Chemical peel

From Wikipedia, the free encyclopedia
Jump to: navigation, search

A chemical peel is a body treatment technique used to improve and smooth the texture of the facial skin using a chemical solution that causes the dead skin to slough off and eventually peel off.[1] The regenerated skin is usually smoother and less wrinkled than the old skin. Thus the term chemical peel is derived. Some types of chemical peels can be purchased and administered without a medical license, however people are advised to seek professional help from a dermatologist, esthetician, plastic surgeon, oral and maxillofacial surgeon, or otolaryngologist on a specific type of chemical peel before a procedure is performed.

Types[edit]

There are several types of chemical peels,[1]

Alpha hydroxy acid peels[edit]

Alpha hydroxy acids (AHAs) are naturally occurring carboxylic acids such as glycolic acid, a natural constituent of sugar cane juice and lactic acid, found in sour milk and tomato juice. This is the mildest of the peel formulas and produces light peels for treatment of fine wrinkles, areas of dryness, uneven pigmentation and acne. Alpha hydroxy acids can also be mixed with a facial wash or cream in lesser concentrations as part of a daily skin-care regimen to improve the skin's texture.

There are five usual fruit acids: citric acid, glycolic acid, lactic acid, malic acid and tartaric acid. Many other alpha hydroxy acids exist and are used.

AHA peels are not indicated for treating wrinkles.[2][3]

AHA peels may cause stinging, skin redness, mild skin irritation, and dryness.

Beta hydroxy acid peels[edit]

It is becoming common for beta hydroxy acid (BHA) peels to be used instead of the stronger alpha hydroxy acid (AHA) peels due to BHA's ability to get deeper into the pore than AHA[citation needed]. Studies show that BHA peels control sebum excretion, acne as well as remove dead skin cells to a certain extent better than AHAs[citation needed] due to AHAs only working on the surface of the skin. Salicylic acid is a beta hydroxy acid.

Jessner's peel[edit]

Jessner's peel solution, formerly known as the Coombe's formula, was pioneered by Dr Max Jessner, a German-American dermatologist. Dr Jessner combined 14% salicylic acid, lactic acid, and resorcinol in an ethanol base. It is thought to break intracellular bridges between keratinocytes.[citation needed] It is very difficult to "overpeel" the skin due to the mild percentages associated with the acid combination.[citation needed]

Retinoic acid peel[edit]

Retinoic acid is a retinoid. This type of facial peel is also performed in the office of a plastic surgeon, oral and maxillofacial 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 wrinkles and pigmentation problems.[citation needed] It is usually performed in conjunction with a Jessner; which is performed right before, in order to open up the skin, so the retinoic acid can penetrate on a deeper level. The client leaves with the chemical peel solution on their face. The peeling process takes place on the third day. More dramatic changes to the skin require multiple peels over time.

Complications of chemical peels[edit]

The deeper the peel, the more complications that can arise.[1] Professional strength chemical peels are typically administered by certified dermatologists or licensed estheticians. Professional peels and lower-concentration DIY home peel kits can pose health risks, including injury and scarring of the skin. Possible complications include photosensitivity, prolonged erythema, pigmentary changes, milia (white heads), skin atrophy, and textural changes.[1][citation needed]

Anesthesia[edit]

Light chemical peels like AHA and glycolic acid peels are usually done in medical offices. There is minimal discomfort so usually no anesthetic is given because the patient feels only a slight stinging when the solution is applied. No pain killer is needed.{cn}

Medium peels like TCA are also performed in the doctor’s office or in an ambulatory surgery center as an outpatient procedure and can cause more discomfort. Frequently, the combination of a tranquilizer like diazepam and an oral analgesic is administered. TCA peels often do not require anesthesia even if the solution itself has - at the contrary of phenol - no numbing effect on the skin.[clarification needed] The patient usually feels a warm or burning sensation.[4]

Phenol is the classic deep chemical peel. Old phenol peel solutions are very painful and most practitioners will perform it under either general anesthesia, administered by an MD-anesthesiologist or nurse anesthetist. More recent formulas easily allow a simple heavy sedation, usually intravenous.

See also[edit]

References[edit]

  1. ^ a b c d Chemical Peels | The Ageing Skin
  2. ^ Textbook of Chemical Peelings, P.Deprez, Chapt 8, Informa Healthcare
  3. ^ Textbook of Cosmetic Dermatology, R.Baran, Chapt 54, Informa Healthcare
  4. ^ Halaas YP: Medium depth peels. Facial Plas Surg Clin North Am 2004 Aug; 12(3):297-303