Objectives: After this session the physicians will learn about the history and changes in phenol-croton oil peeling until 2024.

Introduction: From the discovery of the pinoles of the spices islands (Croton tiglium seeds) to the mixture with phenol for skin treatments, many advancements have been incorporated in the practice of plastic surgery and dermatology.

Materials / method: Review of the main steps of discovery and understanding of the mechanism of actions.

Results: Currently the formula is stable, with more safety by using Hetter's method of volume/volume of the ingredients and calling formulas by the concentration of active ingredients (phenol and croton oil).

Conclusion: In Baker-Gordon and Hetter's formulas, novisol has substituted septisol (no longer available) and different concentrations of croton oil impact the inflammation of the peel, while higher concentrations of phenol allow for faster endpoints and more coagulative injury.

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Objectives: To present a clinical case of improvement in a patient's overall skin quality using only botulinum toxin, 0. 4% croton phenol peeling on the lower eyelid and 20% TCA on the entire face.

Introduction: The use of phenol croton peel, once popular with the Baker formula, faced limitations due to extended recovery periods and a heightened risk of hypochromia. However, modern advancements, particularly the Hetter formula using 0.2% to 1.6% croton oil, have replaced the need for 2% croton oil. Furthermore, incorporating 20% Trichloroacetic Acid (TCA) in a single session enhances overall facial skin quality, diminishing blemishes and fine lines

Materials / method: A 53-year-old patient presented concerns regarding forehead and eye area wrinkles, blemishes, and dull skin. To address these issues, the initial step included the application of botulinum toxin across the face. A comprehensive facial peel was performed one week later, combining a 20% Trichloroacetic Acid (TCA) session with a 0.4% Croton phenol peel following Hetter's formula. Significant improvements were observed after these two procedures, demonstrating an excellent cost-benefit ratio.

Results: The combination of botulinum toxin on the entire face, croton phenol peeling on the lower eyelid, and 20% TCA peeling on the rest of the face generated a complete rejuvenation in just two visits.

Conclusion: This clinical case demonstrates that low-cost, old-fashioned methods, combined with the proper technique, can produce significant results.

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Objectives: The histological results after treatment of Melasma with phenol peeling (Hetter's formulas) are described.
The objective of this class is to demonstrate the histological differences achieved in a patient with Melasma treated with phenol peeling.
We present the results of phenol peeling after two days, one month and three months of follow-up.
We can observe in the results the decrease in melanin, the thickening of the epidermis and the decrease in elastosis, among others.
We follow patients whose results are maintained for 2 years.

Introduction: Melasma is a chronic dyschromia characterized by brownish spots on the face of young women with a high skin type. Melasma shares histological changes with photoaged skin, such as: elastosis, degeneration of the basement membrane and vascular changes.
Melasma treatment is a challenge for dermatologists.
Phenol peeling is a deep peeling, which causes necrosis followed by inflammation, scarring and remodeling of the skin. Melasma treatment with phenol peeling can be a good option.

Materials / method: Women with chronic Melasma between 20 and 65 years old without hormonal changes in whom a biopsy was performed on an exposed area before and after peeling.
Application of phenol peeling with the following formulation:
- Water 5.5 ml
- Soap 0.5 ml
- Stock solution (1 ml of croton oil and 24 ml of phenol 88%) 1 ml
- Phenol 88% 3 ml
The final solution has 35% phenol and 0.8% croton oil (Hetter's formula)

Results: The exam results are presented during the class:
- Post phenol 2 days
- Post phenol 1 month
- Post phenol 3 months

Conclusion: Phenol peeling with Hetter's formula 0.8% croton was safe and effective for treating Melasma.

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Objectives: demostrar la importancia de la tecnologia laser en la terapeutica del tratamiento del melasma, sobre todo en la parte del componente vascular , que es la piedra angular en la parte de la fisiopatologia del mismo.

Introduction: el melasma es una de las 5 patologias mas frecuentes de la consulta diaria en la dermatologia latinoamericana. por lo tanto es el melasma es importante tener claro los puntos claves en su terapeutica.

Materials / method: se presentan iconografias de pacientes con melasma facial , antes y despues , para ver la indicacion especifica del laser ,en cada tipo de este ( pigmentario, vascular o mixto ), para ver que tipo de laser es lo mas indicado segun se el caso clinico especifico.

Results: se muestran los resultados para ver donde actua el laser que es la parte angular en la terapeutica del melasma (componente vascular ), la parte inflamatoria .

Conclusion: hasta el dia de hoy NO EXISTE una crema que quite los vasos (componente vascular)
,por lo tanto el laser es la herramienta principal para retirar esta parte de la inflamacion cronica , en esta patologia dermatologica , tan comun de la consulta diaria dermatologica en latinoamerica.

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Objectives: 7 min to convince that peels is a good alternative to laser

Introduction: Controversies
Handle
Cost
Danger
Which peels can be use for melasma

Materials / method: Practicals cases to desmonstrate the facility’s to use peels

Conclusion: Peels is really a good alternative to laser

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