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6 SA is widely used in cosmetic formulations (concentration 2%4%%) and also therapeutically as a keratolytic (peeling) agent to treat skin conditions, such as calluses, keratoses, acne, and photoaging.
It is a keratolytic (peeling) agent, causing elimination of the outer layer of the skin, thus preventing follicle blockage.
Retinoids also enhance the penetration of the peeling agent.
In particular, the comedolytic property of salicylic acid makes it a useful peeling agent for patients with acne.
It is wise to perform the initial peel with a 20% SA formulation in order to assess sensitivity and reactivity of the patient's skin to the peeling agent.
Newer formulations of SA containing polyethylene glycol have shown promising results in decreasing and preventing skin tumors in mice, making it a potentially attractive peeling agent for use in the future.
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The greatest concern may be for those who are exposed on a regular basis, including practitioners who regularly apply peeling agents and consumers using over-the-counter products a bit too enthusiastically.
"I've done R&D for a large cosmetic company, and unfortunately to launch these over-the-counter peeling agents, the rule of thumb is to recommend twice-weekly use," Alexiades-Armenakas said.
At 28 days, all skin specimens treated with chemical peeling agents exhibited a unique connective tissue layer composed of fine collagen fibers beneath the epidermis.
Design: three chemical peeling agents, 30% salicylic acid, dissolved in macrogol (a new formulation), 35% trichloroacetic acid (TCA) dissolved in distilled water and 20% glycolic acid dissolved in glycerin were applied to the backs of UVB-irradiated hairless mice.
The physician should be well versed in the basic chemistry of peels, and should have a good understanding of acids, bases, and the pH and pKa of peeling agents.
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