Chemical Peels Niti Khunger
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1STEP BY STEP® CHEMICAL PEELS2
1. Let knowledge grow
From one to more….
2. A mind once stretched by a new idea can never return to its original dimensions.
Oliver Wendell Holme
3. Twenty years from now you will be more disappointed by the things you didn't do than by the ones you did.
Mark Twain
4. Yes, reach for the mountain top. But enjoy the climb as well.
Robin Sharma
5. Leave the crowd. The only place you'll reach if you follow the crowd is the exit.
Robin Sharma
6. It's never too late to become the person you have always dreamed of being.
Robin Sharma
7. Most of the people fail not because they plan to fail, but because they fail to plan.
Anon
8. I kept six honest serving men, they taught me all I know, their names are WHAT, WHY, WHEN, HOW, WHERE, WHO.
Rudyard Kipling
9. Deciding what you want most in life is the first step towards achieving it.
Constance Foster
10. Think big and your deeds will grow, Think small and you will fall behind, Think that you CAN and you WILL, It is all in the state of mind.
Anon
3STEP BY STEP® CHEMICAL PEELS
Niti Khunger MD DNB DDV Associate Professor and Senior Specialist VM Medical College and Safdarjung Hospital New Delhi India
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Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Step by STEP® Chemical Peels
© 2009, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editor and the publisher.
First Edition: 2009
9788184485301
Typeset at JPBMP typesetting unit
Printed at Ajanta Press
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Dedicated to all my patients who inspire me to innovate, improvise and implement
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7Contributors
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9Preface
Chemical peeling is an ancient procedure that has stood the test of time for rejuvenating the skin. It is the application of a chemical agent of defined strength to the skin that causes destruction at the required depth, followed by remodeling without scarring.
In recent times, there has been an explosive interest in procedural techniques for skin rejuvenation and the trend is increasingly for procedures that are noninvasive or minimally invasive, requiring little downtime. The majority of the chemical peeling procedures fit into this category. The long-term experience with chemical peels has shown them to be safe and effective for a variety of common conditions like dyschromias, photoaging and acne. An added advantage is the relative low cost of these procedures as compared to lasers and other procedures to rejuvenate the skin. Lasers are still very expensive to acquire and maintain. This has led to a resurgence in the use of chemical peels, which is now a re-emerging art with newer peels and newer combinations.
New advances in peel approaches including combination, sequential and segmental peels are safer and lower-strength peeling agents are allowing clinicians to tailor their practices to patients’ needs, often without added costs. Chemical peels are thus not only a part of the cosmetic scene of the past, but also a definite cornerstone of the future.10
This book is a step-by-step practical guide to perform chemical peels. There is some repetition of the basic procedure in the chapters with the aim that the reader will find easier to follow, while doing a particular peel and not miss any important step. The interesting cases give examples of treatment in difficult situations, while ten golden rules summarize the essence of chemical peeling.
The aim of this book is to expose young physicians to the array of chemical peels available today and guide the practising dermatologists how to safely use this versatile technique in the treatment of common day-to-day conditions such as skin rejuvenation, photoaging, melasma and acne.
Niti Khunger
11Acknowledgements
The birth of this book was initiated by young dermatologists, eager to start their practice, who always questioned me during various scientific meetings. It incubated and took shape through interactions with all my colleagues, who shared their expertise and knowledge gathered world-wide.
I am indebted to Dr Philippe Deprez for teaching the fine art of combining sandabrasion with chemical peels. All my experiences crystallized into this book, with unwavering support from my patients, who reposed complete faith in me.
I am thankful to my teachers, particularly Dr Chetan Oberai and late Dr PN Behl who injected me with academic enthusiasm right from the beginning of my career.
I am grateful to Shri Jitendar P Vij (CEO) and Mr Tarun Duneja, Director (Publishing) and the staff at Jaypee Brothers Medical Publishers (P) Ltd Delhi, who made my work very easy by their technical expertise.
My deepest thanks goes to my family, my spouse Dr JM Khunger and my children, Monica and Arjun, who enthusiastically supported me and let me work unhindered in writing this book.