What is a Chemical Skin Peel?
“Chemical peel” is a general classification for a number of chemical treatments used to exfoliate and rejuvenate the skin
What do chemical peels do?
The outer portion of the skin (epidermis) is composed of multiple layers of epidermal cells. These cells provide a barrier against the environment, protecting deeper, more delicate tissues, maintain an even internal temperature and also prevent against dehydration.
Epidermal cells are anchored together in two ways. Microscopic fibers called tonofilaments run between individual cells, helping anchor them together. An extracellular matrix surrounds each cell, acting as a sort of “glue” to further keep cells together. Over time, these cells are invisibly shed through the body’s natural means of exfoliation. Speeding up this process can instantly restore a more youthful glow to the skin and address other subtle signs of the aging process.
Whereas microdermabrasion breaks the tonofilaments through the act of physical exfoliation, chemical peels work to dissolve the “glue”. One of the most frequent questions is which procedure is better? The answer is that each works well, but neither provides a thorough exfoliation when used alone. That is why incorporating both treatments into a regimen can produce a much more satisfying result.
Type of Peels
There are a variety of different chemicals used for the purpose of rejuvenating the skin in what are called “chemical peels”. The main reason to select an active agent is based upon the desired depth of the chemical peel. If the skin concern is predominantly superficial, then a milder, less caustic ingredient is selected. If deeply placed conditions exist, then far stronger products with matching levels of potential complications may be necessary.
A. Very Superficial:
This really isn’t a true peel, more of an exfoliation. The most superficial layers of the stratum corneum (at the top of the epidermis) is removed or thinned during exfoliation. Most chemical peels have a preoperative regimen of using exfoliating agents such as Renova, Tazorac or a strong glycolic acid cream for 2-4 weeks prior to the actual procedure. This helps the chemical peeling agents penetrate more deeply and evenly. The use of these exfoliants also have the obvious beneficial properties of smoothing out thickened rough areas, helping self tanners go on more evenly and helping other skin rejuvenation products reach deeper tissues. Additionally, there has been good evidence that vitamin A exfoliants can help stimulate collagen deposition.
Superficial chemical peels remove skin through a portion or all of the epidermal layer. These are the “refreshing” forms of skin peels. They can also help with reducing the appearance of very mild blotchy skin discoloration, remnant acne discoloration and help cleanse the pores. This is the most common form of peel that you would find performed in a spa or by an aesthetician. And typically they would only utilize glycolic, AHA blends or BHA as the active ingredients. True peels with higher levels of glycolic acid (30% or higher) or those containing TCA, resorcinol or Jessner’s ideally would be performed in a medical setting.
Here’s the cut off point that distinguishes medically performed peels from those offered in a spa, by an aesthetician or facialist. A medium strength chemical peel allows the acid to penetrate through the epidermis, down into the upper most portion of the dermis known as the papillary dermis. A medium strength peel will be far more likely to be associated with complications, both temporary and permanent.
In addition to the pre-peel use of exfoliants, the use of a skin bleaching agent, such as 4% hydroquinone, and a broad-spectrum sunscreen a month prior to the procedure, may be added for more aggressive forms of these peels, or for patients who already suffer from some form of skin discoloration. Inflammation from this level peel may temporarily produce an increase in skin tone.
A variety of acid compounds can be used for a medium peel: Glycolic Acid 70%+ (non-buffered), TCA 35-70%, combination peels such as solid CO2, (also called dry ice), followed by medium strength TCA, and glycolic acid followed by TCA.
This peel goes through the epidermis, papillary dermis and into the deeper portion of the dermis known as the reticular dermis. These peels are not a simple procedure. The down time from this procedure is obviously the longest, 2-3 weeks is generally required before you want to be seen in public. Due to the depth of the peel leaving deeper tissue exposed, there is an increase in photosensitivity to the sun. Sunblocks which offer UVA, UVB and visible light protection such as Total Block are ideal.
Examples of ingredients used in deep peels include: Baker’s phenol alone or under occlusion by tape. The tape drives the phenol deeper into the skin.
Realistic Goals Of Chemical Peels
- Chemical peels can correct actinic (sun) damage.
- They can reduce mild scarring.
- You can experience a reduction or eradication of your wrinkles.
- Improvement of dark skin discoloration is possible.
- Chemical peels can remove excessive / stubborn blackheads.
- The peel may temporarily reduce excessive skin oils.
Unrealistic Goals Of Chemical Peels
- It cannot remove or reduce the appearance of blood vessels on the skin.
- It is impossible to truly change pore diameter. However, by removing blackheads, the pores may actually appear less pronounced after treatment.
- This is not a procedure to get rid of keloidal types of scars.
- Chemical peels are not a facelift.
This is typically not appropriate for improving dark skin discoloration in people of color (Asians, African Americans, Caucasians of Mediterranean extraction, Hispanics, etc.)
Chemical peels can truly retexturize the skin, restore radiance and a youthful appearance. Whether looking for magic or simply the ideal treatment to maximize your rejuvenation routine, chemical peels are undoubtedly here to stay.
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