Abstract

Background: Chemical peel is a cutaneous resurfacing procedure that is a popular treatment option for pigmentary disorders, scarring, fine lines, wrinkles, inflammatory dermatoses, and photoaging. Objective: In this study, we aim to visually see and quantify the inflammatory cells, collagen remodeling, keratinocytes, and melanin through the help of confocal microscopy. We also aim to visualize the exfoliation/peeling process via clinical pictures to reduce any misconceptions that exist about the peeling process. Methods: We performed a chemical peel on 15 subjects. 3 subjects were followed over time in the office to perform confocal microscopy at regular intervals post-peel (5 mins, 10 mins, 2 hrs, 48 hrs, and 9 days). All the subjects were instructed to take clinical pictures during their exfoliation/peeling phase. We used confocal microscopy analysis software, “Confo scan”, to quantify inflammatory cells, keratinocytes, and fragmentation index of collagen. Results and Conclusion: Via confocal, we were able to visualize and quantify changes in collagen fibers. The fragmentation index of collagen was increased in all 3 subjects when measured on 9th-day post peel. Inflammatory cells were highest at 10 minutes post peel. The number of keratinocytes was highest on the 9th day. We observed that collagen remodeling was inversely related to inflammation. Via clinical pictures taken by all 15 subjects, we were able to visualized and observe the different intensities of exfoliation amongst the subjects.

Financial Disclosure:
No current or relevant financial relationships exist.