular dermis and slides as a thin independent sheet.…”

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confidence: 99%

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Medium-depth Trichloroacetic Acid and Deep Phenol–Croton Oil Chemical Peeling for Facial Rejuvenation: An Update

Atiyeh

Oneisi

Ghieh

2021

Journal of Craniofacial Surgery

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displacement of the condylar process (Fig. 1). Fractures segments were accessed through the preauricular incision. A 7 mm-long 2.0 mm self-drilling IMF screw (Lorenz Plating System, BIOMET Jacksonville, FL) was inserted to the condylar neck by using the battery charged screwdriver (Power Driver) of the same plating system. The cerclage wire was passed through the ring of the IMF screw, which then made it possible to retracted and manipulate the proximal bone segment. Internal fixation was achieved with 2.0 mm 4-hole medium titanium plate and 4 screws (2 on each side of the fracture line) at the reduced position of the fragmented bones and in the end IMF screw was extracted (Fig. 2). In long-term follow-up, there were no problems for occlusion and normal range of temporomandibular joint motion at 12-months (Fig. 3). The proximal bone fragment, that is, condylar process is prone to dislocate medially under the mechanical forces of the lateral pterygoid muscles on the condylar process of the mandible, whereas the distal bone fragment is prone to displaced toward the condylar fossa under the mechanical forces of the masseter and medial pterygoid muscles inserter to the mandibular angle and of the temporalis muscle inserted to the coronoid process. 1 It is not easy to manipulate the proximal segment effectively, that is, to bring the displaced condylar process in its anatomic position and to hold it there until the rigid internal fixation process is completed. Application of a self-drilling IMF screw, mostly overcomes this problem. Insertion of the self-drilling IMF screw is a straightforward easy procedure. Once the proximal

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Section: Trichloroacetic Acid Peelmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Medium-depth Trichloroacetic Acid and Deep Phenol–Croton Oil Chemical Peeling for Facial Rejuvenation: An Update

Atiyeh

Oneisi

Ghieh

2021

Journal of Craniofacial Surgery

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“…n the 1990s, the trichloroacetic acid peel approach 1 was popularized by Obagi, a renowned American dermatologist. Obagi is credited for the revival of the trichloroacetic acid peel technique through a series of instructional courses.…”

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confidence: 99%

Universal Trichloroacetic Acid Peel Technique for Light and Dark Skin

Fanous

Zari

2017

JAMA Facial Plast Surg

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IMPORTANCE Despite their great potential, medium and deep trichloroacetic acid peels are underused in light-skinned patients and are rarely used in darker-skinned patients because of the widespread fear of pigmentary complications and scarring. This concern has led many physicians to opt for the use of lighter types of peels (glycolic acid peel, Jessner peel, etc) and different lasers and intense light technologies. Trichloroacetic acid peels have been described in numerous publications. However, no study to date has described the precise technique and the practical pearls of a successful trichloroacetic acid peel approach in a clear, detailed, and reproducible manner.OBJECTIVES To clarify a practical approach to a universal trichloroacetic acid peel and to offer novice and experienced facial plastic surgeons an organized, easy, and safe technique for medium and deep trichloroacetic acid peels. DESIGN, SETTING, AND PARTICIPANTSThis study was a case series of universal trichloroacetic acid peels in an academic setting. The study dates were January 1, 1996, to November 1, 2015. MAIN OUTCOMES AND METHODSThis article discusses the preoperative evaluation for a chemical peel, a previously published genetico-racial skin classification, and the trichloroacetic acid peel technique, which aims at standardizing and controlling the application of the acid to improve results and lessen complications. The "strip" technique is described, which increases the physician's control over the peel depth.RESULTS A total of 923 trichloroacetic acid peels in 803 female patients (87.0%) and 120 male patients (13.0%) were reviewed (mean age, 41.59 years). The follow-up period ranged from 6 months to 13 years (mean, 13 months). This case series revealed a low incidence of complications, including 54 patients (5.9%) with persistent hyperpigmentation, 3 patients (0.3%) with mild telangiectasia, 2 patients (0.2%) with acute herpesvirus infection, 2 patients (0.2%) with bacterial Staphylococcus infection, and 1 patient (0.1%) with hypopigmentation.CONCLUSIONS AND RELEVANCE When properly applied, trichloroacetic acid peels are efficient and safe for light and dark skin. The technique can be an easily implementable addition to a physician's cosmetic practice.LEVEL OF EVIDENCE 4.

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Skin Rejuvenation

and¹,

Kranendonk²

2012

Cosmesis of the Mouth, Face and Jaws

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Obagiʼs Modified Trichloroacetic Acid (TCA)-Controlled Variable-Depth Peel

Cited by 41 publications

References 0 publications

Medium-depth Trichloroacetic Acid and Deep Phenol–Croton Oil Chemical Peeling for Facial Rejuvenation: An Update

Medium-depth Trichloroacetic Acid and Deep Phenol–Croton Oil Chemical Peeling for Facial Rejuvenation: An Update

Universal Trichloroacetic Acid Peel Technique for Light and Dark Skin

Skin Rejuvenation

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