Chemical Peel, Part 2

In the previous post, I explained what chemical peels are, the types of chemical peel and how chemical peels are applied. Here are a few more aspects to consider;

Which One Is Right For Me?

Chemical peels can remove just a few or many layers of skin. The key factors to consider in determining which chemical peel is correct for you include; the amount of skin problem/aging/sun damage, the skin colour or type, the amount of skin rejuvenation you would like to accomplish, and the amount of recovery time that is acceptable to you.

As a general rule, the deeper the peel, the more side effects and potential complications will be encountered. Usually the recovery period will also be longer. Also, the darker the skin type, the greater the number of problems may be encountered after the procedure. This applies especially to pigmentation problems such as post inflammatory hyperpigmentation. This occurs when the treated skin becomes darker than the untreated skin. Therefore, care should be taken when applying deeper peels in darker skin types. Consideration should be given towards performing several more shallow peels rather than one deep peel.

The extent of skin aging will also determine which peel to use. For patients with less skin damage, pigmentation and wrinkles, only superficial peels will be required. The opposite also holds true.

Different skin ailments respond differently to particular chemical peels. As an example, acne responds well to Jessner's peel and salicylic (beta hydroxy acid) peels. These chemical peels are very oil soluble, are able to penetrate deeper into pores to remove oil and sebum, and are anti-inflammatory. Both alpha hydroxy acid and beta hydroxy acid help exfoliate the skin. TCA peels, alpha hydroxy acid peels and Jessner's peels are best suited to pigmentation issues and sun damage.

Wrinkles can be best treated using any medium to deep chemical peel, such as TCA peels. These peels can be a cost effective alternative to laser skin treatment.

How To Prepare For A Chemical Peel

Skin preparation can be done by applying skin care products containing retinoic acid such as Retin-A/Stieve-A, which are available by prescription only. Topical lightening agents, which are creams or serums used to help lighten skin and skin pigmentation problems, can also be used. These include hydroquinone, kojic acid or arbutin. This should be started at least two weeks before peeling to help with even penetration of the chemical peel, decreasing the healing period and to reduce complications like post-inflammatory hyperpigmentation. Use of alpha hydroxy acid cleansers/exfoliants in the two weeks prior to chemical peeling can also help the peeling agent. These, however, do not reduce the risk of post-inflammatory hyperpigmentation.

Medical Issues That Your Doctor Should Know About Before A Chemical Peel

Patients with cold sores (herpes simplex virus) should advise their doctor before chemical peeling. If the cold sore is active, they may need to wait until it has passed before having a chemical peel. Or if the person has a history of cold sores, the doctor may recommend a course of anti-viral medication as a prophylaxis to any re-occurence during the treatment.

A presence of keloid (thick, pigmented scarring) may exclude a person from all but the most superficial of chemical peels.

Patients with HIV/AIDS or immunosuppression should stay away from chemical peels as it may increase the possibility of infection and scarring.

Also those who have recently had a course of isotretinoin (or Roaccutane) for the treatment of acne should avoid chemical peels for six months before undertaking medium or deep chemical peels. Likewise, people who have recently had a facelift should not undergo chemical peels for at least six months.

Chemical Peel, Part 1

What Is A Chemical Peel?

A chemical peel is an anti aging treatment used to improve skin using a chemical solution. The solution brings on a controlled injury to the skin that causes the dead skin to peel off. By removing the top layers of skin, collagen production is induced thereby improving sun damaged skin and skin pigmentation problems, reducing wrinkles, and improves skin texture and overall appearance of the skin. The younger looking skin has fewer wrinkles than the old skin.

Some types of chemical peels can be purchased and applied without a medical license; however people are advised to seek professional advice on a specific type of chemical peel beforehand. The strength of the chemical solution will determine the depth of the peel. Deeper peels may have a greater number of complications and require a longer recovery period, but will also result in a greater improvement to the skin.

Chemical peels can be applied to several different parts of the body other than the face. For example, the procedure can be done on the chest and back for acne, or on the neck or decolletage to treat sun damage.

Types Of Chemical Peels

Chemical peels fall into several categories. Each type is suited to treat different skin ailments. Chemical peels also vary in solution strength and are classified as either 'superficial', 'medium' or 'deep', according to the level of skin to be treated.

Supercial chemical peels include;

• Alpha hydroxy acid (AHA) peels - these contain glycolic and lactic acid.
• Beta hydroxy acid (BHA) peels - salicylic acid is the main ingredient in these peels.
• Retinoic acid peels - retinoic acid is the ingredient found in Retin-A and Stieva-A (tretinoin) skin care products, but in much less concentrations than the retinoic peels.
• Jessner's Peel - contains a combination of salicylic acid, resorcinol and lactic acid.
• Trichloroacetic acid (TCA) peel - typically contains 10 - 20% TCA.
• Deep sea peel - this is a natural organic, herb/plant-based peel.

Medium depth chemical peels include;

• Trichloroacetic acid (TCA) peel - typically containing 35% TCA.

Deep chemical peels include;

• Baker-Gordon phenol peel.

Applying A Chemical Peel

It is recommended that the application of a chemical peel be performed by an experienced doctor or nurse.

The skin should be thoroughly cleansed. For facial peels, vaseline can be used to prevent the peel from entering the eyes. Your eyes should be closed during the procedure. As your skin is likely to get hot during the procedure, keep a fan handy to cool the area.

The chemical peel solution is applied to the skin for a set time before neutralizing the solution. However, if there is any unexpected skin reaction before the end of the allotted time, or if the pain is excessive, neutralization can be done early. Sodium bicarbonate is used for the neutralization stage.

At the end of the procedure, the peel is completed by placing sunscreen and a soothing balm on the skin.