With the advancement of trichloroacetic acid peel technology and wound care, trichloroacetic acid peeling has become very successful in Korea. Its success has opened studies on the possibility of using phenol on Korean skin. Dr. Mee's phenol formula (molding mask technique) was chosen for experiments on Korean skin because of the presumed safety of use on non-Caucasian skin. Between January of 1996 and January of 1998, 30 cases of significant small pox scars were treated with phenol at the Korea University Anam Hospital. The age range was from 43 to 60 years, with a mean of 49 years. The average follow-up period was 13 months, ranging from 1 month to 2 years. All of the procedures were performed in the operating room while the patient was under deep IV sedation. After the entire face was peeled, it was covered with an occlusive tape mask. During the recovery period, the patients underwent a post-peel skin care program. All 30 patients showed significant improvement of the severe pox marks with a marked rejuvenation effect. There was no sign of hypopigmentation or hyperpigmentation. As a complication, two patients developed hypertrophic scars on the perioral area, which responded well to steroid injections. Another pair of patients had herpetic infection, which left minimal scarring. Five patients developed cardiac arrhythmia with this rapid technique, but this was safely managed by an anesthesiologist during the procedure. Korean skin belongs to Fitzpatrick types IV and V and occasionally to type III or VI. It is common knowledge that performing chemical peeling on the latter types of skin is dangerous, but in this report, excellent results were obtained from all 30 patients, even though the peeling itself was very deep with more knowledge and experience, phenol peel can be safely conducted on Asian skin.
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