Chemical Peels

Your skin is made up of millions of cells that protect you from the environment and regulate your body temperature. Every day thousands of cells die, flake off and are replaced by new cells from beneath the skin. In younger people with very oily skin, the oil can act a bit like a glue, that sticks the otherwise dead skin layer back down again. This layer of dead skin cells contributes to blockage of the pores and predisposes to acne and blackheads (comedones). Partial removal of the outer dead skin layer is an effective treatment of both cystic and comedonal acne. But, as you will discover on reading on, there are also many other benefits to be gained from chemical peeling.

Skin renewal

As we age our skin regeneration rate begins to slow down. Our skin may become dull and show less complexion. Dark blotches, fine lines and other signs of sun-damage and ageing begin to appear.

Chemical peels have been used for over 100 years to create an even and controlled shedding of built up or damaged skin cells. A chemical peel involves using a solution applied to the skin to remove dead skin cells which stimulates the production of new skin cells. It unblocks pores, tightens the skin, reduces wrinkling, reduces superficial pigmentation and restores a more youthful appearance.

During the consultation with your skin doctor you will want to explain the level of skin improvement you hope to achieve. Your doctor will then review your medical history and examine your skin type and pigmentation to determine if you are a good candidate for a chemical peel. Together you can evaluate the advantages and disadvantages of the different types of chemical peels, discuss your options, your expectations and determine the best treatment for you.

Which skin conditions can a chemical peel improve?

A chemical peel is not a substitute for a facelift. It cannot eliminate excessive or lax skin. But, in many cases, a chemical peel is performed in conjunction with other simple office procedures like a dermal filler.

Chemical peels DO NOT fix redness of the skin or broken capillaries- only laser treatments will do that!  In fact, because chemical peels remove the outer pigmented layer of skin so well, anyone with underlying broken capillaries may in fact notice these vessels more after the procedure. These vessels can then be removed with one of our vascular lasers (eg Coolglide, Laser Genesis), leaving your final complexion comprehensively renewed and restored..it’s all a bit like preparing a canvas before painting the masterpiece!

What is the treatment like?

Unlike some types of laser resurfacing, chemical peels can be performed all over the body, including the backs of the hands and the chest or back. Most chemical peels are performed as outpatient procedures in the doctor’s office or medispa. Depending on your skin type and the desired results, your doctor may recommend a superficial, medium or deep chemical peel. Your doctor will select the most appropriate solution (eg. Glycolic acid, Jessner’s solution or TCA solution) and apply the solution to the treatment area. Once applied, the solution produces a separation and peeling of the the outer layers of the skin. This stimulates the production of new skin from beneath.

After treatment most patients experience a warm to hot sensation, which may last as long as ten minutes. For deeper peels, some patients require anaesthesia. At Skin Temple, we only offer peels that can be comfortably tolerated by fully conscious patients. For most people, this means that the strongest peel will be our 20% TCA peel.

What should you expect after treatment?

Reactions to chemical peels are dependent on the type of peel undertaken.

A glycolic peel causes immediate softening of the skin without any visible post treatment reddening, making them very popular as quick and effective ‘lunchtime’ treatments.  There is no obvious peeling of the skin, so no need to take any time off work or limit social activities.

Jessner peels cause an immediate effect similar to mild or moderate sunburn, depending on the number of layers applied and skin preparation. The redness generally lasts for 24 hours and is followed by a tightening sensation as the outer dead layers of skin dry and then are shed over the next 7 days. It is important to avoid using any glycolic or alcohol based skin products during this period. Instead, patients are advised to apply a simple moisturiser as often as required. Do not pick at the peeling skin during the first 5 days. These peels are wonderful for the treatment of acne, but are usually not done as a first step in our acne programme.

TCA peels are performed only by medical practitioners, and involves the application of a solution of trichloracetic acid in strengths ranging from 10, 15, or 20%. The solution is neutralised carefully before being rinsed off prior to the patient leaving our spa. Recovery takes approximately one week, sometimes longer in some areas such as the chest with a slower cell turnover. These peels are usually done by those without acne problems, but who seek treatment for pigmentation, freckling or age related wrinkle changes. Sometimes TCA peeling is done as a very cost effective alternative to fractional CO2 resurfacing. It doesn’t penetrate as deeply, but it is incredible what improvement can be seen.

It is essential that sun exposure is avoided following a chemical peel. Your new skin may be very sensitive and remains susceptible to injury from UV light. Always apply a wide spectrum sunblock of at least SPF 15+ every morning before leaving home. Even in winter! The most effective and reliable sunscreens are those with a high (or exclusive) mineral content (zinc oxide and/or titanium dioxide). These will always be comedogenic to some extent, so make sure you thoroughly remove them at the end of the day or you may start to experience congestion again! Unfortunately, the lighter the sunscreen product, the more likely it is to only contain chemical sunscreen..which works for only 2 hours. Sometimes after a peel you’ll want to apply moisturiser every 2hours anyway, so this is the ONLY time i would ever endorse using a chemical sunscreen, especially for those who are having a peel as part of their acne treatment! Once the skin has shed, and your acne is looking better, former sufferers MUST switch to a mineral sunscreen for long term use.

What is abnormal following a peel, and may require urgent medical assistance?

Abnormal reactions can occur because the wrong peel has been done in the wrong patient, or at the wrong time of the year, or because of the client picking at the skin and introducing infection (eg herpes simplex, or staphylococcus infections) or exposing the new skin to sunlight too soon. Sometimes trauma alone can be enough to stimulate a re-activation of cold sores in someone prone to them.

Unfortunately we are seeing a number of burns occuring in salons, where the client, perhaps an olive-skinned patient, has had microdermabrasion first, and then undergone some form of chemical peel. This is sometimes referred to as a ‘power peel’ and has the effect of causing much more aggressive absorption of the peel solution than is sometimes appropriate for the client’s skintype.

Power peels should never be undertaken in salons, and should only be done by medically qualified personnel.

They should never be done in olive skinned individuals, or in warmer climates. The risk of having a complication such as worsening of pigmentation or some other form of scarring is much greater with a power peel, compared with regular chemical peeling.

In the event of experiencing an adverse reaction to a chemical peel, be sure to seek urgent medical advice, preferably from someone trained and experienced in dealing with these sorts of complications. Appropriate advice early on may mean the difference between permanent scarring and an acceptable outcome.

Maintaining your new skin

Not everyone wants to have a chemical peel every time their skin starts to dull again or become congested. A great way to minimise the frequency of needing a peel is to have regular Deluxe Microdermabrasion treatments every 1-2 months. Microderm varies a lot between spas and devices, but our deluxe microderms are a fabulous hour long session involving a lot more than just a quick microderm once-over!