What is a chemical peel and what is it for?
It is a technique in which a substance (solution, cream or paste) is applied to the skin that will remove the outermost layers of the skin –exfoliation–. This phenomenon produces a renewal of the external part of the skin and can increase the synthesis of collagen in its intermediate layers (dermis): the objective is to improve the appearance of the skin by minimizing imperfections such as spots (lentigos), blackheads (comedones) or pores open and fine wrinkles. If the peeling is deep, it reduces skin flaccidity and eliminates deep wrinkles and furrows.
How is a chemical peel performed?
First of all, a skin preparation must be carried out for two weeks before the peeling itself, applying a preparation on the area to be treated that contains active ingredients that enhance the peeling action: salicylic acid, glycolic acid and / or tretinoin, among others. The previous preparation will allow the peeling to penetrate evenly, increasing its effectiveness and the performance of the procedure.
Once the preparation is done, the superficial or medium chemical peels will be carried out in consultation by the dermatologist. Initially, the skin should be cleaned with a specific solution to remove excess sebum and detritus from the skin surface. Then the peeling is applied properly: depending on the type, one or another substance will be used. Although each of the active principles must be applied with a specific technique, in general they are repeatedly deposited on the skin with a brush, swabs or gauze. Throughout this process, the patient experiences a growing stinging sensation (variable depending on the type of peeling), which will disappear once the dermatologist neutralizes the substance applied to finish the act. The stinging experienced is perfectly tolerated the vast majority of times and generally only lasts a few seconds or minutes.
The completion of the peeling includes cleaning the treated area and the subsequent application of a soothing and / or regenerating preparation.
Deep peels, which are rarely performed today and will not be discussed in this post, should be done in an operating room under general anesthesia. The main deep peel is phenol or very high concentration trichloroacetic acid.
What types of chemical peels are there?
Depending on the depth of action, only part or all of the outermost cutaneous layer (epidermis), part of the intermediate layer (up to the papillary dermis) or all of it (up to the reticular dermis) will be removed. Peels that only remove the epidermis are called superficial; the second, middle and deep third.
What type of chemical peel is ideal?
The deeper a peel, the more action it has and the better the aesthetic results, although potential adverse effects are also more frequent and the recovery period after its completion is lengthened.
Superficial peels made with glycolic and / or pyruvic acid are indicated for the treatment of mild skin aging, for lentigos (sun spots), acne and their scars, melasma, comedones (blackheads) and open pores, and as prevention of skin cancer in areas where there are actinic keratoses as a consequence of accumulated solar radiation (for example, on the scalp of alopecic men).
The superficial salicylic acid peel is especially effective for excess sebum, active acne and in combination with the non-ablative fractional laser for the treatment of acne scars.
Intermediate peels with trichloroacetic acid are very useful for moderate or severe aging of the skin, and for deep acne scars (“in ice picks”).
Deep phenol peels will only be used for very ambitious goals in terms of skin aging or atrophic scars. They must be performed in the operating room, under general anesthesia and with cardiac monitoring due to the intense pain it causes and the risks of the procedure.
How many sessions are necessary?
The more superficial a peel, the more sessions are required to achieve the desired effect. Also, the deeper the fewer sessions are necessary, but the more aggressive the procedure and the longer it requires recovery time afterwards.
As for superficial peels, it is recommended to repeat them every 2-6 weeks until the desired objective is achieved, or routinely every 1-2 months as prevention of skin aging.
A single peel, unless it is deep or intermediate, produces a slight improvement, and several sessions are required to perceive noticeable changes.
How does the skin look after doing the peeling?
In superficial peels, there are usually no complications and only minimal flaking and / or redness are appreciated that are imperceptible with the application of a moisturizer or makeup. For this reason, they are the ones that are routinely practiced and those that provide the most satisfaction to the patient, since they do not involve any sick leave or the formation of scabs or wounds. You just have to use sun protection on a regular basis and it is possible to use cream formulas that lengthen and enhance the effect of the peeling performed in the Dermatology office.
Intermediate or deep peels cause a noticeable injury to the skin and crusts form that can become intense, as well as pain that is no less noticeable. They also require prior oral treatment for herpes simplex to avoid possible infection, and it is necessary to do a period of rest and sick leave due to the appearance of the face for weeks. At present it is rare to apply this type of peel unless the patient’s preference and expectations suggest it.