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What is a chemical skin peel?

"Chemical peel" is a general classification for a number of chemical treatments used to exfoliate and rejuvenate the skin. A chemical solution is applied to the skin and the top layers of the skin dissolve. The body's healing response is activated, causing new tissue to emerge. The depth and strength of the reaction varies based upon the strength of the chemicals used and the length of time the solution is applied.

Some chemical peels are so strong that they are able to remove multiple layers of the epidermis. But due to the increased chances of side-effects and a long recovery time, these forms of peels have generally been replaced by laser treatments. Laser provides a greater and more precise level of control to the practitioner. Most chemical peels today are less destructive and more superficial.

Type of Peels Available

  • Alpha hydroxy acid peels: AHAs are naturally occurring carboxylic acids such as glycolic acid, a natural constituent of sugar cane juice and lactic acid. This is the mildest of the formulas and can be administered at home or in a beauty salon. AHAís are used in the treatment of fine wrinkles, areas of dryness, uneven pigmentation and acne.
  • Beta hydroxy acid peels: It is becoming more common for BHA peels to be used instead of AHA peels due to its ability to get deeper into the pores. BHA peels control sebum excretion which in turn improves acne and removes dead skin cells. Whereas AHAs only work on the surface of the skin.
  • Retinoic acid peel: Retinoic acid is derived from retinoids. This type of facial peel is 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 fine wrinkles and pigmentation problems.
  • Trichloroacetic acid peels: Trichloroacetic acid is used as an intermediate to deep peeling agent. It is the preferred treatment for darker-skinned patients over Phenol peels. TCA smoothes out fine surface wrinkles, remove superficial blemishes, correct skin pigment problems and may take several days to heal depending on the peel depth.
  • Phenol peels: Phenol is the strongest of the chemical solutions and produces a deep skin peel. Phenol peels are used to correct blotches caused by sun exposure or aging, smooth out course to deep wrinkles. Because of its strength, risks such as infections, scarring, prolonged sun sensitivity, irritation are possible. A severe side-effect could include cardiac arrhythmias in reaction to the chemicals used. As a result of the high level of risk, many physicians have largely replaced phenol peels with laser or other alternative treatment options.

How is a chemical peel applied?

A chemical peel can be performed in a doctor's office or in a clinic on an outpatient basis. The skin is thoroughly cleansed with an agent that removes excess oils. Eyes and hair are protected. One or more chemical solutions are applied to the affected areas of the skin. The reaction to the chemicals produce a controlled wound, enabling new regenerated skin to appear.

Does the treatment hurt?

With TCA or Phenol peels, the chemicals act as an anesthetic, so there is little pain. During an AHA peel, there is a slight stinging sensation during the treatment. With deeper peels like the Phenol peel, the recovery time may last for over a week. With the lighter peels like AHA, there is little to no downtime.

Maintenance after the procedure

The different chemicals used and concentration thereof will have an effect on the overall results, recovery time and the ongoing maintenance. Mild peels may be repeated at one to four-week intervals until the desired clinical effect is achieved. Medium to deep peels may be repeated at six to twelve month intervals, if necessary.

It is important to avoid exposure to the sun after a chemical peel since the new skin is fragile and more susceptible to infections and complications. Your doctor will prescribe the proper follow-up care to minimise the side-effects associated with the procedure.

Are there any side-effects of a chemical skin peel?

The deeper the chemical peel, the higher the chances of their being complications. Chemical peels are risky and need to be administered by certified dermatologists or medical practitioners.

In certain skin types, there is a risk of developing a temporary or permanent color change in the skin after a chemical peel. Taking birth control pills, subsequent pregnancy, or family history of brownish discoloration on the face may increase the possibility of developing abnormal pigmentation.

Although low, there is a risk of scarring, certain individuals may be more prone to scarring than others, which is why it is important for a patient to inform the physician of any past history of keloids or unusual scarring tendencies.

There is a small risk of reactivation of cold sores in patients with a history of herpes. This problem is treated with medication as prescribed by the doctor. Your doctor may also choose to give you medication before or immediately after the peel in order to prevent a herpes outbreak.

One of the most severe as well as the rarest complications associated with chemical peels- specifically the Phenol peel- is cardiac arrhythmia. A cardiotoxic chemical is used in the procedure, which is a chemical that has adverse effects on the heart.

Proís and Conís of skin peels

Proís

  • Reduces sun damage, fine lines, acne scars, dry or rough skin, dull skin tone, hyper pigmentation and enlarged pores.
  • Improves the general appearance and condition of skin
  • Dead skin cells are replaced by healthy ones improving skin clarity and brightness

Con’s

  • There is a risk of side effects from the chemicals used
  • There is a risk of scarring or having permanent skin discolourations
  • Increased sensitivity to sunlight and avoidance of sun exposure is usually advisable for several months after the treatment.

Author: South African Spas