SKIN RESURFACERS & PEELS
Chemical peeling or chemoexfoliation is a process whereby a chemical substance or enzyme is applied to an area of skin to loosen and digest the glue like substance (intracellular glue) that holds dead and damaged skin cells together. By applying acids and enzymes dead and damaged skin cells are able to shed from the surface and help reveal new skin cells. This has huge anti-aging and skin rejuvenating advantages such as:
- Allowing the skin to breath properly and function better
- Improved absorption of active skin ingredients such as retinols and vitamins
- Stimulation of new, healthy cells promoting smoother and more radiant skin
- Increase in collagen and elastin production
- Minimise fine lines, open pores and superficial scar tissue
- Improve uneven skin texture and tone
The shedding of dead cells on the skins outermost surface is a normal process that results in younger cells underneath the surface. Whereby the skin looks and feels soft, smooth and supple with each shedding. The skin requires assistance to help this process particularly as we get older as the cycle of shedding and regenerating new skin cells slows down considerably. This slower cellular turnover and excessive dead skin laying on the surface is one of the causes of dull, lacklustre, unhealthy or wrinkled skin. Therefore increasing the rate of exfoliation can diminish the visible signs of ageing.
What treatment options are available?
Exfoliation is considered one of the most important techniques that you can perform on your skin to resolve certain skin problems as well as achieving healthy and glowing skin. To address the above skin issues exfoliation performed either in a mechanical or chemical way is recommended. The mechanical method uses actions like rubbing, scrubbing and polishing to remove the intracellular glue away, whilst chemical substances will dissolve these bonds between the dead cells in the skin surface.
Abrasive materials are used such as micro-bead facial scrubs, sponges, brushes etc. As well as methods such as microdermabrasion which uses tiny rough grains to buff away the surface layer of the skin.
This method employs choosing between a variety of organic acids with different chemical strengths and properties to exfoliate and regenerate new skin cells. The most common acids used are lactic, salicylic, glycolic, TCA (Trichloracetic acid), pyruvic and mandelic acid.
Why choose chemical peels?
There is a very broad range of chemical acids to choose from and these can be individualised depending on the skin condition being treated and the depth of skin damage needed for the required outcome. You can control the depth of the acid activity on the skin; you may want to only treat at a superficial level by removing the dead skin cells on the outer skin surface (epidermis) or apply an acid that can penetrate to a deeper skin depth to help with remodelling of the dermis.
Mechanical exfoliation can be inappropriate on the following skin types:
Red, irritated skin
Fragile or thin skin will become red and irritated
Older, fragile skin which can bruise or even tear in extreme cases
Active acne skin papules, pustules and cysts
Mechanical exfoliants only remove the dead skin cells and debris of the epidermis whilst chemical peels have the ability to work deeper in the skin structure and alter the cellular turnover quickening the process. Chemical peels are mainly used on the face, neck, décolletage and sometimes the hand area.
Skin indications for chemical peels:
Photo–damaged skin (mild to moderate sun damage)
Fine lines and superficial wrinkles
Solar lentigines (age spots)
Hyperpigmentation such as freckles, melasma (help to lighten pigmentation)
Age management (to even skin tone and improve skin texture, stimulation of new collagen)
Exfoliation for sensitive skin types
Prior to any chemical peel being performed a full medical history and facial assessment including skin type (Fitzpatrick scale) will be undertaken to determine the appropriateness of the treatment and the condition being treated. A treatment plan will be designed to suit the individual’s needs; it may be decided that a course of superficial peels is advantageous over a medium depth peel. Options will be fully discussed as well as risks and benefits of each type of peel. A patch test of the acid will be applied to the skin at least 72 hours prior to any undertaking of this procedure to assess any sensitivity or reactions. If there is a positive reaction then unfortunately this treatment will be declined.
Chemical Peels will not be performed on individuals who:
- Are pregnant or breast feeding
- On medications such as Roaccutane or have been in the last 6 months
- Uncontrolled diabetes or epilepsy
- Under the age of eighteen years
- Non compliance to using an SPF of 30+ pre and post treatment
- Active skin infections, skin diseases or sunburn
- Waxed or shaved area in the last 48 hours
- Allergy or sensitivity to any of the acid ingredients
- Prone to scarring
- Cancer or auto-immune diseases
Cautions and special considerations:
The Fitzpatrick classification system is used to determine the tendency of an individual towards hyperpigmentation and erythema (redness) risks from acid applications. Anyone over a type 111 will need to prep their skin for a longer period of time before a chemical peel and also use a melanin pigment control product. For all skin types it is imperative to use a SPF 30+ pre and post procedure to protect the vulnerable new skin cells from the damaging effects of UV rays and prevent hyperpigmentation.
If you are prone to cold sores then a peel can actually bring on an outbreak and it is recommended that you take a short course of antiviral medication before and after the treatment.
Pre-conditioning the skin prior to a chemical peel:
It is important to pre-condition the skin prior to a chemical peel by using professionally prescribed products in a home care regime to allow for optimum skin condition. Skin that is in balance with a hydrated epidermis, a healthy dermis and suppressed melanocytes will sting less, respond with less irritation and not react with hyperpigmentation. This will be fully discussed and recommendations made at the consultation visit.
Applying the chemical peel:
Prior to applying the chemical peel the skin will be doubly cleansed using an appropriate cleanser for your skin type and the peel being used. Then the skin will be degreased before the peel is applied so that all the oil and debris are removed to enable the peel to penetrate properly. The peeling solution will be left on for the appropriate time period and then the activities halted by the – should read the activity is halted by the application of a neutralising solution (some acids are self neutralising) and aftercare products may be applied.
You may feel warmth, stinging, itching or a burning sensation over the area being treated and the use of a cooling fan may be used for your comfort. The sensations will stop once the peel is over yet at any time the peel can be stopped.
These may include mild redness, itching, occasional swelling and tightness, peeling and scabbing of the skin. Usually with superficial peels you will not peel there may be patches of dryness or flakiness. With stronger concentrations of acids peeling would occur approximately around 3-5 days.
The time scale varies with some people seeing results early possibly around 10 days and for others it may be longer. Yet the appearance of the treated skin will have a more youthful texture with a uniform coloration that will blend with their untreated skin.
Recommended skin care products should be used and it is particularly important to keep the skin hydrated. Until the skin is completely healed avoid:
- Hot baths, showers, saunas or hot tubs
- Scrubbing, picking or rubbing the skin which could lead to scarring
- Retinol or AHA products for at least 10 days
You must use an SPF 30+ daily to protect the skin from direct sunlight for a minimum of three days yet it would be advisable to continue to use for the next six months.