Risks of Phenol Peel on Neck and Chest?

Phenol peeling done as part of the Baker's formula peel is an excellent procedure for the face.  However, the depth of penetration is too much for the neck and chest.  It will cause scarring that is horrific.  For those looking for peeling of the neck and chest, we use a Jessner's-TCA peel with a 15% TCA concentration.  This does not produce the same depth of peel compared to a Baker's peel, but is safer to use.  

Phenol peel solutions have been around for a long time. If used straight, 88% phenol will act as a medium depth peel. When mixed with other chemicals or even water, it will go deeper. Traditionally phenol peels have been performed on the face due to the concentration of hair and oil structures. Since the chest and neck do not have as many structures, scarring may result from a deeper peel. Phenol is toxic to the pigment cells, and could be used as a straight peel to spot treat some sun spots, but I would advise against a whole neck or chest peel. It is also toxic to the heart so such a large area should be performed in an operating room, with Intravenous fluids and a heart monitor.

Phenol peels on the neck are a risky procedure. The reason for this is that there are very few adenexal structures on your neck or oil glands that can assist the healing process after a chemical or laser peel. Basically, a chemical peel such as phenol is a burn that allows the new skin to heal over which is often smoother and not sun damaged. To heal effectively, you need a good population of oil or sweat glands to repopulate the skin and the neck and chest has very few of those structures. Safer alternatives would be a milder TCA (tricholoracetic acid) peel or erbium laser treatments. Even Fraxel treatments may be an option.

The ability to heal after a peel resides on the reservoir of cells that remain in the deeper structures of the skin such as the sweat or oil glands or hair follicles; these are collectively called the adnexal structures. Skin that has more of these strutcures heals quickly after a resurfacing procedure. Skin that has fewer of these structures heals more slowly. Delayed healing can result in hypertrophic scarring.
The skin of the neck specifically has very few adnexal structures.

A phenol peel cannot be done on neck and chest.  That much phenol can be dangerous to the myocardium and in addition scaring will result.  Phenol is ok about the facial area only, nowhere else. It is a great peel but only when appropriately used.