化学剥脱在痤疮治疗中的应用

Application of chemical peels in the treatment of Acne vulgaris

痤疮是一种损容性皮肤病,会极大程度地影响患者的生活质量。目前,化学剥脱(化学换肤)已成为除系统口服药物、局部外用药物以外,痤疮最重要的治疗方法。其基本原理是利用各种化学剥脱剂,使皮肤再生重塑并控制炎症反应,以治疗痤疮。根据化学剥脱剂作用深度不同,化学剥脱可分为浅表剥脱、中层剥脱、及深部剥脱。虽然应用化学剥脱治疗痤疮具有经济、简便、有效的优点,但也容易造成皮肤感染、炎症后色素沉着、瘢痕形成等不良反应。对患者进行良好的术前评估、合理选择化学剥脱剂及剥脱方法,是治疗成功与否的关键。在化学剥脱治疗前,可以根据Fitzpatrick皮肤分型选择适当的治疗方法,并评估可能出现的不良反应、并发症及治疗效果。文章着重介绍了几种常见化学剥脱剂的性质及在痤疮治疗中的使用方法。

Acne is a kind of appearance-impaired dermatosis that may greatly affact patients' quality of life. In addition to systemic and topicals therapies, chemical peels has becoming the most important treatment of acne. It is a skin resurfacing procedure intended to regenerate skin by the application of exfoliative agents. Chemicals peels are classified based on the depth of penetration, into superficial, medium, and deep peels. Although chemicals peels is economical, simple, and effective, it is also likely to cause infection, post-inflammatory hyperpigmentation, and scar. Therefore, selecting the patient and the appropriate peel is of great importance. The physician can evaluate preoperative risk of post peel response and complications depending on the Fitzpatrick skin type scale. This article aims to present the most important factors when selecting an acne patient for a chemical peel and the special considerations when choosing a specific agent.