An examination of the phenol-croton oil peel: part IV. Face peel results with different concentrations of phenol and croton oil

In Part IV of this examination of the phenol-croton oil peel, the author presents peeling solutions using phenol in concentrations between 16% and 50% as the carrier for croton oil. Previously, in Part I, the author showed that phenol alone in concentrations of less than 50% has no significant peeling effect on the skin in the absence of taping. All of these formulas are dependent on the addition of croton oil for their peeling action. A topographic map of the face is presented that divides the face into the zones that the author believes are best treated with different strengths of croton oil. Five patients peeled between late 1992 and late 1995 were chosen as examples to illustrate the effect of different strengths of croton oil between 0.25% and 2.78%. The author has documented their immediate postoperative course photographically to show the effect of the different concentrations. It is clinically apparent that peels using croton oil between 0.25% and 0.5% generally heal within 7 days; peels between 0.6% and 1.0% usually heal within 9 or 10 days, and peels using concentrations higher than 1% heal later and have some risk of pigmentation loss. Peels using croton oil concentrations at 2% and above almost always have pigmentation loss and have healing delays in areas other than the thick skin of the lower nose and perioral area. The practical clinical formulas distributed at the time of the presentation of this article at the 1996 Annual Meeting of the American Society for Aesthetic Plastic Surgery in Orlando, Florida, entitled "Heresy Phenol Formulas--1996," are provided here. These have been used in both the United States and Europe over the past few years. A metric standard for drop size is suggested at 0.04 ml. This relates to the drop size used clinically over the years to measure croton oil. The adoption of this unit will make formulas around the world easier to calculate and compare. The author has produced a metric formula using the suggested standard size drop for croton oil. This uses 35% phenol as the carrier and provides the same range of treatment dilutions as the 1996 "Heresy Phenol Formulas." The need for research into "carriers" and solvents for croton oil is pointed out. Despite what is not known about how it works, the combination of croton seed extract and phenol has been a success story in providing facial rejuvenation from the 1920s to the present. The croton oil-phenol peel in its many formulas still sets the standard for facial rejuvenation.     

An examination of the phenol-croton oil peel: Part III. The plastic surgeons' role

In Part II, the author focused on the lay peelers' history and success using croton oil-containing phenol peeling recipes. In Part III, the author reviews what was known or should have been known about croton oil and phenol as physicians became keenly interested in face peeling in the mid-1950s. The lay peelers recognized that croton oil was a critical ingredient of the so-called phenol peel while physicians focused on phenol without recognizing the intense cytotoxic effect of croton resin. Physicians have persisted in this systematic error for 40 years. Both dermatology and plastic surgery have shown a remarkable credulity about phenol's action and lack of curiosity about croton oil's action. A hitherto unreferenced and unknown croton oil-containing formula of Adolph Brown, patented in 1959, has been unearthed, preceding Litton's and Baker's formulas in time. The recollections of Litton, Baker, Truppman, and Georgiade shed some light on the interaction between them and the lay peelers and how the formulas were transferred. Other plastic surgeons probably acquired the same knowledge, used it in their practices, but chose not to draw attention to it. None of the physicians credited the lay peelers. Brown, Litton, and Baker each could have published a complete formula, but only Baker did. However, his formula was vastly stronger than the lay formulas but, nevertheless, came to dominate medical peeling for the next 35 years because of its simplicity of preparation. A review of the peel literature reveals many oft-repeated but unsupported dogmas regarding the mode of action of phenol, which have obscured our understanding of the phenol-croton oil peel. Animal studies exist that refute these dogmas, e.g., (1) lesser concentrations of phenol wound more deeply; and (2) phenol has an all-or-nothing action. As well, studies from the early 1980s showed that the presence of croton oil caused much deeper burns than phenol alone. Suggested areas of research that could solve the conundrum of the phenol-croton oil peel are presented.     

Quantitative and qualitative effects of chemical peeling on photo-aged skin: an experimental study

Chemical peel reverses the visible stigmata of photo aging in human skin. The qualitative and, in particular, the quantitative changes in the dermis that effect this transformation are unclear. This study used a recognized photo-aged animal model, the Skh:HR-1 hairless mouse, to quantify and qualify the changes that occurred in collagen and glycosaminoglycan content after chemical peel. One hundred Skh:HR-1 hairless mice were photo-aged by use of chronic ultraviolet B irradiation for 14 weeks. After irradiation the animals were randomly distributed into five groups of 20 mice each: group 1, control; group 2, 50% glycolic acid peel; group 3, 30% trichloroacetic acid peel; group 4, 50% trichloroacetic acid peel; group 5, phenol peel (Baker-Gordon formula). The respective peeling agent was applied to the dorsal skin of each animal while it was fully anesthetized. Punch biopsies were taken at several times after peel for histological and biochemical analysis. Glycosaminoglycan content was assessed at 14, 28, and 60 days using a colorimetric assay. Collagen content per unit volume increased initially 3 days after the procedure in all chemical peel groups, declining on day 7, and peaking again on day 28. Significant elevations (p < 0.04) were seen in the 30% trichloroacetic acid, 50% trichloroacetic acid, and phenol peels on days 3 and 28 in comparison with controls. This increase in collagen content was not maintained and returned to control values by 60 days. Glycosaminoglycan content per unit volume was elevated initially after peel with significant elevation (p < 0.02) in the 50% trichloroacetic acid and phenol groups on days 14 and 28. This increase in glycosaminoglycan content was not maintained beyond 28 days and declined to control values by day 60 in all groups. Histological examination demonstrated an increase in dermal thickness in the 50% trichloroacetic acid and phenol groups in comparison with controls by day 60. Under polarized light all chemical peel groups at day 60 demonstrated a reorganization of collagen in the reticular and papillary dermis. The elastotic masses that are pathognomonic of photo aging were present in the control group but were absent in the peel groups and demonstrated a reorganization of the elastic fibers in the dermis. This effect was deeper in the dermis in the deeper peel groups (50% trichloroacetic acid and phenol peel). The beneficial effects of chemical peel were due to a combination of two findings; a reorganization in dermal structural elements and an increase in dermal volume. These effects were more pronounced in the deeper peel groups.     

An examination of the phenol-croton oil peel: Part II. The lay peelers and their croton oil formulas

From the turn of the century, lay face peelers, known as "skinners," ran "beautifier" salons. Beginning in the 1920s, lay peelers were using croton oil-phenol formulas in Hollywood. These persons were renowned, made a good living, and treated many, if not most, of the leading "stars" of the day. They had a treatment, a "secret," that physicians did not. Physicians brought their own wives to the peelers for their expertise. The leading lay peel personalities from the 1920s through to our time are presented. The lay peelers dominated the field until the 1960s, when legal attacks on them, often directly instigated by the newly educated physician peelers, put them at a legal disadvantage. Nevertheless, there was considerable interaction with many plastic surgeons along the way. Some plastic surgeons came into possession of the techniques and some also into knowledge of the ingredients in a formula. The author has presented the recipes of four of the renowned lay peelers, two from Hollywood, Gradé and Kelsen, and two from Miami, Coopersmith and Maschek. These recipes all have 80 to 90 percent less croton oil than the "classic" Baker formula and, therefore, wound less deeply. The Hollywood formulas were used on many celebrities both inside and outside the film world from the 1920s to the early 1990s. These lay recipes are cumbersome to prepare. The author has simplified the preparation of these lay recipes by using USP liquid phenol instead of crystals. These simple formulas are provided in a table and are as easy to prepare as the Baker formula.     

Long-term histologic follow-up of phenol face peels

Deep phenol peels were done on 11 middle-aged white women with severe actinic damage. Subsequently, face lifts were carried out after periods of 1.5 to 20 years. This made it possible to obtain a full-thickness specimen extending several centimeters on either side of the border between peeled and unpeeled skin. In contrast to the markedly abnormal elastotic appearance of unpeeled skin, a new band of connective tissue 2 to 3 mm in width was laid down in the subepidermal region. Fine elastic fibers formed a dense network in the band of regenerated collagen. The disarray and cytologic abnormalities of sun-damaged epidermis were also largely corrected. Melanocytes were not eliminated, but melanin synthesis was evidently impaired, accounting for the bleaching effects. The effects of a phenol peel are very long lasting and adequately account for the effacement of wrinkles and obliteration of actinic keratoses, mottling, and freckling.     

Impact of Aging Time on the Dermal Penetration of Phenol in Soil

Phenol is released to soil through accidental spills, manufacturing processes, and waste disposal. With time, chemicals can become more sequestered in soil (aging). Since skin is the body's primary route of entry for phenol, the impact of aging time on the dermal penetration of phenol was assessed in Atsion and Keyport soils. In vitro studies were conducted on dermatomed male pig skin using a flow-through diffusion cell methodology and radiolabeled phenol. After 3 and 6 months of aging in the Atsion soil, dermal penetration decreased from 84% of the initial dose for pure phenol (without soil) to 15% and 8%, respectively, while the dermal penetration of phenol aged in the Keyport soil was reduced to 22% and 17%, respectively. Atsion soil has a higher organic matter content (4.4%) than Keyport soil (1.6%) suggesting that the lower bioavailability of phenol aged in the Atsion soil may be due to the amount of organic matter in that soil. Although the data indicate that the potential health risk from dermal exposure to phenol would be lower after aging in soil than to pure chemical, further experiments are warranted at lower soil loads and with additional concentrations of phenol to quantify the risk.     

Adjunctive treatment of congenital pigmented nevi with phenol chemical peel

The purpose of this study was a retrospective evaluation of the treatment of congenital pigmented nevi using the phenol chemical peel technique. Patients were treated with standard Baker formula in the operating room under general anesthesia or intravenous sedation with continuous electrocardiogram monitoring. A total of 20 patients were reviewed (13 girls and 7 boys, mean age 3.8 years). Eight patients had nevi located on the face, five patients had trunk lesions, and three patients had lesions on the thighs. Two patients had nevi located on both the face and the trunk, and two patients had involvement of the face, trunk, and thigh. Three of the above patients had the classic "bathing trunk" distribution of the nevi. A test area was peeled in four patients, and in five patients preoperative biopsies were performed to rule out malignancy before initiation of therapy. An average of 2.6 treatments were performed per patient. Two patients had adjunctive dermabrasion to increase the depth of peel and to contour surface irregularities. The length of follow-up ranged from 6 to 84 months with a mean of 28 months. Healing of the wounds occurred within 2 to 3 weeks postoperatively. Seventy-five percent of patients had satisfactory cosmetic improvement in the appearance of the lesions following treatment. Four patients had recurrence of the pigmentation after an initial lightening response, three of whom had their nevi subsequently excised. There was no incidence of hypertrophic scarring or cardiac and/or renal complications. There was one death from complications of leptomeningeal melanocytosis. Chemical peeling of congenital pigmented nevi is an acceptable alternative method of therapy for those lesions that are too large for excision and primary closure or for lesions in which excision would result in unacceptable scars in areas such as the face.     

Changes in the Volatile Flavor Constituents of Citrus sinensis (L.) Osbeck During Storage

The methods of GC with fused silica capillary column, its Kovats retention index of GC and GC-MS-DS etc. We were used to study the aromatic compounds of the peel essential oil of Citrus sinensis (L.) Osbeck and aromatic concentrates of fruit flesh. 29 chemical constituents from the peels and 40 chemical constituents from the fruit flesh were identified. The trace constituents α-sinensal 0.01% and β-sinensal 0.01% are the special aroma ones for Citrus sinensis. At the same time, the changes flavor components in Citrus sinensis peels and fruit flesh during storage were also explored.     

台琼海桐蒴果皮油及籽油的主要挥发性化学成分

采用GC-MS技术,对台琼海桐蒴果皮的水蒸气蒸馏油样,以及蒴果籽的索氏提取油样的甲酯化样品进行分析。样品中各化学成分的相对含量用面积归一化法确定。在实验条件下,果皮油样共分离出24个峰,鉴定了17个,占总峰面积的94.70%。其主要成分为柠檬烯(24.27%)、γ-榄香烯(8.30%)、β-榄香烯(17.13%)、α-榄香烯(16.02%)、长叶龙脑(15.52%)和α-松油醇(2.17%),α-石竹烯(1.88%)。果籽油的甲酯化样品共分离出16个峰,鉴定了12个,占总峰面积的96.69%,其主要成分为棕榈油酸(34.83%)、反油酸(26.63%)、14-甲基-十五烷酸(17.08%),十八烷酸(1.88%),十四烷酸(1.61%)。分析结果说明台琼海桐蒴果皮富含挥发性芳香油,而蒴果籽油含有多种脂肪酸。     

Resistance to pathogens in terpene down-regulated orange fruits inversely correlates with the accumulation of D-limonene in peel oil glands

Volatile organic compounds (VOCs) are secondary metabolites acting as a language for the communication of plants with the environment. In orange fruits, the monoterpene D-limonene accumulates at very high levels in oil glands from the peel. Drastic down-regulation of D-limonene synthase gene expression in the peel of transgenic oranges harboring a D-limonene synthase transgene in antisense (AS) configuration altered the monoterpene profile in oil glands, mainly resulting in reduced accumulation of D-limonene. This led to fruit resistance against Penicillium digitatum (Pd), Xanthomonas citri subsp. citri (Xcc) and other specialized pathogens. Here, we analyze resistance to pathogens in independent AS and empty vector (EV) lines, which have low, medium or high D-limonene concentrations and show that the level of resistance is inversely related to the accumulation of D-limonene in orange peels, thus explaining the need of high D-limonene accumulation in mature oranges in nature for the efficient attraction of specialized microorganism frugivores.     

Studies on the development of functional powder from citrus peel

The suitability of citrus peels, generated as a by-product of the juice industry, as a source of antioxidants was investigated. Citrus peel powder was prepared by lyophilizing 70% ethanol extract from citrus peels. Extraction was carried out at room temperature (20 degrees C) for 72 h. The extract was subjected to gamma-irradiation treatment (20 kGy). The aqueous solutions of citrus peel powder were examined for color characteristics and antioxidant potential in terms of 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging, beta-carotene bleaching and nitrite scavenging activities. There were significant changes in Hunter color values due to irradiation. The a*- and b*-values decreased due to radiation treatment. DPPH radical scavenging, beta-carotene bleaching and nitrite scavenging activities were not affected by irradiation treatment. Nitrite scavenging activity was the highest in the extract at pH 1.2 followed by pH 4.2 and 6.0. These functional properties of the aqueous solution were found to be stable in heat treatment. It could significantly improve oxidative stability of lipids in fish meat system. Based on these results there may be opportunities to use citrus peel powder as a functional component in the food processing industry with gamma irradiation treatment improving its color characteristics without adversely influencing the functional properties.     

Red Star Ruby (Sunrise) and blond qualities of Jaffa grapefruits and their influence on plasma lipid levels and plasma antioxidant activity in rats fed with cholesterol-containing and cholesterol-free diets

Bioactive compounds of peels and peeled red Star Ruby (Sunrise) and blond qualities of Jaffa grapefruits were analyzed and their antioxidant potential was assessed. The dietary fibers were determined according to Prosky et al., the total polyphenol content by Folin-Ciocalteu method and measured at 765 nm, minerals and trace elements by atomic absorption spectrometer, phenolic and ascorbic acids by HPLC and the antioxidant potential by two different antioxidant assays (DPPH and beta-carotene linoleate model system). It was found that the contents of most studied bioactive compounds in both qualities are comparable. Only the contents of total polyphenols and flavonoids were higher in red grapefruits, but not significant. The antioxidant potentials of red peeled grapefruits and their peels were significantly higher than of blond peeled grapefruits and their peels (P<0.05 in both cases). Diets supplemented with peeled red and blond qualities of Jaffa grapefruits and their peels have increased the plasma antioxidant capacity and improved plasma lipid levels, especially in rats fed with cholesterol added diet. In conclusion, both qualities of Jaffa grapefruits contain high quantities of bioactive compounds, but the antioxidant potential of red grapefruits is significantly higher. Diets supplemented with both qualities of Jaffa grapefruits improve the plasma lipid levels and increase the plasma antioxidant activity, especially in rats fed with cholesterol added diets. Jaffa grapefruits, especially their red Star Ruby quality, could be a valuable supplementation for diseases-preventing diets.     

Copper and boron fixation in wood by pyrolytic resins

A phenol-formaldehyde (PF)-resin designed to penetrate wood and immobilize copper and boron in wood cells for protection against decay was investigated. The phenol portion of the PF-resin was partially substituted with pyrolysis oil derived from softwood bark. The objective was to reduce the environmental impact associated with the production of petroleum-borne phenol, as well as to improve the product economics. Leaching tests were conducted with three different formulas of resins containing 50%, 75% or 85% by weight of pyrolytic oil on a total phenol basis. The leachates were analyzed for the presence of copper by atomic absorption spectroscopy while inductively coupled plasma spectroscopy was used for boron detection. Copper leaching was reduced up to 18 times when comparing the treatments with and without the resin. Preservative leaching varied between wood species as well as between the resins containing different concentrations of pyrolytic oil. The organic leachates were measured using gas chromatography and mass spectroscopy. Trace amounts of organics, mostly acetic acid, were found in the leachates.     

Patterning, prestress, and peeling dynamics of myocytes

As typical anchorage-dependent cells myocytes must balance contractility against adequate adhesion. Skeletal myotubes grown as isolated strips from myoblasts on micropatterned glass exhibited spontaneous peeling after one end of the myotube was mechanically detached. Such results indicate the development of a prestress in the cells. To assess this prestress and study the dynamic adhesion strength of single myocytes, the shear stress of fluid aspirated into a large-bore micropipette was then used to forcibly peel myotubes. The velocity at which cells peeled from the surface, V(peel), was measured as a continuously increasing function of the imposed tension, T(peel), which ranges from approximately 0 to 50 nN/ micro m. For each cell, peeling proved highly heterogeneous, with V(peel) fluctuating between 0 micro m/s ( approximately 80% of time) and approximately 10 micro m/s. Parallel studies of smooth muscle cells expressing GFP-paxillin also exhibited a discontinuous peeling in which focal adhesions fractured above sites of strong attachment (when pressure peeled using a small-bore pipette). The peeling approaches described here lend insight into the contractile-adhesion balance and can be used to study the real-time dynamics of stressed adhesions through both physical detection and the use of GFP markers; the methods should prove useful in comparing normal versus dystrophic muscle cells.     

Major electrocardiographic changes during chemical face peeling.

In phenol face peels, when 50 percent or more of the face was treated in less than 30 minutes, there was a high incidence of cardiac arrhythmias. When the same was done during a period of 60 minutes or more, arrhythmia did not occur. Other factors studied in this group of 43 patients, including the preoperative electrocardiograms, did not correlate with the development of arrhythmias. We believe that patients undergoing phenol face peels should have cardiac monitoring, and appropriate cardiopulmonary resuscitative capabilities should be available.     

Chemopreventive action of Phyllanthus urinaria Linn on DMBA-induced skin carcinogenesis in mice

The inhibition of tumor incidence by hydro-alcoholic extract of the whole plant of P. urinaria was evaluated in 6-7 weeks old female albino mice on two-stage process of skin carcinogenesis induced by a single application of 7,12-dimethylbenz(a)anthracene (50 microg/50 microl of acetone), and 2 weeks later, promoted by repeated application of croton oil (1% in acetone/three times a week) till the end of the experiment (15 weeks). Topical application of the extract at a dose of 5 mg/kg body weight/day for 15 weeks at the peri-initiational stage (i.e., 7 days before and 7 days after DMBA application), promotional stage (i.e., from the time of croton oil application) and both peri and post-initiational stages (i.e., 7 days prior to DMBA application and continued till the end of the experiment) on the shaven backs of the mice recorded a significant reduction in tumor incidence to 50, 33.3 and 16.7% respectively in comparison to the control (i.e., the mice treated with DMBA and croton oil only) where tumor incidence was found to be 81.8%. The average number of papillomas per mouse was also significantly reduced. The results suggest a possible chemopreventive property of P. urinaria against DMBA-induced skin papillomagenesis in mice.     

The carcinogenic effect of TPA (12-0-tetradecanoylphorbol-13-acetate) when applied to the skin of hairless mice

Groups of hairless mice received one, two, five and fifty applications of 20 nmoles TPA (12-0-tetradecanoylphorbol-13-acetate) on the skin of the back, and were observed for 20 months. The animals developed some papillomas, some squamous cell carcinomas, some fibrosarcomas of the dermis, and some malignant and benign tumours in internal organs. There was a small, not significantly different, incidence of benign and malignant tumours after 1, 2 and 5 paintings, and a significantly higher tumour incidence after 50 applications. Apart from reticuloses, which are commonly seen in these animals, the occurrence of other tumours is believed to be related to the TPA treatment. The results are interpreted as showing that TPA, like croton oil, should be regarded as a complete carcinogen.     

Dietary fibre components and pectin chemical features of peels during ripening in banana and plantain varieties

The effects of the ripeness stage of banana (Musa AAA) and plantain (Musa AAB) peels on neutral detergent fibre, acid detergent fibre, cellulose, hemicelluloses, lignin, pectin contents, and pectin chemical features were studied. Plantain peels contained a higher amount of lignin but had a lower hemicellulose content than banana peels. A sequential extraction of pectins showed that acid extraction was the most efficient to isolate banana peel pectins, whereas an ammonium oxalate extraction was more appropriate for plantain peels. In all the stages of maturation, the pectin content in banana peels was higher compared to plantain peels. Moreover, the galacturonic acid and methoxy group contents in banana peels were higher than in plantain peels. The average molecular weights of the extracted pectins were in the range of 132.6-573.8 kDa and were not dependant on peel variety, while the stage of maturation did not affect the dietary fibre yields and the composition in pectic polysaccharides in a consistent manner. This study has showed that banana peels are a potential source of dietary fibres and pectins.     

Comparative content of some bioactive compounds in apples,peaches and pears and their influence on lipids and antioxidant capacity in rats

The aim of this study was to compare some bioactive compounds in apples, peaches and pears and their influence on lipids and antioxidant capacity in rats. The content of total polyphenols (g/100g) was 0.23 +/- 0.03; 0.22 +/- 0.03 and 0.68 +/- 0.1 in peeled fruits and 0.48 +/- 0.04, 0.47 +/- 0.04 and 1.2 +/- 0.12 in peels of peaches, pears and apples, respectively. Caffeic, p-coumaric and ferulic acids and the total radical-trapping antioxidative potential (TRAP) values in peeled apples and their peels were significantly higher than in peaches and pears, respectively. Contrarary, no significant differences in the content of dietary fiber among the studied fruits were found. The content of all studied indices in peels was significantly higher than peeled fruits (p < 0.05 ). A good correlation between the total polyphenols and the TRAP values was found in all fruits. Diets supplemented with apples and to a less extent with peaches and pears have improved lipid metabolism and increased the plasma antioxidant potential especially in rats fed with added cholesterol. The highest content of biologically active compounds and the best results in the experiment on rats makes apple preferable for dietary prevention of atherosclerosis and other diseases.     

FORMATION AND ORIGIN OF BASAL LAMINA AND ANCHORING FIBRILS IN ADULT HUMAN SKIN

The purpose of this investigation was to study the formation and origin of basal lamina and anchoring fibrils in adult human skin. Epidermis and dermis were separated by "cold trypsinization." Viable epidermis and viable, inverted dermis were recombined and grafted to the chorioallantoic membrane of embryonated chicken eggs for varying periods up to 10 days. Basal lamina and anchoring fibrils were absent from the freshly trypsinized epidermis before grafting although hemidesmosomes and tonofilaments of the basal cells remained intact. Basal lamina and anchoring fibrils were absent from freshly cut, inverted surface of the dermis. Beginning 3 days after grafting, basal lamina was noted to form immediately subjacent to hemidesmosomes of epidermal basal cells at the epidermal-dermal interface. From the fifth to the seventh day after grafting, basal lamina became progressively more dense and extended to become continuous in many areas at the epidermal-dermal interface. Anchoring fibrils appeared first in grafts consisting of epidermis and viable dermis at five day cultivation and became progressively more numerous thereafter. In order to determine the epidermal versus dermal origin of basal lamina and anchoring fibrils, dermis was rendered nonviable by repeated freezing and thawing 10 times followed by recombination with viable epidermis. Formation of basal lamina occurred as readily in these recombinants of epidermis with freeze-thawed, nonviable dermis as with viable dermis, indicating that dermal viability was not essential for synthesis of basal lamina. This observation supports the concept of epidermal origin for basal lamina. Anchoring fibrils did not form in recombinants containing freeze-thawed dermis, indicating that dermal viability was required for anchoring fibrils formation. This observation supports the concept of dermal origin of anchoring fibrils.