An Introduction to Chemical Peels

AN INTRODUCTION TO CHEMICAL PEELS

I LOVE chemical peels!

Before discovering chemical peels I had a good skin care habits yet my skin was dry, uneven, and I had many issues with recurring cystic acne. No matter what expensive cream or facial cleanser I used, I just couldn’t get my skin to look nice.

Things didn’t change for me until I met medical esthetician, Elizabeth Weiler, Owner of Med E Spa. Elizabeth educated me and encouraged me to begin doing a series of chemical peels every year. With Elizabeth’s help my skin has become soft, even in color, and with fewer fine lines for my age. I haven’t had a cystic pimple in YEARS! I am in my 30’s and I really enjoy being told I look “twenty something”!

The idea is to “bulldoze” the face to encourage the skin to produce healthy new cells. I thought it would be fun to document what it is like to get a series of facial treatments at a med spa. I also thought it would be nice to describe some basic information regarding the types of peels available and how to prepare for receiving them.

My Experience:

Visit 1 (initial visit in the series):

First thing Elizabeth did was dermaplane my face. A light alpha hydroxy mask and a heavy extraction followed the dermaplaning. The goal was to prep my skin to absorb further treatments.

Visit 2 – Chemical peel #1 (a couple days after the dermaplaning and alpha hydroxy mask):

After my face “cooled off” we did a superficial chemical peel (salicylic acid) with a “modified Jessner” solution. The salicylic acid aides in the breakdown of congested skin and the Jesner reduces signs of sun damage.

Here are some pictures to show the progression of my face after the chemical peel:

Day one – 9 hours after application: My face looks shiny and wind burned. There’s some tightness and a little residual peppery feeling from the initial application of the peel.

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Day two – 21 hours after application. I feel some sensitivity similar to sunburn. The texture of my skin does not feel much different than usual yet it looks like there have been changes. The abrasions you see near my eye and cheek were extractions that required the proper use of a lancet.

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Day two – 27 hours – after light foundation application. It was relatively easy to cover up the redness from the peel. I was able to go to work without feeling insecure about the appearance of my skin.

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After airbrush makeup application (I had a date… this chemical peel won’t stop me!):

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Day three – My skin feels tight yet it also feels like it is hovering over my under layers of skin. It definitely feels like the top layer is foreign. I can feel the texture of my skin starting to break up on my chin. The look of my skin is rough, as if I’ve aged and all my wrinkles are apparent. I know that I don’t usually have many lines on my face so I won’t freak out. I know that is just looser layer of yucky skin.

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Day three – First signs of flaking. Flakes were highlighted by a HEAVY application of sunblock (Obaji Medical Nu-Derm Sun Shield SPF 50). My face itches.

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Day 4 and 5 – I look terrible! But I know it’s for the greater good! I have to remember to not pick the skin off of my face! NEVER try to remove the dead the skin flakes before they are ready to fall off.

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Two days later – While the flaking and peeling have ended I notice my wrinkles have become more prominent. I freaked out a little but calmed down after contacting Elizabeth. She explained to me that this was a temporary effect due to a lack of “superficial moisture” also know as Glycosaminoglycan – GAGs. GAGs have several functions and in this case they promote the ability of the collagen and elastin fibers to retain moisture.

Visit 3 – Chemical peel #2 – Two weeks later. (I didn’t have time to document all of the changes with photos). Rest assured my skin went through the same stages of peeling as the last time.

The third peel I received was a Glycolic Acid peel. The Glycolic peel felt tingly and needle-like while the others felt hot and somewhat spicy. Elizabeth allowed me to use a fan on my face during the process. It was mildly uncomfortable for only a short period of time. Over the years I have gotten used to the burning sensations.

Here is my face directly after the peel (the sun was in my eyes!). Notice that I am not wearing any makeup other than mascara. I had already shown improvement from the last session. This next peel really pushed my skin to produce healthy cells.

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I really love the way my skin looks and I can’t wait to do it again next year! Now that you have heard my experience I want to provide you with a little more information:

What is a chemical peel and why do we want them?

As we age, our skin’s natural ability to slough dead skin cells and replicate healthy new cells diminishes. A chemical peel is an acid that provides a controlled burning of the upper layers of the skin. This burning of the skin jump-starts the body’s natural ability to rejuvenate the production of new skin cells. The end result is an evener skin tone, minimized pores, reduced fine lines, reversal of sun damage, reduction of bacteria causing acne, and a general improvement in the appearance of the skin.

Where can you get a chemical peel?

The strength of a chemical peel determines where you can get the treatment as well as who can administer it:

Light exfoliators – provide light surface exfoliation and minimal results. These types of treatments can be bought over the counter from places such as Sephora or Ulta. i.e. Dr. Dennis Gross Skincare Alpha Beta Peel Extra Strength Formula or Peter Thomas Roth’s AHA/BHA Cleansing Gel.

Superficial peels – only affect the epidermal layer and can be administered by any licensed and trained medical esthetician working under a physician. This is the most popular type of procedure and is the focus of this article. Medical estheticians typically work in a med spa (plastic surgeon or dermatologist office). This differs from estheticians found in spas typically associated with beauty salons.

Medium to deep chemical peels- penetrate the dermal layer and stimulate the production of collagen. A physician can only administer these peels.

Types of chemical peels:

There are many types of acids used in superficial peels. Any combination of these acids can be administered at a med spa by a medical esthetician to produce varying amounts of peeling. The amount of peeling (or depth of chemical burn) is determined by the initial condition of your skin.

Alpha Hydroxy acids (AHA):

There are 5 types of alpha hydroxy acids: glycolic, lactic, malic, tartaric, and citric. Glycolic and lactic acid are the most commonly used at med spas. Malic, tartaric, and citric are weaker acids that are most commonly used as exfoliates found in over the counter skin care products. Alpha hydroxy acids are relatively weak and contain minimal risk in their use. Alpha hydroxy acid is more effective the longer it is left on the skin.

Beta-hydroxy Acid (BHA):

Salicylic Acid peels – These peels are a self-neutralizing acid that can be layered to produce different effects. The more layers applied, the more peeling you will experience. Salicylic acid peels are most commonly used for acne, enlarged pores, oily skin, and hyper-pigmentation in dark-skinned patients. Salicylic acid is also used to pave the way for receiving other, more aggressive treatments that penetrate at a deeper level. Salicylic acid is known to have anti-inflammatory properties and is considered generally safe for people with sensitive skin.

*If you are allergic to Tylenol, do not use Salicylic acid.

Jessner’s peels:

Jessner’s peels or “Modified” Jessner’s peels – A Jessner’s peel contains an equal combination of salicylic acid, lactic acid, and resorcinol. Like a salicylic acid peel, a Jessner’s peel is self-neutralizing and can be layered. This peel is great for reducing hyper-pigmentation and acne. It can also be used to prime the skin for more aggressive treatments administered by a physician. Most peels created are considered modified Jessner’s peels.

Trichloroacetic Acid (TCA) Peels:

Trichloroacetic acid (TCA) is a medium-depth, self-neutralizing peel that is usually administered by a physician. TCA comes in different concentrations and should be used with caution.

Phenol Peels:

While not frequently used, Phenol provided a very deep chemical burn. Phenol peels are not recommended because other medium-depth peels can be used to provide the same result with less down time. Phenol is considerably toxic, uncomfortable to receive, and requires local or general anesthesia.

How to “prepare” for a Chemical peel procedure:

After consulting with your medical esthetician, you may be advised to use varying products or treatments to prime the skin prior to receiving a chemical peel. Examples include creams, exfoliation treatments, facial cleansers, and masks:

*Retin-A (Tretinoin) – a form of vitamin A that helps the skin renew itself.

*Salicylic Acid – from the bark of a willow tree, Salicylic Acid is a type of phenolic acid and a beta hydroxy acid. This acid is the main ingredient in tylenol (a fever reducer and pain reliever). In lower percentages it is found in acne creams, foot creams (to treat warts), shampoos that treat dandruff, and Pepto-Bismol.

*Derma Planing / Epidermal Leveling / Blading – a manual exfoliant that removes the outer most layers of dead skin cells. Treatment is performed by using a #10 sterile surgical blade held against the skin at a 45 degree angle and stroked along the skin in a shaving-like motion.

*Microdermabrasion – tiny crystals are sprayed onto the skin to gently remove the outer layer of the skin. Modern versions of microdermabrasion use wands with a diamond tip instead of crystals.

*Skin lightening creams – work to reduce melanin pigment in the skin.

Some precautions:

DO NOT self diagnose or self treat a medical condition. All procedures mentioned in this article should be discussed with your doctor first.

Chemical peels affect the epidermal layer of the skin and result in photosensitivity. An SPF of 30 or higher is recommended for a minimum of 2 weeks following a treatment.

Do not wax any part of the face at least two weeks before or two weeks after a chemical peel. Please follow aftercare instructions carefully.
Please be sure that your esthetician reviews your medical history and goes over any questionable health issues.

If pregnant or nursing do not receive a chemical peel.

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