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| Chemical Peels |
AHAs are often referred to as fruit acids. They include glycolic acid (from sugar cane), lactic acid (from sour milk), citric acid (from citrus fruits) and tartaric acid (from fermented grapes). Glycolic acid is most frequently used for superficial peels and in cosmetic formulations. When used as a peel, the pH (measure of acidity) is low (more acidic) and thus more irritating. Products for home use have been partially neutralized (resulting in a pH closer to that of the normal skin surface, 4.2-5.6) and are less irritating.
Medium Peels
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Medium peels can be used to treat a number of skin conditions, but they are most often used to treat the effects of sun damage. They also diminish the appearance of vitiligo or leukoderma (conditions marked by the presence of areas lacking pigmentation) by reducing the color contrast of surrounding skin. Deep wrinkles are less responsive and require additional treatments. Frequently a series of medium peels is required to achieve the desired result.
Deep Peels
Deep peels cause similar but more intensified effects than medium peels. These peels, often accomplished by the use of phenol, produce the most dramatic results but are the most painful and require the most post-treatment care. Damage extends to the mid dermis. In addition to treating wrinkles, scars and blemishes, phenol peels may be used to treat precancerous skin lesions. Because phenol peels cause a permanent lightening of the skin they are generally not used in dark-skinned individuals. Sedation is frequently given prior to the treatment. In certain individuals the heart is monitored with an ECG due to the potential for irregular heart rhythms. Pain medication may be prescribed after the treatment.
After a deep peel, the area is swollen and raw. The proper post-treatment care is essential to avoid complications and produce the best results. This often involves the use antibiotics, compresses, special soaks and ointments. Normal activities are usually resumed after 2 weeks. After the scab heals, the skin appears red for 2 to 3 months, however cosmetics can be used after an initial period of time to mask the redness. A single treatment is usually sufficient to provide the desired results.
To varying degrees medium and deep peels cause remodeling of the collagen in the dermis and an increase in the elastic fibers. Collagen and elastin (an elastic fiber) are the main structural proteins in the dermis. With aging, the dermal collagen and elastin content decreases as the skin becomes thinner. This is accelerated by sun exposure and is the major factor associated with wrinkling. The changes in the dermis take effect over weeks to months.
Although the use of sunblock is widely recommended, it is especially important for people who have had medium or deep peels because the treated skin is more vulnerable to the damaging effects of the sun. Side effects of the peels vary with the type and depth, and the experience of the operator. Deep peels in particular carry a small risk of infection and/or scarring. Patients with allergies may experience a flare-up of skin allergies. Fever blisters and/or cold sores may also develop. In people prone to fever blisters, antiviral drugs are often prescribed before and after the peel.
A phenol peel generally causes a permanent lightening of the treated skin, which is particularly noticeable in dark-skinned individuals. Infrequently the development of a thick scar occurs after a deep peel. This is more common in Asians, Africans and Indians. Very rarely, a person undergoing a deep peels experiences an abnormal heart rhythm.
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After a deep peel, the area is swollen and raw. The proper post-treatment care is essential to avoid complications and produce the best results. This often involves the use antibiotics, compresses, special soaks and ointments. Normal activities are usually resumed after 2 weeks. After the scab heals, the skin appears red for 2 to 3 months, however cosmetics can be used after an initial period of time to mask the redness. A single treatment is usually sufficient to provide the desired results.
To varying degrees medium and deep peels cause remodeling of the collagen in the dermis and an increase in the elastic fibers. Collagen and elastin (an elastic fiber) are the main structural proteins in the dermis. With aging, the dermal collagen and elastin content decreases as the skin becomes thinner. This is accelerated by sun exposure and is the major factor associated with wrinkling. The changes in the dermis take effect over weeks to months.
Although the use of sunblock is widely recommended, it is especially important for people who have had medium or deep peels because the treated skin is more vulnerable to the damaging effects of the sun. Side effects of the peels vary with the type and depth, and the experience of the operator. Deep peels in particular carry a small risk of infection and/or scarring. Patients with allergies may experience a flare-up of skin allergies. Fever blisters and/or cold sores may also develop. In people prone to fever blisters, antiviral drugs are often prescribed before and after the peel.
A phenol peel generally causes a permanent lightening of the treated skin, which is particularly noticeable in dark-skinned individuals. Infrequently the development of a thick scar occurs after a deep peel. This is more common in Asians, Africans and Indians. Very rarely, a person undergoing a deep peels experiences an abnormal heart rhythm.
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