Skin Manifestations Clinical Trial
Official title:
Effectiveness, Safety, and Cost Efficacy of Water (H2O) as a Substitute for Sodium Bicarbonate (NaHCO3) Plus Solution in Neutralization of Chemical Peeling Using 35% Glycolic Acid Solution
Chemical peeling is an applied procedure which creates controlled destruction of all layers
of the epidermis or dermis, subsequently causes exfoliation followed by regeneration of
layers with the final result of improved texture and appearance of the skin. Various
indications of chemical peeling actions include damage to skin structure (skin aging, scars,
pigmentation disorders), superficial tumors (seborrheic keratosis, lentigo, actinic
keratosis), and inflammation such as acne vulgaris. Various chemicals commonly used for
procedures in peeling include alpha hydroxy acid or alpha-hydroxy acids (AHA) such as
Glycolic Acid (GA) 20−70%, lactic acid, malic acid, pyruvic acid; beta hydroxy acids / BHA
(10-30% salicylic acid), carbon dioxide snow, Jessner solution, lipohydroxy acid, resorcinol,
retinoic acid, trichloroacetic acid (TCA), phenols, Baker − Gordon formula. In this study,
the investigators are using glycolic acid 35% solution. Based on its mechanism of action,
glycolic acid (GA) is a keratolytic agents, in which it penetrates the stratum corneum and
interfere with corneocyte adhesion by damaging the intercellular desmosome bonds. Until now,
GA is a superficial peeling that is very popular and most widely used throughout the world .
The advantages of GA peeling include odorless, colorless, painless, permanently effective,
and minimal side effects. However, unlike non-AHA peeling materials, peels made from AHA
cannot be neutralized by themselves. Without neutralization, AHA will penetrate deeper and
may cause scars. Neutralization is the process of applying a base solution to stop the work
of chemicals in peeling. In neutralization, liquids that can be used are alkaline liquids
such as water, sodium bicarbonate, sodium hydroxide or ammonium saline solution to stop its
work. In various literature, it is stated that water can be used as a neutralizing liquid in
the chemical peels of AHA. It has also been mentioned in the literature that neutralization
with sodium bicarbonate on the market does not provide any advantage over water use, as long
as the acid is completely removed from the skin surface. The objective of this research is to
look into the effectiveness, safety , and cost efficacy of water (H2O).
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