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Modernizing Phenol-Croton Oil Peels: Cracking Hetter's Formula

Halka, JT Lamb, PW Shikhman, A Subichin, MP
Summa Health
2022-02-01

Presenter: Halka, JT

Affidavit:
50% of the work is by halka including the experimentation and abstract writing, 10% Lamb 10% Shikhman 40% Subichin for experimentation and abstract writing

Director Name: Ananth Murthy

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics

Background:
Phenol-croton peels are colloids that will not fully mix. To achieve emulsification, Baker and Gordon added Septisol-a detergent. This formula was later utilized by Hetter when he demonstrated the importance of croton oil concentration. Unfortunately, Septisol was banned by the FDA. This has lead to substitutes for Septisol including soaps and other chemicals. We sought to evaluate the effectiveness of Septisol substitutes in phenol-croton peels.

Methods:
To determine the optimal agent for use in Hetter's formula, we selected one detergent (Spa Soap), two soaps (Castile Soap, J&J Baby Soap), one hydrophobic cleanser (Cetaphil) , and one control (Mineral Oil). Phenol-Croton oil solutions were mixed based on a 0.8% Croton oil formula. After mixture, each solution was agitated for 10 seconds and then observed at 1 minute, 5 minutes, 30 minutes, and then every 6 hours.

Results:
At 1 minute all formulas remained in solution, at 5 minutes Castile, J&J Baby Soap, and Mineral Oil had complete separation. At 30 minutes, the Cetaphil agent was the only formula remaining in solution. This remained in solution for approximately 48 hours (p<0.05). The times for separation remained consistent on repeat agitations and mixtures.

Conclusion:
Based on our study, Cetaphil skin cleanser is the most effective emulsifying agent to allow for stability and homogenization of phenol croton peels. This demonstrates that use of soaps and detergents may lead to heterogenous peel solutions and less predictive results.

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