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Phenol-croton oil peel, widely known as Hetter's peel, is a deep chemical peeling agent used for facial rejuvenation, particularly for treating severe rhytids and photoaging. The formulation is a combination of phenol, which acts as a caustic agent to denature skin proteins, and croton oil, which serves as a penetration enhancer and inflammatory agent. Standardized by Dr. Gregory Hetter, this formulation allows for more predictable and adjustable depth of injury compared to the traditional Baker-Gordon peel by varying the concentration of croton oil. Mechanistically, the peel induces a controlled chemical injury that triggers regenerative pathways, including the modulation of TGF-β1, PPAR-γ, and RANK, leading to neocollagenesis and durable tissue renewal.
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