Chemical Peels in Skin Cancer: A Review

Abstract

Background: Chemexfoliation is widely used to reverse signs of photodamage. Although photodamage can eventually lead to skin cancer, it remains unclear whether chemical peels also affect photocarcinogenesis. Moreover, concerns about the systemic and/or cutaneous toxicity of peeling agents have already arisen. Objective: This review sought primarily to summarize the data available on the effects of chemical peels on ultraviolet-induced skin carcinogenesis, focusing particular attention on actinic keratoses and cutaneous field cancerization. In addition, considerations about the systemic and/or cutaneous toxicity of peeling agents, particularly trichloracetic acid, are briefly discussed. Methods: The PubMed, MEDLINE, and SCOPUS databases were searched using the keywords "chemical peeling," "actinic keratosis," "cutaneous field cancerization," "skin cancer," "skin cancer prevention," and "cutaneous and systemic carcinogenicity," both alone and in combination with one another. Additional relevant references were also isolated from citations in the reviewed literature. Results: A total of 42 articles involving both in-vitro and in-vivo human and animal models were included for analysis. The data were mainly confined to laboratory animals. Conclusion: Apart from efficacy in clearing visible actinic keratoses, the findings point towards the possible clinical use of chemical peeling for the prevention of skin cancer. To date, no evidence on systemic toxicity following dermal exposure of humans to chemical peels has been identified.

Keywords: Actinic keratosis; cutaneous field cancerization; field therapy; photoaging; photocarcinogenesis.

FIGURE 1.

From left to right: multiple actinic keratoses of the scalp—Before (a), during (b), and two months after (c) medium-depth peel (Jessner’s solution and 35% TCA)