Chemical Peel and Skin Cancer

Aging skin undergoes a number of changes over time. The skin will thin, fall, and crease along muscular and gravitational folds. The effect of the sun's UV rays provides additional problems including thickening, solar elastosis, and resultant pigmentary irregularities. More seriously, the UV's carcinogenic effects can lead to skin cancer.

The skin is by far the organ most commonly affected by cancer; 1 in 5 people develop skin cancer; one half of cancers of the body are skin cancers. More than 1 million cases of skin cancer occurred in the United States in 1997 and the incidence of skin cancers is expected to increase particularly with the destruction of the protective ozone layer. Although common skin cancers (i.e. basal cell, squamous cell) tend to be localized and nonmetastatic, melanoma incidence doubled from 1973-1991. Of the 8500 skin cancer deaths in the United States in 1991, melanoma accounted for 6 in 7 deaths.

Sun damage, especially from UV-A wavelengths, causes ionization and oxidation of dermal elements and genetic information, resulting in pre-malignant and malignant skin lesions. Skin cancer can be exhibited as actinic keratoses, basal and squamous cell cancers, and less directly to melanomas.

Actinic keratoses are pre-cancerous growths and are characterized as thick, warty, rough, scaly reddish growths spots, most commonly found on the face, lower arms, and back of the hands in individuals who have had significant sun exposure. If not treated, some actinic keratoses may be precancerous to squamous cell carcinoma.

Although chemical peels are not treatments for all skin cancers, experts have found that skin resurfacing procedures such as deep chemical peels may actually decrease the chance of developing these types of skin cancers. A study has observed a noted decrease in the incidence of superficial skin cancers and actinic keratoses after resurfacing procedures.

Chemical peels are skin treatments that exfoliate the skin. A strong chemical peel (i.e. phenol chemical peel) may kill very early skin cancer cells since the treatment removes the top layer of sun-damaged skin, which may include precancerous cells as well as the sun-damaged cells that give the skin a rough, blemished discolored appearance.

Most people want to get chemical peels or microdermabration for cosmetic reasons, to smooth out their skin and to get better skin tone.

If skin cancer is of concern, it is best to have some biopsies of the suspect areas and to treat the skin cancer with more appropriate means. There is certainly some merit to treating some sun damaged skin, which is at high risk for skin cancer, with some of the deeper chemical peels.

Although usually considered a cosmetic procedure, patients who have severe sun damage with skin cancers or pre-cancerous skin changes could be considered for superficial chemical peels, which have been shown to decrease the incidence of skin cancer and improve the skin. In procedures such as this, insurance may cover the cost.