Effectiveness of modified phenol peel (Exoderm) on facial wrinkles, acne scars and other skin problems of Asian patients

Deep depth peeling using phenol is one of the most effective chemical peeling methods. However, it has been rarely used on Asian people because of side-effects, especially hypopigmentation. In order to reduce side-effects, a number of modified phenol peeling formulas were developed. Exoderm, a modified phenol peel, has shown reduced side-effects such as arrhythmia, long-lasting erythema, hypopigmentation, hypertrophic scar and keloid. In the present study, our aim was to evaluate the effectiveness of Exoderm on wrinkles, acne scars, and melasma and its safety for Asian patients. Forty-six patients were treated with Exoderm. Twenty-eight patients (61%) were treated for wrinkles and 11 patients (24%) for acne scars. Clinical improvement and side-effects were evaluated and the degree of improvement was graded into four stages. The overall average improvement scores were 3.39 and 3.30 out of 4.00 as evaluated by the doctor and patient, respectively. Forty-one patients (89%) showed 51% or more improvement. All patients with wrinkles improved 51% or more and their average improvement score was 3.64 out of 4.00. Seven of 11 patients (64%) with acne scars improved 51% or more and their average improvement score was 2.73 out of 4.00. The most frequent side-effect was postinflammatory hyperpigmentation (74%). Prolonged erythema, keloid and milia were observed temporarily, however, hypopigmentation persisted for 6 months in the follow-up period. All side-effects were tolerable and reversible except for one complication of hypopigmentation. We conclude that Exoderm is very effective for treating the facial wrinkles and acne scars of Asian patients.