Makoto Mizuno, Hajime Asano
Abstract
Chemical peeling results in a defect in the epidermal and dermal barrier. Therefore there is a possibility that chemical peeling may increase the risk for allergic contact dermatitis. In particular, from the viewpoint of allergic contact dermatitis, one should be cautious of peeling agents which destruct the epidermal and dermal barrier, penetrate deeply into the skin and increase the opportunity to interact directly with antigen presenting cells. However, to our knowledge, experimental trials on the skin sensitizing properties of peeling agents as a group have not been reported yet. In this study, we evaluated the skin sensitizing properties of five peeling agents, lactic acid, glycolic acid, trichloroacetic acid, salicylic acid and phenol, using the Human Cell Line Activation Test (h-CLAT), which is an in vitro test method. Lactic acid and glycolic acid were judged to be “non-sensitizers” by this test method. In addition, there are no reports of allergic contact dermatitis for them in clinical practice. Therefore, it can be concluded that they are quite safe as peeling agents from the aspect of allergic contact dermatitis. Trichloroacetic acid, salicylic acid and phenol were defined as “sensitizers” in this study. And there are a few case reports of allergic contact dermatitis for salicylic acid. It is very rare, but one should be aware that salicylic acid has a very weak sensitizing potential. Although it is unlikely that trichloroacetic acid and phenol are “sensitizers”, in fact, one should be aware that they have the ability to augment CD54 and CD86 expression, which are co-stimulatory molecules, on antigen-presenting cells. One should make a careful choice of nonsensitizing chemicals as a chemical peeling agent, since the skin is always exposed to the peeling agents under the unusual circumstance of losing its barrier functions during the chemical peeling procedure.