ABSTRACT
The possibilities for treatment with chemical peels are many and depend on the agent chosen as much as on the way in which it is used. We can take a narrow view of peels as the destruction of damaged tissue with acid.1 From this perspective, a result can be achieved only by “destroying beneath the lesion.” This is, of course, often the case, but we must not forget that chemical peels help to stimulate as much as destroy. Many of their positive effects are largely due to this stimulation. Consider glycolic acid, for example, whose action is mainly intraepidermal2 but which is associated with activation of the papillary dermal fibroblasts. The destructive effect, which removes the stratum corneum and even part of the epidermis (depending on the concentration used), improves the appearance of rough skin, while the effects of remote stimulation improve the extracellular matrix constituents secreted by the fibroblasts.
