Toxicity

Phenol as carbolic acid on the point of vue of organic chemistry are characterized by a group hydroxyl (OH) which is on the top of the carbone of the benzene ring.

Carbolic acid

is used in the industry like desinfectant,for the manufacture of resins,polymers as medicins like acetylsalicylats, hydroquinones, ...
In medicine, phenol is used as deep peeling and carbolic acid is used as antiseptic and here for endopeel .

We will compare the toxicity of carbolic acid of endopeel vs phenol 5%.

We will then remember here the toxicity of phenol >5% first

Carbolic acid is used as antiseptic because it is

-bacteriostatic (0.2%)
-bactericide ( 1%)
-fungicide (>1.3%)

Phenol

is a general protoplasmic agent which causes the disruption of the cellular membrane with denaturalisation of proteins.

Phenol can be absorbed via oral, transcutaneous and through the mucosae

Phenol is metabolized in phenylglucuronide and phenylsulfate and some little quantities will be oxidated in catechols and quinols which are conjugated.

The phenol systemic toxicity is got through the digestive absorption as transcutaneous one.
The phenol local digestive toxicity is got after ingestion

The phenol chronic toxicity simulates a syndrom of Reye in the clinical exam as in laboratory.

The phenol systemic toxicity can stimulate the nervous system and may provoke convulsions and arythmies with a central posterior depression.

Phenol is irritant and caustic ( strong basis) and its systemic intoxication lead to convulsions and hypotension.

The solutions containing phenol >5% can provoke too burns.

Phenol is neurotoxic in animals creating less norepinephrine, dopamine and 5 hydroxytryptamine.

The concentrations of phenol in the blood are :
- free phenol : 0-4mg/100ml
- conjugated phenol : 0.1-2mg/100ml
- total phenol : 0.15-7.96mg/100ml

The concentrations of phenol in the urines are : 0.5-81.5mg/l

The toxic dosis are :
-for the children : ingestion 50-500mg ( can be lethal)
-for the adults : ingestion 16-32g. The mortality can begin with phenol 15% even after gastric lavage.

For clinical use of phenol >15%, it is recommended
- to have a cardio monitoring of the patient, followed by a board certified anaesthesist
- any solution of phenol >5% damage the oesophagus in case of ingestion and provoke nausea and patient give up
- a gastric lavage is necessary if big quantities have been ingested but has to be done in the 1 st hour.
-Never use any kind of fat element per os
-In case of ocular projection, you need to take off the lenses and you may wash the eyes with saline solution and send the patient to the ophtalmologist.

Conclusion


The Endopeels carbolic acid is far away of any risks of toxicity if the physician doesn t use more than 1 box/patient/ day ( 250 mg)
Also there is no needs of cardiomonitoring or presence of anaesthesist during any Endopeels procedure
The carbolic acid will be eliminated in 24 hours and in case of many indications in same patient ( which may need more than 1 box) , it is highly recommended to make the procedures on more consecutive days .
There is no risks in case of contact with the skin or if injected