The Marylebone Clinic
Providing excellence in
Dermatology
Dermatology
Chemical Peels
However, chemical peels are not only used to remove layers of the skin, but also to induce collagen formation in the dermis, as antibacterial agents, as regulators of sebaceous gland function and as bleaching agents.
There are many types of chemical peels ranging from superficial peels to deep peels. If you are considering a peel, Dr Brazzini would carry out an extensive examination of your skin and overall health taking into account factors such as your age, the condition to be treated, the degree of the condition, your expectations and the extent of your exposure to the sun.
Many conditions can be dramatically improved by being treated with chemical peels. These include: acne, acne scars, lines and wrinkles, photo ageing, greasy skin, localized hyper-pigmentation(lentigo - age spots) and melasma.
How many types of chemical peels are there?
There are various types of peels which are divided into:1. Very superficial peels:
Glycolic acid 30% to 50% applied 1-3 times
Salycilic acid 25% applied in 1 coat
Jessner solution applied in 1-3 coats
Low concentration resorcinol 20% applied briefly (5-10 minutes)
TCA 10% applied in 1 coat
10% Retinol
2. Superficial peels:
Glycolic acid 50% to 70% applied 3-10’
Salycilic acid 25% applied 4-10 coats
Pyruvic 40% applied in 4-5 coats
Jessner solution applied in 4-10 coats
Resorcinol 40% applied for 30’ to 60’
TCA 20%
3. Medium peels:
TCA 35%
Pyruvic acid 50-60% applied in several coats
Augmented TCA (glycolic acid 70% + TCA 35%, Jessner solution + TCA 35%, salycilic acid + TCA 35%)
4. Deep peels:
TCA 50%
Phenol
Which chemical peel and when?
Choosing the correct type of chemical peel for each patient is the most important step. Only very experienced dermatologists and plastic surgeons after a careful skin examination are able to suggest the best agent to use.The choice depends on many factors such as: skin type, age, condition to be treated and degree of the condition, realistic expectations of the patient, philosophy of sun exposure.
Very superficial peels are used:
1.for darker skin types (III-VI) (asian skin and black skin) with very low risk of side effects
2.for greasy skin
3.to improve skin texture, to make the skin “glow”
4.for mild papulo-pustular acne
5.for comedonic acne
6.for hyperpigmentation in dark skin individuals
7.for mild acne scars
Superficial peels:
1.for papulo-pustular acne
2.mild to moderate photoagieng
3.mild to moderate line and wrinkles
4.melasma
5.lentigo (age spots)
6.moderate acne scars
Medium peels:
1.melasma
2.lentigo
3.moderate to severe photoagieng
4.moderate acne scars
5.lentigo (age spots)
Deep peels:
1.severe acne scars
2.severe lines and wrinkles
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| Fig.1 Wrinkled and marked face. | | Fig.2 Post-peeling erythema. |
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| Fig.3 Exfoliation. | | Fig.4 Result. |
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Are chemical peels painful? Is anesthetic necessary?
Very superficial and superficial peels are slightly uncomfortable but not painful. There is slight stinging and burning sensation that ceases as soon as the peel is neutralized. Retinol peels are absolutely painless.Medium peels cause a quite intense burning and stinging sensation for 2-5 minutes that ceases once the peel is neutralized. Resorcinol peels cause a slight burning sensation once the peel is taken off.
Deep peels instead require local anesthetic with sedation and are performed in an operating theater sometimes one-day hospitalization.
How long is the treatment?
The duration of the chemical peel itself varies from very few minutes (2-5 minutes) to one and a half hour (resorcinol peel).How often should chemical peels be performed?
The number of sessions depends on the type and severity of the condition to be treated.Is it important to prime the skin before a chemical peel?
It is very important to prime the skin before medium anddeep peels. Before very superficial and superficial peels it is not always necessary to prime the skin.Skin priming is prescribed by the doctor during the consultation and usually consists of the application of AHA and retinoid based creams for about 15 days prior to the treatment.
Can Chemical peels be used in dark skin individuals?
Yes. Expert doctors can use chemical peels on dark skin individuals. Very superficial and superficial peels have a very low the risk of transitory hyperpigmentation.However, patients with dark must bare in mind that when their skin goes dry it often becomes darker. Therefore they must expect a slight darkening and patchiness of the skin for 5-7 days after the peel.
Medium and deep peels may be performed on dark skin individuals as long as the patient accepts the risk of transitory hyperpigmentation for 3-9 months after the peel.
Do significant after-effects occur after the treatment with chemical peels?
After very superficial and superficial peels the skin is pink for a few hours. The skin then becomes dry and exfoliates during the following 5-7 days.After intermediate peels the skin is pink for 1-2 days then becomes violaceous-tanned for 2 days and on the 4th-5th day the exfoliation begins and lasts for max 10 days. It is advisable to take 5 days off work.
After deep peels the skin will be red and the area might be swollen for 2 days. On the 2nd or 3rd day the skin will become violaceous-tanned for 2 days and on the 4th-5th day the exfoliation begins and lasts for max 10 days.
What is important during the post-peel period?
It is very important to follow the instruction the doctor will give.It is also very important not to pick the skin and tear it. No sun-exposure for 2 weeks up to 2 months according to the depth of the peel. No saunas (and similar) and no swimming pool for 5-10 days according to the depth of the peel.