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Skin Peels

        

There are several types of chemical peels.

Alpha hydroxy acid peels [AHA]

AHAs are naturally occurring carboxylic acids such as glycolic acid, a natural constituent of sugar cane juice and lactic acid, found in sour milk and tomato juice. This is the mildest of the peel formulas and produces light peels for treatment of fine wrinkles, areas of dryness, uneven pigmentation and acne. Alpha hydroxy acids can also be mixed with a facial wash or cream in lesser concentrations as part of a daily skin-care regimen to improve the skin's texture.

There are five usual fruit acids: citric acid, glycolic acid, lactic acid, malic acid and tartaric acid. Many other alpha hydroxy acids exist and are used.

AHA peels are not indicated for treating wrinkles.

AHA peels may cause stinging, skin redness, mild skin irritation, dryness, and take multiple treatments for desired results.

Beta hydroxy acid peels[ Salicylic acid ]

It is becoming common for beta hydroxy acid (BHA) peels to be used instead of the stronger alpha hydroxy acid (AHA) peels due to BHA's ability to get deeper into the pore than AHA's. Studies show that BHA peels control sebum excretion, acne as well as remove dead skin cells to a certain extent better than AHAs due to AHAs only working on the surface of the skin. Salicylic acid is a beta hydroxy acid.

Jessner's peel

Jessner's peel solution, formerly known as the Coombe's formula, was pioneered by Dr Max Jessner, a German-American dermatologist. Dr Jessner combined 14% salicylic acid, lactic acid, and resorcinol in an ethanol base. It is thought to break intracellular bridges between keratinocytes. It is very difficult to "overpeel" the skin due to the mild percentages associated with the acid combination.

Retinoic acid peel

Retinoic acid is a retinoid. This type of facial peel is also performed in the office of a plastic surgeon or a dermatologist in a medical spa setting. This is a deeper peel than the beta hydroxy acid peel and is used to remove scars as well as wrinkles and pigmentation problems. It is usually performed in conjunction with a Jessner; which is performed right before, in order to open up the skin, so the retinoic acid can penetrate on a deeper level. The client leaves with the chemical peel solution on their face. The peeling process takes place on the third day. More dramatic changes to the skin require multiple peels over time.

Trichloroacetic acid peels

Trichloroacetic acid (TCA) is used as an intermediate to deep peeling agent in concentrations ranging from 20-50%. Depth of penetration is increased as concentration increases, with 50% TCA penetrating into the reticular dermis. Concentrations higher than 35% are not recommended because of the high risk of scarring.

Trichloroacetic acid peels:

  • are preferred for darker-skinned patients over Phenol
  • smooth out fine surface wrinkles
  • remove superficial blemishes
  • correct skin pigment problems

Trichloroacetic acid peels may:

  • require pre-treatment with Retin-A or AHA creams
  • require repeat treatment to maintain results
  • require the use of sunblock for several months (this is a must)
  • take several days to heal depending on the peel depth

Complications of Chemical Peels

The deeper the peels the more complications that can arise.Chemical peels are risky and need to be administered by certified dermatologists. The possible complications include prolonged erythema, pigment changes, milia (white heads), skin atrophy and textural changes.

Anaesthesia

Light chemical peels like AHA and glycolic acid peels are usually done in medical offices. There is minimal discomfort so usually no anesthetic is given because the patient feels only a slight stinging when the solution is applied. No pain killer is needed.

Medium peels like TCA are also performed in the doctor’s office or in an ambulatory surgery centre as an outpatient procedure and are a bit more painful but rarely require any anaesthesia.

See the sort of result skin peels can achieve.