A 72-year-old woman with moderate-to-severe deep wrinkles (Glogou 3) was treated with a 1.1% phenol-croton oil peel around the mouth, extending onto the cheeks.
A 72-year-old woman with a history of pseudoxanthoma elasticum (PXE–an abnormality in elastic fiber formation) presented with severe photodamage around the mouth with deep wrinkles. Given her genetic condition she never had any previous cosmetic procedures or resurfacing. And there are no case reports in the literature of patients with similar genetic disorder undergoing deep chemical resurfacing.
The patient was treated with oral sedation followed by intraoral nerve blocks for comfort. She was also placed on a CR monitor during the entire procedure.
The perioral region was treated with Hetter solution (phenol–croton oil), and the rest of the face was treated with a medium depth peel consisting of four passes of Jessner solution and 35% TCA. Finally the Hetter solution was blended onto the cheeks to avoid any demarcation lines. The healing process, similar to laser resurfacing, is challenging for some patients and most patients typically re- epithelialize by day 10. There may be some persistent redness that lasts about a month afterwards.
The original photographs are taken with the patient's make-up on, and follow-up photographs are taken in a different light. Nonetheless, dramatic resolution of perioral wrinkles as well as substantial tightening around the jowls are noted. In addition, she had significant improvement of fine wrinkles on the cheeks as well, and she is thrilled with her result.
