Understanding Chemical Peels

Years of sun exposure, problematic acne since childhood and aging in most cases leave your skin tone uneven, wrinkled, discolored, spotted or scarred. If you want your skin to look smoother and younger, a chemical peel is very effective at improving it’s texture. The gradual process is a series of visits which combines appropriate chemical solutions to remove the damaged outer layers.

A chemical peel, also called chemexfoliation or derma peeling, is one of the least invasive ways to improve the appearance of your skin. Although chemical peels are used mostly on the face, they can also be used to improve the skin on other parts of the body.

A series of properly performed peels by a knowledgeable esthetician or physician can improve:

•    Scars
•    Sun-damaged skin
•    Acne or acne scars
•    Age and liver spots
•    Fine lines and wrinkles
•    Freckles
•    Irregular skin pigmentation
•    Rough skin and scaly patches

How does a chemical peel work?

Chemical solutions are carefully applied to your skin to improve the texture by removing damaged outer layers. The chemicals used are phenol, trichloroacetic acid and alphahydroxy acids. Each one has a different purpose. The formula used by your esthetician will be adjusted to meet your particular needs.

(Note: There are certain levels of chemical peeling from light to deep.  Typically, most spas can perform light and medium peels with minimal to no downtime.  However, if you are a better candidate for aggressive peels, you will need to consult with a dermatologist or plastic surgeon, as they are the only ones who can perform deep peels.)

Understanding the skin layers

Figure: Illustration of skin layers

Light Chemical Peel

Light chemical peeling will achieve subtle improvements at first, but that healthy glow achieved after each visit will increase with more treatments.

If you have uneven pigment, dryness, acne or fine wrinkling, a light chemical peel is usually an appropriate choice. This kind of peel removes the outer layer of skin (epidermis) in a light exfoliation and results in a healthier glow. Your esthetician will use a combination of alphahydroxy acids and beta hydroxy acids, such as glycolic acid, lactic acid, salicylic acid and maleic acid. All of these chemicals are the mildest choices. You can repeat these treatments weekly for up to six weeks to achieve your desired results.

How it works:
•    Your face will be cleansed.
•    The chemical solution is brushed onto your skin and left for up to 10 minutes. You may feel some mild stinging, however, if the client cannot tolerate it, the esthetician can quickly neutralize the acids to immediately stop the action.
•    Depending on how the client reacts to the first layer, the esthetician may decide that additional layers are necessary to achieve better results.
•    After the acids are left on the skin for the required time, the esthetician will apply a neutralizer to stop the acid action.
•    A sun protection barrier with UV-A and UV-B protection will be applied.
•    To achieve superior results, the clients can return once a month (or as soon as 2-3 weeks depending on the type of peel) to maintain a vibrant look.

Chemical peels combined with a regular regimen of facials can achieve superior results for smooth skin texture and maintain a youthful and vibrant look.

Medium chemical peel

Using medium chemical peels, your skin will be noticeably smoother and fresher-looking.

Acne scars, deeper wrinkles and uneven skin color can all be treated with a medium chemical peel. The chemicals used for this type of peel will remove skin cells from both the outer layer of skin (epidermis) and upper part of your middle layer of skin (dermis). Your esthetician will use trichloroacetic acid, sometimes used in combination with glycolic acid.

How it works:

•    Your face will be cleansed.
•    The chemical solution is brushed onto your skin and left for just a few minutes. You may feel some burning or stinging.
•    The treated area may turn a whitish grey color, this process is called “frosting”.  When the esthetician sees frosting on the skin, she will typically neutralize the skin to stop the acid action as the acids have penetrated the upper part of your dermis.
•    A sun protection with UV-A and UV-B protection will be used on the skin.
•    Your skin may turn red or brown in the days just after the peel. Because this is a more aggressive peel, it may take up to six weeks for your skin to look normal.

You may repeat a medium chemical peel every 6 to 12 months to maintain your glowing new skin.

Deep chemical peel

Deep chemical peels are only done by dermatologists and plastic surgeons.  Results are dramatic, but recovery takes the longest.

If you have deeper facial wrinkles, skin that’s sun damaged, scars, areas that appear blotchy or even pre-cancerous growths, deep facial chemical peels might be the most appropriate. Your physician will use the strongest chemical called phenol to penetrate down to the lower dermal layer of your skin. For this type of peel, you may need a local anesthetic and a sedative to manage any discomfort.

How it works:

A deep chemical peel usually involves some sort of pretreatment for up to 8 weeks. This will prepare your skin for the peel and speed the healing process. Pretreatment may include use of Retin A – a prescription medication that’s derived from vitamin A. This works to thin out the skin’s surface layer, allowing the chemical solution to penetrate more evenly and deeply. If you cannot tolerate Retin A as a pre-treatment, your doctor may prescribe another medication.
•    You will be given a sedative to relax along with a local anesthetic to freeze your face.
•    Your face will be cleansed.
•    Phenol is brushed onto the area and can remain from 30 minutes, up to two hours. The chemical is neutralized with water.
•    After allowing your skin to rest for an hour, a thick coat of petroleum jelly is smoothed over your skin, covering the crust which develops. The petroleum jelly must stay in place for up to two days. Sometimes the physician will opt to cover your skin with strips of adhesive tape with openings for your eyes and mouth, rather than the layer of petroleum jelly. Your doctor will choose this approach if you have severe wrinkling.

Managing your discomfort: Deep chemical facial peels will result in peeling, redness and discomfort for several days. Your doctor will provide painkillers to keep you comfortable. Although the swelling is likely to disappear in about two weeks, your skin may be red for up to three months.

One treatment with a deep chemical peel will produce long-lasting and dramatic results which can last up to 10 years.

Special considerations, risks and recovery

You should understand that all chemical peels will carry some risks and uncertainties. It is usually a very safe procedure when performed by qualified technicians and experienced plastic surgeons.

For people with certain skin types, there is a risk of developing a temporary or permanent color change in the skin. Birth control pills, getting pregnant, or a family history of brownish discoloration on the face may increase the possibility of developing abnormal pigmentation.

Inform your physician if you have a history of keloids (scar tissue overgrowth) or any unusual scarring tendencies.

Other considerations for each type of peel include:

Light chemical peel

You are likely to experience some redness, stinging, skin crusting and irritation from a light chemical peel. After repeated treatments these side effects will likely subside. Other risks include:
•    Hyper pigmentation. Your new skin may have too much pigment which will turn to brown blotches in sunlight. Avoid this by always using a high-factor sunscreen.
•    Infection

Medium chemical peel

When trichloroacetic acid is used in a medium chemical peel, you’ll experience some redness, stinging and skin crusting just like a light chemical peel. While these chemicals will not bleach your skin, you may see some color changes. You will be advised to avoid the sun for several months to protect that fresh new layer of skin. Other risks include:
•    Hyperpigmentation (when too much pigment occurs, causing brown blotches) may result even if you use sunscreen.
•    Redness, which occurs in everyone after the peel, may last longer than a few months for some people.
•    Permanent scarring is another, infrequent, risk.

Deep chemical peel

The chemical used for this kind of peel, phenol, can lighten the skin that is treated. Your skin tone may be a determining factor as to whether or not this is an appropriate treatment for you. With this kind of peel, your new skin often loses its ability to make pigment, therefore you will not be able to get a tan. You will always need to protect your skin from the sun. Phenol also can pose a special risk for people with heart disease. Be sure to tell your surgeon about any heart problems and include it in your medical history. Other risks include:
•    A red face which can last three to four months.
•    Cysts or white spots may appear with a deep peel and they can last up to several weeks.
•    Scarring is an infrequent risk.
•    Some areas of your skin may lose pigment permanently.
•    Hyperpigmentation (when too much pigment occurs, causing brown blotches) may result even if you use sunscreen.

A deep chemical peel requires that you have an adequate recovery time.

Now that you know what a facial chemical peel can do for your skin, it is important to understand that it cannot:
•    Treat deep facial lines
•    Tighten loose or sagging skin
•    Stimulate collagen production
•    Remove broken capillaries
•    Change pore size
•    Remove deep scars

What to expect from Chemical Peels at Lotus?

Although all chemical peels are designed to peel away superficial layers of skin, not all chemical products are created equal!  At Lotus we perform light to medium chemical peels using Environ and Glotherapeutics (which are also widely used by plastic surgeons and dermatologists).  We took a careful look at the products available to us in the market and we paid careful attention to the quality and purity of the chemicals involved to provide the desired effect while creating the least trauma to the skin.  Our peel formulations work at the cellular level without seeing any visible signs of peeling!  We are able to help you determine the depth of peeling you desire and fit it into your lifestyle and skin type.

We also work with our clients to make sure that they have realistic expectations of what a chemical peel can do for them before starting a series of treatments. The first goal is to accelerate the rate of cell turnover in the skin, which naturally slows down as we age resulting in dull, lifeless-looking skin.

The second goal is to limit the injury of the skin to only the desired layers. Achieving the balance between the first and second goal is difficult to accomplish and requires a fully trained and experienced esthetician for safety and efficacy. We maintain that a realistic expectation would be a lighter, brighter skin with an improved texture.

We usually perform our peels in a series of six visits, but this can vary from person to person and will depend on the strength of the peel chosen and the client’s desired outcome. Peels can be booked anywhere from two weeks to one year apart. Generally acneic skin types can be treated every two weeks, sun-damaged skin every three weeks and aging skin once a month to once a year.

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