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.