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Chemical Peels Tips

5 Benefits Of Chemical Peels - Know Them Now!

Dr. Radhika Rachamreddy 86% (33 ratings)
MD - Dermatology , Venereology & Leprosy, MBBS
Dermatologist, Secunderabad
5 Benefits Of Chemical Peels - Know Them Now!

Our skin requires proper care from time to time, and therefore it is essential to implement the right steps at the right time. Peels are useful assets for polishing and bringing life to our skin. In today’s age, it becomes difficult to maintain the tone and texture of the skin. So, peels help in making this successful in the best ways.

Here are some of the notable and effective advantages of peel treatment.

  1. Cleansing your skin: Are you tired of dull skin? Then it’s time to opt for a peel treatment. There are different types of peel treatment which lead to excellent results for the skin tone and texture. It helps in cleansing the skin especially the facial skin. It works deep through the facial skin successfully thus leading to much improved and clean skin.
  2. Works well for acne: Acne is one of the most commonly occurring skin problems in the recent times. It leads to a severe change in the looks of the facial skin. Acne results in deposition of the dirt in the clogged pores when not treated for an extended period. Various peel treatments help in bringing out the dirt from the pores, thus clearing the areas affected by acne.
  3. Radiant skin: Peel treatments are useful in creating radiant skin just after the procedure. If you are struggling with bringing that glow to your facial skin, then peel treatments work best for almost every type of skin. After the peel treatment, you will be able to see the change in your skin with grace and appreciate the results immediately.
  4. Revive your skin: Daily exposure to sun damages the sensitive skin after a certain period. This leads to the necessity to bring back that tone and texture of your skin. Peel treatments are effective in reviving the quality of the skin. So, if you are planning to opt for some new type of skin treatment in the sooner time then make sure that you try peel treatments for reviving back your precious facial skin.
  5. Can cure wrinkled skin: With age, all of us tend to get wrinkles, and these are most prominent on the facial part of the skin. In order to prevent any adverse effects of aging on the looks of the individual, wrinkles can be cured with the help of peel treatment. So, opt for the best peel treatments to get rid of the wrinkled skin.

Thus, if you are looking for some of the fine solutions for improvement of the facial skin then make sure that you choose for the peel treatments. These are some of the advantageous features of the peel treatments which fetch the desired results for the skin.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3353 people found this helpful

How a Facial Chemical Peel Can Help You Look Younger

Dr. Anup Nangia 86% (11 ratings)
MD, MBBS
Dermatologist, Gurgaon
How a Facial Chemical Peel Can Help You Look Younger

Do you ever wish you could start all over and take better care of your skin? A chemical peel could give you that chance. Peels can dramatically reduce lines, wrinkles, acne scars, dark spots, and roughness caused by years of sun.

A chemical peel is a solution applied to the face to remove the outermost layer or layers of skin. It's a technique used to improve the appearance of the skin on the face, neck or hands. A chemical solution is applied to the skin that causes it to exfoliate and eventually peel off. The new skin that grows in its place is softer, smoother and has fewer imperfections. The new skin is also temporarily more sensitive to the sun.

There are three basic types of chemical peels:

Superficial or Lunchtime Peel: Alpha-hydroxy acid or another mild acid is used to penetrate only the outer layer of skin to gently exfoliate it. The treatment is used to improve the appearance of mild skin discoloration and rough skin as well as to refresh the face, neck, chest or hands.

Medium Peel: Glycolic or trichloroacetic acid is applied to penetrate the outer and middle layers of skin to remove damaged skin cells. The treatment is used to improve age spots, fine lines and wrinkles, freckles and moderate skin discoloration.

Deep Peel: Trichloroacetic acid or phenol is applied to deeply penetrate the middle layer of skin to remove damaged skin cells. The treatment removes moderate lines, age spots, freckles and shallow scars. A thorough evaluation by a dermatologic surgeon is imperative before embarking upon a chemical peel.

When is a chemical peel appropriate?

Chemical peels are used to treat a number of conditions including:

  1. Pigmentation on face or body
  2. Tanning
  3. Dyschromias
  4. Fine Wrinkles
  5. Acne
  6. Acne marks and scars
  7. Dullness
  8. Aging skin
  9. Crow's feet
  10. Sagging skin

Who should not opt for chemical peels?

Generally, light-haired and fair skinned people are the best candidates for chemical peel. The procedure is not recommended for individuals with infections, active skin disease, cut or broken skin, or sunburns. Other contraindications include patients who are:

  1. Nursing or pregnant.
  2. Have taken Accutane in last six months.
  3. Have psoriasis, eczema, dermatitis or rosacea.

Possible complications

Temporary change in skin color, particularly for women on birth control pills, who subsequently become pregnant or have a history of brownish facial discoloration.

Changes are transient and easy to take care of if taken care properly.

  1. Scarring
  2. Reactivation of cold sores
  3. A variety of chemical treatments can be used to exfoliate and rejuvenate the skin.

Depending on the depth of treatment required, your surgeon may choose one of the following peels:

  1. Alpha-hydroxy acid peel (AHA)
  2. Trichloroacetic acid peel (TCA)
  3. Phenol peel
  4. Croton oil peel

Aftercare and recovery

Your dermatologist will discuss how long it will be before you can return to your normal level of activity and work. After surgery, you and your caregiver will receive detailed instructions about your post-surgical care, including information about:

  1. Normal symptoms you will experience
  2. Potential signs of complications

In case you have a concern or query you can always consult an expert & get answers to your questions!

2595 people found this helpful

Chemical Peels: Conditions They Treat - A Warning!

Dr. Deepak Kothari 87% (1342 ratings)
M Ch. Plastic Surgery, MS - General Surgery, MBBS
Cosmetic/Plastic Surgeon, Durg
Chemical Peels: Conditions They Treat - A Warning!

A chemical peel is a form of skin treatment where an acid solution is used for the removal of damaged outer layers of the skin. Alpha hydroxyl acids and trichloroacetic acids are used in chemical peels. Phenol is also applied to the skin. Chemical peels aid in improving the skin’s appearance. The chemical acid solution makes the skin peel off. The new skin is much smoother and is less wrinkled.

Chemical peels are of several types:

  1. Superficial peels: In this type, alpha hydroxyl acid is used to penetrate the outer layer of the skin and exfoliates it gently. Superficial peels are used for improving the appearance of mild skin discoloration and rough skin.
  2. Medium peels: In medium peels, trichloroacetic acid is used for penetrating into the middle layers of the skin to remove damaged cells. Improvement in age spots, lines and wrinkles can be done using medium peels. Rough skin is smoothened.
  3. Deep peels: In the case of deep peels, trichloroacetic acid or phenol is used for penetrating the middle layers of the skin to remove damaged cells. Skin appearance is improved drastically.

Conditions treated with chemical peels
Chemical peels are used for the treatment of certain conditions. They can be used to treat the following conditions:

  1. Reduction in fine lines which occur under the eyes or around the mouth.
  2. Treatment of wrinkles which are caused due to sun damage or old age. This is done using chemical peels.
  3. Chemical peels help in improving the appearance of mild scars on the skin surface.
  4. Several types of acne are cured by chemical peels.
  5. Chemical peels help in reducing age spots, freckles and dark patches known as melasma, which occur because of pregnancy or because of taking birth control pills.
  6. The overall look and feel of the skin are improved after using chemical peels.

After a chemical peel treatment is done, the skin becomes extra sensitive to the sun. Hence, it is recommended to use a sunscreen lotion, which also protects against UVA and UVB light rays.

Are chemical peels safe?
Chemical peels are very effective and provide perfect rejuvenation to the skin. However, as far as safety is concerned, you should know that chemical peels have some side effects.

  • They may result in a temporary or permanent change in the skin color, especially in women who take birth control pills.
  • Scarring can occur and cold sores can get reactivated.

Chemical peels involve the use of chemicals or acid to improve the appearance and condition of the skin. This procedure is an effective one and satisfactory results are obtained.

8 people found this helpful

Chemical Peels - Know Its Benefits!

Dr. Govind Suresh Mittal 91% (216 ratings)
MBBS, MD - Dermatology , Venereology & Leprosy, FRGUHS ? Dermatosurgery
Dermatologist, Bangalore
Chemical Peels - Know Its Benefits!

Not many of us like the image that stares back at us in the mirror. We all would love to have those wrinkles gone, the dull appearance improved, the fine lines disappear, the spots (brown, black, gray, whatever) just vanish. However, they don't. They are all real, but the good news is that they are not here to stay. There are improved methods of producing younger, glowing skin and chemical peels is one of them.

In 2011, it was rated as one of the top 5 minimally invasive procedure with about a million people in the USA going for it to revitalize their skin.

What do they do: You could be of any age or gender, looking for a youthful, glowing skin. Chemical peels definitely are an option for you. The skin is the most exposed part and is prone to damage from sun, pollution and dust. These leave uneven tone, dull skin, wrinkles and spots. In all these cases, a chemical peel can produce a marked improvement. A chemical preparation (solution) is applied on the skin which dissolves and removes the upper layers of the skin and allows for new skin to form. This is younger looking, softer, and smoother with fewer imperfections. The strength of the solution and the duration of application will depend completely on the patient's presenting situation and goals.

Benefits of chemical peels:

  1. Reduces fine lines and wrinkles: Unlike creams and serums and lotions, these offer a much faster way to achieving smoother, clearer skin.
  2. Improves skin tone: The rough, top layers that were exposed to sun are removed, producing skin with improved texture.
  3. Promotes collagen production: The skin is made to produce more collagen, which results in skin that has better elasticity and glow.
  4. Eliminates scars from acne: The damage done by acne through scars left behind can be 'peeled' off with a chemical peel.
  5. Improves damage from sun exposure: Exposure to sun is most harmful to skin, and chemical peels help reduce this damage by removing off the top layers of skin that is affected by constant exposure to sun. 
  6. Economical: Compared to the expensive creams and lotions that make huge promises, chemical peels are definitely cost effective.
  7. Boosts self-esteem: A smoother, glowing skin that is free of spots, wrinkles, and fine lines is sure to improve the person's confidence.

Following are the Indications for Chemical Peels-

  • Treatment and Prevention of Acne
  • Pigmentation
  • Anti-aging
  • Sun-induced Pigmentation
  • Tanning

Chemical peels can be done on face, back, arms and legs, feet. elbows and knees, knuckles to even out pigmentation and smoothen the skin. Post care precautions are simple to follow-up avoidance of direct sunlight for first 4-5 days, strict application of sunscreen and keeping skin hydrated regularly.

A detailed discussion with your doctor about expectations is definitely the first step if you are thinking of going for a chemical peel. Consult an expert & get answers to your questions!

3872 people found this helpful

Pathophysiology of Chemical Peels!

Dr. Vivek Mehta 92% (104 ratings)
Diploma In Trichology - Cosmetology, PG Diploma In Clinical Cosmetology (PGDCC), Diploma In Aesthetic Mesotherapy, PG Diploma In Clinical Research
Aesthetic Medicine Specialist, Ahmedabad
Pathophysiology of Chemical Peels!

Chemical peeling is a medical procedure which includes application of a chemical agent to the skin, causing controlled destruction of the epidermis, with or without the dermis, leading to exfoliation and removal of superficial lesions, followed by regeneration of new epidermal and dermal tissues. In simple words chemical peeling or chemical rejuvenation is procedure where a chemical agent or combination of agents of defined strength are applied the skin causing a controlled destruction of layers of the skin. This is followed by regeneration and remodeling leading to improvement of texture and surface abnormalities. It is a safe, effective and affordable option for improving skin ageing and imperfections.

Skin is considered the largest organ of the body and has many different functions. The skin is divided in two main regions, the epidermis and the dermis. The dermis is attached to an underlying hypodermis also called subcutaneous connective tissue.

Epidermis: It is the most superficial layer of the skin. The first barrier of protection from the invasion of foreign substances. The epidermis is divided into four layers – stratum corneum, stratum granulosum, stratum spinosum and stratum basalis(basal layer).

Dermis: It is composed of fibroblasts which are responsible for secreting collagen, elastin and ground substance that gives support and elasticity to skin. It supplies the epidermis with nutrients and has its role in thermoregulation. The dermis is subdivided into two zones, upper papillary and lower reticular layer.

Classification of peels according to histological depth

  1. Very superficial peel – Exfoliation of the stratum cormeum, without any epidermal necrosis.
  2. Superficial peel – Destruction of the full epidermis, up to the basal layer
  3. Medium peel – Destruction of the epidermis, papillary dermis and upto the upper one third of the reticular dermis.
  4. Deep peel – Necrosis of the entire epidermis and papillary dermis with inflammation extending to the mid reticular dermis.

Classification of chemical peeling agents

Very superficial Peel:

  • Glycolic Acid 30-50% applied for 1-2 minutes
  • TCA* 10% applied as one coat
  • Jessner’s solution 1-3 coats

Superficial Peel:

  • Glycolic acid 50-70% applied for 2-10 mins (depending on the type and thickness of the skin)
  • TCA 10-30%
  • Jessner’s solution 4-10 coats
  • Very superficial and superficial Peels are the mildest form and often called, “the lunchtime peel.” These peels break down corneocyte adhesion, causing dead skin cells to shed off to reveal the fresh, healthy underlying skin. These peels address minor skin irregularities like discoloration, acne, surface scarring, fine lines, and sun spots.

Medium Peel:

  • Glycolic acid 70% applied for 3-30 mins (depending on the type and thickness of the skin)
  • TCA 35-50%
  • Glycolic Acid 70% plus TCA 35%
  • Jessner’s solution plus TCA 35%

Deep Peel:

  • Phenol 88%
  • Baker Gordon phenol formula
  • Medium and deep peels increase the collagen and glycosaminoglycans content, cause collagen remodeling and increase dermal thickness to improve the clinical appearance of the skin with reduced wrinkles, skin tightening and pigmentary dyschromia.

Reason behind chemical peeling:

  • Wound healing process is an important reason for rejuvenation. The phases of wound healing after chemical exfoliation are apparent:
  • Inflammatory phase (1-5 days) – This phase is evident after peeling as erythma and swelling on the skin
  • Proliferative phase (2-21 days) – In superficial peels, the basement membrane is intact, hence normal epidermis is restored in 2 to 3 days. In medium to deep peels, wound is below basement membrane and re-epithelialization takes time.
  • Remodeling phase (3 weeks to 2 years) – collagen remodeling is the main reason that chemical peels cause rejuvenation and reduce wrinkles.

Indications for peels:

1. Pigmentary disorders

  • Resistant melasma
  • Pigmented cosmetic dermatitis
  • Freckles
  • Lentigines
  • Post inflammatory hyperpigmentation

2. Acne

  • Comedonal acne
  • Post acne scars
  • Acne cosmetic
  • Acne excoriee

3. Cosmetic

  • Photoageing
  • Fine wrinkling
  • Skin glow and rejuvenation
  • Oily to rough skin
  • Actinic keratosis

4. Miscellaneous

  • Keratosis pilaris
  • Macular amyloidosis
  • Dilated pores
  • Seborrheic keratoses

Contraindications

  • Active bacterial, viral and fungal infection and open wounds
  • Oral isotretinoin use within the past three months
  • Pregnancy and breastfeeding
  • History of keloid formation
  • History of taking oral contraceptive and photosensitive drugs
  • Unrealistic patient expectation
  • Uncooperative patient, eg. Patient is careless about sun exposure or application of medicine
  • For medium depth and deep peels, history of abnormal scarring, atrophic skin and isotretinoin use in the last six months.

How to choose a patient:

A patient should be chosen depending upon 4P’s:

P – Pathology

P – Point of depth required

P – Patients skin

P – Previous peeling agents

Newer peels:

Many peels like mandelic acid, kojic acid, lactic acid, citric acid and many more have been introduced in the market which are also available in combination. These peels are not only more skin friendly but also more patient friendly. They have buffering agents like licorice extract and willow bark extract to minimize irritation to skin and antioxidants to infuse the skin with restorative nutrients. The change in the skin often occurs at cellular level and are not apparent to the naked hence making it more popular amongst busy patients who are seeking effective treatments quickly with little or no downtime.

Benefits of chemical peels:

The skin becomes noticeably smoother and rejuvenated.

  • It reduces pigmentation, improves dull and uneven skin tone, reduces signs of photoagaeing, acne and enlarged pores.
  • Removes dead and damaged skin cells and improves skin texture
  • Helps in removal of tan
  • Skin becomes brighter and more vivid because chemical peels not only cause re-epithelialization of the epidermis but also collagen remodeling.

Pre peel and post peel precautions:

  • Patient has to be motivated enough to get multiple sittings of the peel ( 4-8, depending on the indication and type of peel) every 2-3 weekly to get the desired result.
  • Patient should not wax, bleach, scrub, shave(the same day) or get any other aesthetic procedure like microdermabrasion, ipl, derma-roller one day before the chemical peel procedure. A gap of at least 7 days before and after the peel should be maintained.
  • Patient should use a mild soap/ non soap cleanser after the peel
  • Broad spectrum sunscreen and moisturizer should be used liberally, at least 2-3 times a day and sun exposure should be avoided.
  • Patient should be strictly prohibited from scratching, picking or scrubbing the skin.

Take home message:

Chemical peeling is a simple office procedure for the treatment of acne, pigmentation, skin rejuvenation and photo ageing. These are not one time procedures but require 6-8 sessions and maintenance peels to achieve maximum improvement and prevent recurrences. The newer peels are safer and effective. If you wish to discuss about any specific problem, you can consult a aesthetic-medicine specialist.

2771 people found this helpful

Know Everything About Chemical Peeling!

Dr. Jolly Shah 91% (1073 ratings)
MBBS, DNB (Dermatology)
Dermatologist, Mumbai
Know Everything About Chemical Peeling!

Chemical peeling is a skin treatment which involves the peeling of the old skin and its replacement by a new layer of skin. It is generally done on the face, neck or arms and the process involves the application of a chemical solution over the skin in order to improve the overall appearance. The chemical peeling process is generally used to treat common skin disorders like - acne, wrinkles, scars, and such others. 

Common uses 

The chemical peeling process is mostly used to treat skin ailments in general. Some of the most common uses of a chemical peeling are as follows: 

Reducing fine lines on the face 

  1. Curing and preventing certain types of acne 
  2. Healing damages caused due to sun burns 
  3. Reducing age spots, dark patches and freckles on the face 
  4. Improving the softness and overall quality of skin 

What should you keep in mind before opting for a chemical peel

A chemical peel is a huge step towards the treatment of your skin, thus, you should always consult a dermatologist before actually opting for a chemical peeling process. It is a highly recommended measure because chemical peeling in some cases might not suit your skin. So, a complete skin diagnosis by a doctor helps to minimize the possible side effects related to the chemical peeling process. In general, this process is preferred in cases of people having a fair toned skin accompanied by a light hair growth. Before you get a chemical peel done, your doctor might just examine your medical history in order to stop certain medications that you are taking currently. Additionally, the doctor might also prescribe you certain medications, such as Retin-A, Renova, or glycolic acid to boost up the peeling process. The doctor may also prescribe antibiotics or antiviral drugs to ensure that the process is not having any side effects. 

How is it actually done? 

Chemical peels are usually done after a proper cleansing of the skin and then choosing the appropriate type of peel to suit your skin type. After cleansing of the skin the doctor usually applies a chemical solution such as glycolic acid, trichloroacetic acid, salicylic acid, lactic acid, or carbolic acid (phenol) - to small areas of your skin. The peeling process usually lasts for a few minutes and the chemical helps in making controlled wounds on the skin in order to damage the old skin and allow the new skin to grow.

5603 people found this helpful

Chemical Peel - What All Does It Treat?

Dr. Naval Patel 93% (14038 ratings)
MBBS, Diploma In Dermatology & Venerology & Leprosy (DDVL)
Dermatologist, Raigarh
Chemical Peel - What All Does It Treat?

Chemical peels are a skin care procedure that can be used on the face, neck, and even the hands in order to remove and prevent fine lines. These peels are also helpful in treating age spots and blemishes. These peels can be a part of one’s regular skin care regimen in order to improve the overall appearance of the skin.

Read on to know more about chemical peels and the various types available.

The procedure: Chemical peels usually follow a specific procedure where a chemical solution is applied to the skin which makes upper layer to peel off. The new skin that emerges is usually free of wrinkles and smoother as compared to the old skin.

What all does it treat: There are a variety of skin problems that can be treated by chemical peels, including reduction of age spots, dark patches, and other scars. It can also treat severe forms of acne even as it prevents fine lines and wrinkles that have been caused due to constant sun exposure and aging. Also, it reduces the fine lines that form under the eyes and around the mouth. This treatment can also help in treating freckles and dark patches that may be caused due to hormonal changes that happen during pregnancy and also due to birth control pills. It basically gives you smooth and supple skin.

Light peels: This is one of the most commonly used types of chemical peels. These include lactic, salicylic acid and glycolic peels. This type of chemical peel is a mild one that makes the pores smaller and treats surface problems like acne, blackheads, as well as other skin imperfections like light skin discolouration and freckles. This kind of peel is quick and easy to administer, and can help in stimulating collagen production to keep the skin supple. One will typically need about four sittings in a span of two to four weeks.

Medium depth chemical peels: These are stronger peels that show more dramatic results. They may cause visible flaking and peeling after the procedure has been carried out. These peels are usually used to fix the problems that come about due to sun damage. Also, these peels can decrease the appearance of fine lines, wrinkles and large pores. These peels can also repair the patches that appear due to pigmentation problems. One will need a session at least once every three months to maintain the results.

Deep chemical peels: These peels have more risk and deeper complications. They are used for very severe cases that include permanent hyperpigmentation which brings about darkening of the skin. Also, it can fix lightening of the skin due to hypopigmentation. It can also be used for the removal of scars. If you wish to discuss about any specific problem, you can consult a dermatologist.

2717 people found this helpful

Chemical Peel and the Pathology Behind It

Dr. Anupriya 86% (27 ratings)
Diploma in Dermatology, MD, MBBS
Dermatologist, Delhi
Chemical Peel and the Pathology Behind It

Chemical peeling is a medical procedure which includes application of a chemical agent to the skin, causing controlled destruction of the epidermis, with or without the dermis, leading to exfoliation and removal of superficial lesions, followed by regeneration of new epidermal and dermal tissues. In simple words chemical peeling or chemical rejuvenation is procedure where a chemical agent or combination of agents of defined strength are applied the skin causing a controlled destruction of layers of the skin. This is followed by regeneration and remodeling leading to improvement of texture and surface abnormalities. It is a safe, effective and affordable option for improving skin ageing and imperfections.

Skin is considered the largest organ of the body and has many different functions. The skin is divided in two main regions, the epidermis and the dermis. The dermis is attached to an underlying hypodermis also called subcutaneous connective tissue.

Epidermis: It is the most superficial layer of the skin. The first barrier of protection from the invasion of foreign substances. The epidermis is divided into four layers – stratum corneum, stratum granulosum, stratum spinosum and stratum basalis(basal layer).

Dermis: It is composed of fibroblasts which are responsible for secreting collagen, elastin and ground substance that gives support and elasticity to skin. It supplies the epidermis with nutrients and has its role in thermoregulation. The dermis is subdivided into two zones, upper papillary and lower reticular layer.

Classification of peels according to histological depth

  1. Very superficial peel – Exfoliation of the stratum cormeum, without any epidermal necrosis.
  2. Superficial peel – Destruction of the full epidermis, up to the basal layer
  3. Medium peel – Destruction of the epidermis, papillary dermis and upto the upper one third of the reticular dermis.
  4. Deep peel – Necrosis of the entire epidermis and papillary dermis with inflammation extending to the mid reticular dermis.

Classification of chemical peeling agents

Very superficial Peel:

  • Glycolic Acid 30-50% applied for 1-2 minutes
  • TCA* 10% applied as one coat
  • Jessner’s solution 1-3 coats

Superficial Peel:

  • Glycolic acid 50-70% applied for 2-10 mins (depending on the type and thickness of the skin)
  • TCA 10-30%
  • Jessner’s solution 4-10 coats
  • Very superficial and superficial Peels are the mildest form and often called, “the lunchtime peel.” These peels break down corneocyte adhesion, causing dead skin cells to shed off to reveal the fresh, healthy underlying skin. These peels address minor skin irregularities like discoloration, acne, surface scarring, fine lines, and sun spots.

Medium Peel:

  • Glycolic acid 70% applied for 3-30 mins (depending on the type and thickness of the skin)
  • TCA 35-50%
  • Glycolic Acid 70% plus TCA 35%
  • Jessner’s solution plus TCA 35%

Deep Peel:

  • Phenol 88%
  • Baker Gordon phenol formula
  • Medium and deep peels increase the collagen and glycosaminoglycans content, cause collagen remodeling and increase dermal thickness to improve the clinical appearance of the skin with reduced wrinkles, skin tightening and pigmentary dyschromia.

Reason behind chemical peeling:

  • Wound healing process is an important reason for rejuvenation. The phases of wound healing after chemical exfoliation are apparent:
  • Inflammatory phase (1-5 days) – This phase is evident after peeling as erythma and swelling on the skin
  • Proliferative phase (2-21 days) – In superficial peels, the basement membrane is intact, hence normal epidermis is restored in 2 to 3 days. In medium to deep peels, wound is below basement membrane and re-epithelialization takes time.
  • Remodeling phase (3 weeks to 2 years) – collagen remodeling is the main reason that chemical peels cause rejuvenation and reduce wrinkles.

Indications for peels:

1. Pigmentary disorders

  • Resistant melasma
  • Pigmented cosmetic dermatitis
  • Freckles
  • Lentigines
  • Post inflammatory hyperpigmentation

2. Acne

  • Comedonal acne
  • Post acne scars
  • Acne cosmetic
  • Acne excoriee

3. Cosmetic

  • Photoageing
  • Fine wrinkling
  • Skin glow and rejuvenation
  • Oily to rough skin
  • Actinic keratosis

4. Miscellaneous

  • Keratosis pilaris
  • Macular amyloidosis
  • Dilated pores
  • Seborrheic keratoses

Contraindications

  • Active bacterial, viral and fungal infection and open wounds
  • Oral isotretinoin use within the past three months
  • Pregnancy and breast feeding
  • History of keloid formation
  • History of taking oral contraceptive and photosensitive drugs
  • Unrealistic patient expectation
  • Uncooperative patient, eg. Patient is careless about sun exposure or application of medicine
  • For medium depth and deep peels, history of abnormal scarring, atrophic skin and isotretinoin use in the last six months.

How to choose a patient:

A patient should be chosen depending upon 4P’s:

P – Pathology

P – Point of depth required

P – Patients skin

P – Previous peeling agents

Newer peels:

Many peels like mandelic acid, kojic acid, lactic acid, citric acid and many more have been introduced in the market which are also available in combination. These peels are not only more skin friendly but also more patient friendly. They have buffering agents like licorice extract and willow bark extract to minimize irritation to skin and antioxidants to infuse the skin with restorative nutrients. The change in the skin often occurs at cellular level and are not apparent to the naked hence making it more popular amongst busy patients who are seeking effective treatments quickly with little or no downtime.

Benefits of chemical peels:

The skin becomes noticeably smoother and rejuvenated.

  • It reduces pigmentation, improves dull and uneven skin tone, reduces signs of photoagaeing, acne and enlarged pores.
  • Removes dead and damaged skin cells and improves skin texture
  • Helps in removal of tan
  • Skin becomes brighter and more vivid because chemical peels not only cause re-epithelialization of the epidermis but also collagen remodeling.

Pre peel and post peel precautions:

  • Patient has to be motivated enough to get multiple sittings of the peel ( 4-8, depending on the indication and type of peel) every 2-3 weekly to get the desired result.
  • Patient should not wax, bleach, scrub, shave(the same day) or get any other aesthetic procedure like microdermabrasion, ipl, derma-roller one day before the chemical peel procedure. A gap of at least 7 days before and after the peel should be maintained.
  • Patient should use a mild soap/ non soap cleanser after the peel
  • Broad spectrum sunscreen and moisturizer should be used liberally, at least 2-3 times a day and sun exposure should be avoided.
  • Patient should be strictly prohibited from scratching, picking or scrubbing the skin.

Take home message:

Chemical peeling is a simple office procedure for the treatment of acne, pigmentation, skin rejuvenation and photo ageing. These are not one time procedures but require 6-8 sessions and maintenance peels to achieve maximum improvement and prevent recurrences. The newer peels are safer and effective. If you wish to discuss about any specific problem, you can consult a Dermatologist.

4468 people found this helpful
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