Shedding Light On Chemical Peels
As the infamous Sex and the City episode demonstrated, chemical peels, when done incorrectly, may have effects that don’t always turn out pretty. While the episode may have painted an exaggerated picture as to how chemical peels work, changing times have led to advances in the cosmetic industry. Today, new chemical peels won’t leave you red, irritated, crusty, or needing time off to hide from the world.
Skin exfoliation through chemical peels have been around since ancient times. The earliest known chemical exfoliation dates back to the times of Cleopatra, who was known for taking baths in sour milk (from which lactic acid peels are derived). Chemical peels can be used to treat brown spots and pigmentation (such as dark spots from acne and melasma), photodamage, fine lines, mild blemishes, and acne scars. They minimize the signs of aging and skin damage by sloughing away the superficial skin layers, which kickstarts the body’s natural healing process. The response is generation of fresh, new skin cells that work their way to the surface to replace the layers that have been removed. New skin cells lead to an overall appearance to rejuvenation that will make one look refreshed, and may even take a few years off the face. Chemical peels are generally safe, but as with all cosmetic procedures, possible complications sometimes arise, and it’s important to know that there are various types of peels that react differently to each skin type. Not all chemical peels are a one type fits all.
There are three different levels of chemical peels: Superficial (Mild), Medium, and Deep. These peels are categorized according to the depth of skin wounding.
Superficial Peels
Mild, superficial peels include lower concentrations of glycolic acid (20-50%), lactic acid (10-20%), salicylic acid (beta-hydroxy, or BHA) , and Jessner’s peels. The level of skin injury is limited to just the top layer, the stratum corneum. They are suitable for many skin types and result in skin that is smoother and brighter. They produce little to no side effects, and act to remove the very topmost layers of damaged skin. However, it’s important to note that one treatment won’t give dramatic results. A series of peels, done once every 4 weeks will help achieve that youthful glow, smooth surface, and even skin tone. Also you may get the most bang for your buck with a a peel package since most skincare professionals give fair discounts when purchasing peels in series, as opposed to one treatment at a time.
I am a big fan of monthly peels. First off, I don’t like the redness and downtime associated with medium-deep peels, and also I personally feel that “progressive, not aggressive” is the way to go when it comes to skincare. The skin is delicately strong. It is the largest organ in the body and helps to protect from environmental insults, but it is in no way immune to harsh chemicals. It is also important to keep in mind that even the mildest chemical peel will still have a risk of discoloration (hyper- or hypopigmentation) and even scarring. Proper technique and discretion of the person applying the peel must be taken. But generally speaking, superficial peels are safe and there little to no down time associated with light peels, the most common being transient redness and mild sloughing that disappears within a few days.
Medium Peels
Trichloroacetic Acid (TCA) is a popular peel in this category of chemical peels. Other peels in this category are higher concentrations (usually above 30%) of glycolic acid and salicylic acid peels. Medium peels go just a tad deeper than mild peels, and have the major benefit of reducing minor wrinkles. However, they have a greater chance of complications, namely increased sensitivity (redness, stinging), and increased risks of scarring and pigmentation problems. Expect down time to be up to 1 week.
Deep Peels
Deep peels, such as the Phenol peel is much more serious and are aimed at deeper wrinkles, photoaging, and discolorations. Deep peels extend injury to the dermis, and if done correctly, offer the most dramatic results. However, down time with this type of chemical peel is much longer (expect it to be around at least 2 weeks), so be prepared to take time off- a la Samantha in Sex and the City. There is also much higher risks of complications from irritation, chemical burning, and scarring associated with this type of chemical peel. Since the injury goes much deeper into the layers of the skin, healing time is also prolonged. Healing time varies from each individual, and it is common for complete healing time of deep peels to be as much as 14-21 days.
Chemical Peel Procedure: What To Expect During A Superficial Peel 
Chemical peels usually begin with cleansing of the skin, to remove excess oils and impurities. Cleansing also serves to prep the skin for the chemical procedure. The depth of a superficial peel is dependent on 3 factors: The type of peel used, the number of layers applied, and how long it remains on the skin (incubation time). A thin layer of the peel is then applied. Because each person’s tolerance to pain varies, I personally center the peel procedure around the comfort level of the patient. Before application, I would give a person a range from 1 to 5, which would indicate the level of discomfort felt. 1 would feel like a cool sensation, as if something cool and wet were on the skin, 2 feels like a cool tingle, 3 would be a warm tolerable tingle, 4 feels like a tad warmer, with a slight itch, and 5 would feel like an uncomfortable warmth. I also hand him/her a fan to keep the keep slightly cool during the peel incubation. I would ask what number they are feeling after a layer of peel is applied, and every few minutes just to ensure he/she feels comfortable. Depending on the person’s sensitivity, I typically do up to 3 layers for a superficial peel. The peel is then neutralized, and a calming mask applied for 5 minutes. The mask is gently removed, being careful not put too much friction on the freshly treated skin. I finish off with SPF application, stressing to the patient the importance of sun protection because exfoliative treatments like chemical peels leave the skin highly photosensitive.
Chemical peels are a great way to maintain smooth skin that is even in tone. Ask your skincare professional the types of peels offered. Out with the old, and in with the new! New skin is just a peel away!
Images courtesy of:
www.medicalimages.com
www.cosmopolitan.com
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