Phenol-Croton Oil Chemical Peeling Induces Durable Improvement of Constitutional Periorbital Dark Circles

• Published in: Dermatologic surgery Vol. 49; no. 4; p. 368
• Main Authors: Soon, Seaver L, Wambier, Carlos G, Rullan, Peter R, Sterling, J Bart, Brody, Harold J, Lee, Kachiu C, Kreyden, Oliver P, Landau, Marina
• Format: Journal Article
• Language: English
• Published: United States 01.04.2023
• Subjects: Chemexfoliation; Croton; Croton Oil; Female; Humans; Male; Middle Aged; Phenols; Retrospective Studies
• ISSN: 1524-4725
• DOI: 10.1097/DSS.0000000000003708

Constitutional periorbital dark circles (PDC) are common in skin of color and represent a therapeutic challenge. To summarize the experience of the International Peeling Society on the safety and effectiveness of deep chemical peeling in the treatment of constitutional PDC. Multi-institutional, retrospective case series (1990-2020) of constitutional PDC treated by deep chemical peeling. Descriptive analysis by age, sex, Fitzpatrick phototype, phenol-croton formula, degree and durability of improvement, and complications. Fifty-five phenol-croton oil peels were performed in 52 patients: 3 patients received a second peel for periorbital rhytids 72 to 84 months after the first peel. 92% (48/52) of patients were women; the median age was 46 years (range, 23-68 years). 89% (46/52) of patients were Fitzpatrick III-IV. Most common formula included phenol 60% to 65% and croton oil 0.6% to 0.7%. 89% (49/55) of peels demonstrated >50% clinical improvement. The median duration of improvement was 24 months (range, 1.5-168 months), and 69% (36/52) of patients demonstrated ongoing improvement at the last follow-up. 4% (2/55) of peels exhibited complications of persistent erythema that resolved without scarring. Based on its safety and effectiveness, deep chemical peels are a treatment of choice for constitutional PDC.