ABSTRACT
The concept of applying chemicals to the skin to improve its appearance is not new. The ancient Egyptians applied sour milk to the skin as a way to regain its youthful appearance. Unbeknownst to them, lactic acid, an alpha-hydroxy acid (AHA), was the active ingredient (1). During the French Revolution, women of royalty applied aged wine to their skin not knowing that tartaric acid, also an AHA, was the chemical ingredient improving the appearance of the skin (2). In the late 1800s, Dr. P.G. Unna, a German dermatologist, noted improvement of the skin with the application of acids such as salicylic acid, phenol, resorcinol, and trichloroacetic acid (1). During World War I, a French physician, la Gasse, used phenol covered with tape to heal gunpowder burns. His daughter, Antoinette, later brought the technique to Los Angeles in the 1930s and 1940s to treat scars and wrinkles (1). In the 1950s, a number of dermatologists were actively studying chemical peeling. Dr. Max Jessner at New York University reported the application of a combination of 14% salicylic acid, lactic acid, and resorcinol, known today as Jessner’s solution (3). Sir Harold Gillies, a British otolaryngologist, successfully used phenol and tape for peeling of the skin (4). The toxicity associated with using phenol was known and efforts were made to formulate a buffered solution. In 1961, Baker and Gordon developed a saponated formula of 55% phenol mixed with water, hexachlorophene, and croton oil that make up the phenol formulation still used today (1). In the 1980s, animal and human models were used to study the histological depth of penetration of different chemical peels (1). This work resulted in the three-tiered classification of superficial, medium, and deep depth peeling. Today, alpha-hydroxy acids and beta-hydroxy acids are popular for chemical peeling.
