To Peel or Not to Peel

If you hold on to anything long enough it will eventually become popular again (remember those bell bottoms in the back of your closet?) and this has proven very true for chemical peels. Incredibly popular in the 1990s, chemical peels have recently experienced a resurgence even with all of the new aesthetic technology on the market. Chemical peels have proven themselves as a tried-and-true affordable skin modality since the 1960s and are here to stay. From acne to fine lines, hyperpigmentation to redness, there’s a chemical peel formulated for pretty much whatever ails you.

Over the years, I’ve found that patients who are new to chemical peels often use the Sex and the City episode where Samantha gets a peel treatment as their baseline knowledge of the procedure. She shows up to an event with a painfully red and raw face, and Carrie advises her to wear a veil because her skin looks like beef Carpaccio. This example can be a real turn-off for potential patients who think that this is how every treatment ends, so let’s break down what a chemical peel is and does.

A chemical peel is a more aggressive form of exfoliation, wherein an organic acidic solution is uniformly placed on the skin to stimulate cellular turnover through a controlled injury. Protons released by the acid break up the protein bonds holding keratinocytes in place. When skin cells are removed from the surface, the deeper living layers of skin start to replace them with healthier cells with a thinner stratum corneum layer. (Pierre Fabre USA)

Peels are classified in one of three varying depths: superficial, medium, and deep – and the deeper it goes, the more downtime it requires. Superficial treatments only exfoliate the topmost layers of cells in the epidermis. While this will help with some pigmentary and textural issues, superficial peels won’t even start to touch on acne scarring, wrinkles or skin laxity. (Schwanke, March 2006) Removing the dead cells and smoothing out the surface of the skin will help active at-home products, like tretinoin and hydroquinone, penetrate more efficiently and give a client a better end result. Generally, with these types of peels there is no blistering or crusting and visible flaking is minimal. Our office uses several different peels from Glytone including the Jessner, Mandelic, and Glycolic formulations.

The VI Peel and Glytone’s TCA Strong are examples of medium depth peels we frequently do at the office. They are very effective for treating hyperpigmentation, melasma and fine lines but have significantly more down time post-peel (an average of seven to nine days with peeling and redness). With these deeper peels, our office always makes sure that you have proper post-care instructions and products while making ourselves available for any questions or concerns that might arise.

Deep phenol peels aren’t used as much as they once were to treat deep wrinkles because of the high risk of side effects and considerable downtime. Some of the possible side effects include pigmentary changes, be it hypo- or hyper- pigmentation, scarring and infection. (webmd.com/beauty/peels/chemical-peels, 2014) If deep, etched-in lines and wrinkles are your main concern, a CO2 laser resurfacing treatment will deliver a similar end result with less risk.

At our office, pre-treatment prep with retinoic acid and hydroquinone is prescribed to ensure that the patient gets the best results possible, especially if hyperpigmentation is a main concern. The retinoic acid helps to thin the stratum corneum layer, providing better penetration of the peel and products, and stimulates cell growth. (Rubin, 1995) At the same time, this helps to reepithelialize the skin more quickly to shorten the healing time and disperses melanin granuales, too. The hydroquinone helps to reduce the possibility of postinflammatory hyperpigmentation that might occur by blocking the enzyme that’s responsible for melanin synthesis. Pre-treatments usually start four to six weeks prior to a peel but your aesthetician can guide you more accurately during a consultation.

I know that the phrase “chemical peel” sounds scary but I hope, at this point, that you have a better understanding of what the process is and what a peel does. They are definitely a set of procedures that everyone should have in their aresenal as part of their personal skincare “recipe.” Schedule a consultation to talk with an aesthetician in order to find out what type of peel would suit you the best.

 

Written By: Sarah Rutherford, PMA.


Pierre Fabre USA. (n.d.). Glytone by Enerpeel Technical Manual.
Rubin, M.G. (1995) Manual of Chemical Peels. Philadelphia, PA: J.B. Lippincott Company.
Schwanke, J. (March 2006). Superficial chemical peels: Effectiveness varies, M.D. says. Dermatology Times , 27.3, 84-85.
webmd.com/beauty/peels/chemical-peel. (2014, March 12). Retrieved August 2, 2016, from webmd.com: http//www.webmd.com/beauty/peels/chemical-peel