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Chemical Peels

Author: Dr Naomi / 28 Oct 2015

WHAT ARE CHEMICAL PEELS?

A chemical peel involves a chemical solution being applied to the skin causing the dead skin to slough off and eventually peel. The regenerated and resurfaced skin is smoother, with better texture and less lines than the old skin. A chemical peel works by inducing a controlled wound to the skin, removing the top layers of the skin causing collagen remodelling. Peels can be used to treat sun damage, wrinkles fine lines, texture, skin pigmentation and the general appearance of the skin.

Chemical peels range from the least invasive to the most invasive, this relates to their strength, which will determine how deep they will peel. The least invasive peels also have the least risks and complications, but the most invasive peels, have the greatest potential to improve

TYPES OF CHEMICAL PEELS

AHA Peels:

Glycolic and lactic acid peels.

These are great for exfoliation and removing the top layers of skin and stimulating collagen.

BHA Peel

Salicylic Acid is the usual ingredient in a BHA peel. These peels are best for acne prone and oilier skin types, because they are oil soluble and penetrate well in these skin types.

Tretinoin /retinoic acid peels

Tretinoin is the active ingredient in Retin-A and Steiva A. It is a retinoid, which is related to vitamin A.

These peels are suitable for those with sun damage who want younger skin

Jessner’s Peel

This is a combination of AHA and BHA and resorcinol. Great for acne and oily skin

HOW TO CHOOSE WHICH PEEL TO SUIT ME?

The most important questions that need to be asked?

What do I want to improve on my skin?

How much downtime can I tolerate?

What are my risks?

Do I want to peel?

If you are trying to improve oily, acne-prone skin, then the most suitable peels will be the BHA (salicylic acid) and Jessner (which includes a BHA) peels.  Salicylic acid peels and Jessner’s peels (which also contains salicylic acid) are oil soluble, so they are able to penetrate deeper into pores and remove oil and sebum and are also anti-inflammatory (which is very important when treating the inflammation associated with acne).

If you have darker skin then you will have to be wary of deeper treatments as you are at higher risk of PIH (Post Inflammatory Pigmentation)

If you are trying to improve pigmentation or sun damage, TCA peels, alpha-hydroxy acid peels, and Jessner’s peels are suitable.

If you are aiming for exfoliation, AHA and BHA are suitable

If you don’t want to peel a lighter glycolic acid peel might be more suitable.

If you want more significant results with wrinkles then microlaser peel / laser resurfacing may be required

CAN OTHER PARTS OF THE BODY BE PEELED?

Yes, the neck, decoletage, back and arms may be peeled to improve their texture. However, only the most superficial peels are suitable for non-face areas.

PREPPING SKIN FOR PEEL OR SERIES OF PEELS

It is advised to prep for a peel or series of peels. If the patient has a history of or is at risk of Post-Inflammatory Pigmentation (PIH), or a history or melasma/chloasma, then prepping with a prescription skin lightening cream/gel combined with Vitamin A is advised.

The patient will be advised with what to prep the skin during the initial consultation. It may include AHA, salicylic acid, treinoin or other retinoid.

The doctor /therapist will discuss this.

AFTERCARE POST PEEL

Sun avoidance is always advised.

Patients with PIH will have a strict protocol for after care to reduce the incidence or pigmentation after a peel

The doctor/therapist will advise re aftercare.

WHAT WON”T A PEEL HELP WITH

Deep wrinkles, folds and capillaries

DOWNTIME REQUIRED

Some peels have zero downtime (light glycolic) , and others take up to 7 days to peel. It is advised that the patient has the treatment 2 weeks prior to any important social engagement

RISKS / SIDE EFFECTS OF CHEMICAL PEELS

Post Inflammatory Pigmentation (PIH):More likely to occur in those with darker skin tones

Redness: Will often occur in those patients who have a tendency towards redness, can be prolonged

Acne: Emolients used after the peel on the skin can trigger a breakout. May need to be treated with antibiotics

Milia: Very small, superfical cysts may occur after the peel. These are easily treated

Herpes infection: this needs to be treated with anti viral medication asap to avoid scarring

Bacterial Infection: Uncommon, requires antibiotics. Could lead to scarring

Scarring or loss of pigment or textural changes: Very uncommon, mostly associated with deeper peels

Allergies: Uncommon, can occur with Jessner’s peel

Itchiness:

Demarcation lines: can occur where the peeled skin meets the unpeeled skin. This is usually only associated with deeper peels

Facial capillaries: Especially in those who are prone to them

PRECAUTIONS

* No peels while pregnant and breastfeeding

* With a history of herpes, antiviral medication may be prescribed preventatively

* History of Roaccutane use: No peels until 6 months after the roaccutane was stopped

* Immunocompromised (eg HIV) patients should avoid chemical peels

* Recent browlift / facelift: No peels until 6 months after surgery

* Patients with a history of keloid scarring should avoid anything deeper than very superficial peels.

* AHA PEEL (ALPHA HYDROXY ACID PEEL)

eg GP40 peel

The ASAP GP 40 Peel is 40% Glycolic acid (fruit acid),

Who is it for?

Anyone wishing to give their skin a brighter glow and a boost of hydration.  This peel will benefit people with acne prone, dry, scaly or pigmented skin.  It will improve texture of the skin and stimulates collagen renewal.   It contains other active ingredients which assist in skin lightening and hydration.

What doesn’t it do?

The GP 40 peel will not help with deep wrinkles, deep acne scarring or broken capillaries.

Is it suitable for everyone?

No. It is not recommended for anyone with active dermatitis, impetigo, recent facial surgery or very dark skin types.

Will I peel?

Visible peeling is uncommon with this type of peel.

Treatment protocol

A course of 4 treatments at 2 weekly intervals.

How to prep skin?

It is beneficial to prep the skin for 2 weeks prior to treatment with AHA or ASAP clearskin gel for optimal results

Aftercare?

Sunscreen 30+ daily. Reapply as often as necessary.

This is a gentle yet effective treatment  with no peeling involved.

JESSNER PEEL

ASAP Reveal Peel

Key Ingredients of the Reveal Peel

* Glycolic Acid: Great exfoliator, revealing new regenerated and resurfaced skin underneath

* Lactic Acid: Great for fine lines, pigmentation and sun spots

* Citric Acid: For skin brightening

* Salicylic Acid: A great exfoliator

Who is it for?

Those who want to peel! It can be used to slough off the outer layer of dead skin cells revealing smoother and younger and fresher skin.

It is for those who need exfoliation, and want to treat fine lines, pigmentation and sun spots.

What happens during treatment?

Upon application you will normally experience a strong tingling sensation and the skin may appear pink and tight immediately after application. The skin will visibly begin to flake 2-5 days after your treatment removing uneven, sun damaged dead skin cells, stimulating collagen, while smoothing and softening your skin.

Will I peel?

Yes. Peeling should occur at between 3-7 days

Who can’t use it?

Those allergic to aspirin

Treatment protocol

4 treatments, one month apart

LACTIC ACID PEEL (AHA)

We use Rationale lactic acid peels in a range of percentages

BHA PEEL

We use a Rationale BHA peels in a range of percentages

TCA PEEL

We use Rationale TCA peels in a range of percentages

MICROLASER PEEL

At Dr Naomi, we only perform superficial peels. As a more effective, predictable and safe substitute to medium and deep level peels, we use laser resurfacing.

This is the most precise form of “peel”, as there is no guesswork at all about the depth of the peel. The skin is removed approximately 10 microns at a time to the desired depth. The way we choose the desired depth takes into account the allowed downtime of the patient. The laser also adds a heat component to the removal of the top layers, which makes it a more effective “peel” due to increased collagen remodelling.

CHEMICAL PEEL PRICING

GP40 Peel

Reveal Peel

Lactic Acid

BHA

TCA

Nanolaser peel 4-8 microns $600

Microlaser peel 10 microns $800

Microlaser peel 20-30 microns $1200

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