BEST OF THE BASICS , CHEMICAL PEELS
Chemical peels have been used for ages in one form or another . "Chemical exfoliation" of the skin was performed by using oils and alabaster to improve the texture of the skin in ancient Egypt. Legend has it that Cleopatra used to bathe in fermented milk and to use hot sand treatments on her face and body. If this was so, she would have been using the fermented milk for its Lactic Acid chemical peel properties and the Hot sand for its Microdermabrasion qualities. No wonder it was said she always had a milky white , porcelain smooth complexion! Today , we have a multitude of peeling agents that have developed over the last 200 years
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In general, chemical peels are divided as to what type of peeling agents are used and strength of exfoliation( depth ) they give you . The Doctor or Medical Esthetician then determines the depth of the chemical peel by not only adjusting which peeling agent, but also varying the strength( concentration ), number of passes( coats ), and amount of time the peeling agent is left on. Before lasers, strong peels were a common way of treating wrinkles and significantly sun-damages skin. A deeper peel may give better results than a light peel in the short run, but they also have considerable more down time,pain, flaking, oozing, crusting and risks of infection, scarring, and other complications. Many studies have shown using mild to medium peels in a series of three to six will give very good results without the pain, downtime, and risks of discoloration and scarring.Today, with lasers technology improving, lasers, instead of deeper peels, tend to be used for more severe cases, with less risk of complication than very strong peels.
- TYPES OF CHEMICAL PEEL INGREDIENTS
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Alpha Hydroxy Acids
(AHA) are a natural acid compound found in nature. In our office, we often used in combination with Beta Hydroxy Acids (
Alpha-Beta Combo Peels
).
Glycolic Acid
is one of the most popular "Sugar Acids" in the world used for Superficial Chemical Peels. It comes from Sugar cane sugar and fermented down produces Glycolic acids. Usually used in the 20% to 70% range for Peels they have been shown to be excellent for exfoliation and for reducing Hyperpigmention, sun damage and
hyperpigmented conditions
suchs Melasma(mask of pregnancy) and Solar Lentigos (Sun spots).
Lactic acid
, from fermented (sour) milk is also an excellent AHA. Used in superficial peels these AHAs help with evening out complexion, lessening dark spots, smoothing skin texture and complexion, and reducing enlarged pore sizes. They are also helpful in treatment of stubborn acne and its acne "spots" by increasing exfoliation and drawing out the hyperpigmented spots. The most common Alpha Hydroxy Acids are
Glycolic acid, Lactic acid, Citric acid, Malic acid,
and Tartaric acid.
- Beta Hydroxy Acids are also a very popular type of acid used for superficial to medium chemical peels. Often used in step-wise combination with Alpha Hydroxy Acids ( Alpha-Beta Combo Peels ) in our office. The most popular type is Salicilyc Acid . Salycilates are the ingredient making up Aspirin. It was originally found in Willow tree bark. Today Beta Acids are known for their deeper penetration into the pores than the Alpha Acids. Thus we call them our "Acne Busters!" They have a Comedolytic effect by cutting the grease ( sebum) in the pores, exfoliating(unplugging) and helping kill the acne bacteria (Pyobacterium Acnea). Beta Hydroxy acids are also excellent foor gradual impprovement of texture and pore size
- Jessner Peel and Retinoic Acid Peel can be used in combination as the Vitalize Peel (by SkinMedica). The Jessner Peel is performed in the Doctors office is a combination of low conentration Salicylic Acid, Lactic Acid, Resorcinol in an ethanol base. The low level acids used in this peel in a step-wise combination keep it a relative safe, low risk peel. Adding the Retinoic Acid at the end of the peel as a "leave on" step, adds to the efficacy of the peel. The Retinoic acid is left on and rinsed off by the patient at home four hours later. This Peel is great for pigment(dark, splo tchy) skin disorders and for texture, fine line rejuvination and exfoliation.
- TCA (TrichloroAcetic Acid) Peels are for the Medium to Deeper peels only. Usually used for wrinkles, sun damage and pigment issues. It is only used when milder peels are ineffective, and Laser therapies are unavailable .
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- THREE TYPES OF PEEL STRENGTHS
- Superficial Peels are the gentlest of the peels and do not penetrate very deep into the top layers of the skin. They are performed using Low concentration acids such as Glycolic, Lactic or Retinoic acids. They are safe for most skin colors and for most everyone but the most sensitive skin types tolerate them easily... Usually experiencing only itching, prickly or light burn sensations. Superficial peels usually leave the face with a rosy or mild red appearance for 6 to 24 hour period. Flaking is usually light and ocurrs at 2 to 4 days post peel. Superficial peels are wonderful in a peel series and for prolonged maintenance and rejuvination programs. For the low cost, one of the best deals and returns on investment of all cosmetic procedures or products!
- Medium Peels penetrate the skin deeper than a superficial peel and can cause a second degree burn type effect. TCA acid or other Alpha - Beta acids used in combination steps can acheive a medium grade level peel. It will have more side effects than a light peel, including a stronger red appearance in the peeled area for two to four days. Also, more copious peeling for 2 to four days. Sometimes some crusting or tenderness can ocurr, but can be controlled with use of over-the-counter cortisone 1-2X per day for a couple of days.
- Deep Peels penetrate down several layers of skin and cause a second degree burn. Although once popular, before the advent of laser therapies, they are now used rarely and can only be done by experienced Physicians. They must be monitored closely for signs of infection, hyperpigmentation or hypopigmentation, or scarring. They can have drama tic results but can be rather painful for the patient. TCA acid and phenolic agents were the most commonly used when they were in vogue. Deeper peels should never be perfomed on Darker skin colors. They can only be done once on a person and have a high risk of bleaching the skin (hypopigmentation) or Dark Stainin g of the skin (hyperpigmantation) as well as scarring.
