09 Feb Institute BCN – Everything you need to know about skin treatment with chemical peels
What is a chemical peel?
It is a product designed and developed in a pharmaceutical laboratory, containing one or several chemoexfoliating acids, formulated in a certain concentration and level of acidity (indicated by the pH). It is used in medical-aesthetic treatments and comes in the form of liquid (alcohol solution), gel or mask. When it is applied on the skin, it exerts a controlled aggression, accelerating the desquamation of the most superficial cells of the skin, stimulating the natural process of cutaneous regeneration. This reactivates the division of the cells of the basal layer of the epidermis that continue their ascent to the stratum corneum. The chemical peels therefore promote a controlled cell regeneration, through which fibroblasts and other cutaneous adnexa increase their activity returning to the skin its maximum splendour.
What kind of chemical peels exist?
There are many and they are differentiated mainly by two factors: active principle (type of acid) and depth of skin penetration (which is also determined by the degree of acidity of the formula, the PH), although you must also take into account for other key elements that we will see later.
The active principle of each peel will determine its main action on the skin: seborregulation, stimulation of collagen through fibroblast activation, homogenization of skin tone, elimination of wrinkles and fine lines, improvement of acne and its marks (post-acne scars), etc. Some of the most common acids are the so-called hydroxy acids, among which are mandelic, glycolic, lactic… cataloged in &Hydroxy acids, or salicylic acid, which is a β-Hydroxy acid. Others such as retinoic and trichloroacetic, also in different degrees of action, are frequently used in dermatology practices. In order to be more precise in the treatment of different indications, we find more and more formulations that mix different active principles that have similar properties; for example, the BCN Peel # 02 Anti-Aging that combines mandelic and glycolic acid. Here we leave a video that presents this and other peels of Institute BCN:
Let’s go to another factor. According to the penetration depth in the skin we find superficial peels, which act on the epidermis and offer a mild and moderate exfoliation; medium peels, which act at the junction of the epidermis and the superficial dermis, achieving a deeper exfoliation; and, finally, deep peels, which act in the middle and deep dermis and are those that achieve a higher level of exfoliation and skin regeneration.
When we talked about other key elements, we referred to the concentration (% of free acid) and the level of acidity (pH). The concentration of active ingredients in the formula is decisive: a 20% concentrated glycolic acid peel does not work in the same way as 70%. In reference to the acidity (pH), it must be taken into account that, the higher the acidity, the deeper the penetration of the peel. In the example of glycolic acid, this will have a deeper action if it has a pH close to 0.5 and more superficial if it has around 2.
How to choose a chemical peel for my patient?
The most important thing is to examine the skin of the patient and diagnose the problem to indicate the most appropriate treatment (in this case the peeling) that skin needs at that moment.
In the same way that is done when treatments are done with the technique of mesotherapy or microneedling, with the peelings we must evaluate in each session how is the skin, what has been the therapeutic response of that peeling after the previous session, and modify , if necessary, the type of peel for the next application. The variety of possible presentations and combinations of acids allows more and more to make treatments more personalized and individualized.
It is therefore a very versatile treatment in its application (gauze, brush, stick type swab) as well as its various indications. But certainly also by the ability to incorporate it into programs of facial or body treatments before, after or regularly at established intervals of time, along with other procedures performed with injectable products, medical-aesthetic equipment, as well as specific dermocosmetics.
Precisely, this new variety of gelled presentations, as well as different degrees of penetration of the peelings, allows expanding the offer of indications. One of the great advantages of Institute BCN peels is the possibility of treating skins with high phototypes. Due to its controlled action of the preservative pH in its acidity, it can be applied in these skins, avoiding the risk of possible inflammatory reactions by hyperpigmentation of the treated areas. Likewise, in any phototype, in sensitive areas that require a more conservative and controlled treatment (groins, knees, feet, back, arms, buttocks, necklines) Institute BCN peels are an ideal choice.
What to expect when applying a chemical peel?
There are variations according to the type of peeling chosen. In general, skin should be prepared for one or two weeks before with some special dermoscosmetic. They usually include ingredients such as glycolic or salicylic acid in small amounts, and must be applied daily at night (eg, MesoPure). The use of a daily sunscreen then becomes a condition to avoid hyperpigmentation (BCN Solar).
- In the previous moment of the treatment, after a deep cleaning of the skin, and to eliminate any rest of makeup, we proceed to apply a degreaser with the help of a gauze. It helps to unify the pH of the whole area to be treated so that the effect of the peeling is uniform.
- Once this step has been done, the peeling will be applied by brush, gauze or swab in the area or extension of the skin to be treated. Also taking into account if the presentation of the product is liquid, or gelled.
- Once the product has been applied to the skin we wait the time stipulated by the professional in charge, while monitoring the patient and visualizing the entire area to identify when the frosting occurs, which corresponds to the keratolytic effect, although it is only visible for some peels like those that include trichloroacetic acid in high concentration. If this is not the case, the stipulated time of exposure indicated by the product should be respected.
- Subsequently, a neutralizer (based on a basic solution), usually a spray, is applied. While it is being applied, the patient will notice a sensation of acute itching/burning but very bearable and it will diminish in a few seconds. Visually, a whitish effervescence appears throughout the application, which is also limited to the moment of this neutralization. When finished, the patient feels his skin completely normal, (perhaps with a slight feeling of tightness) and can proceed to the application of a cream or mask post peeling (eg. BCN Epithel).
- Before the patient leaves the clinic, the sunscreen is applied, informing them of the need to repeat this application on a regular basis throughout the day. In this regard, it is especially important to bear in mind that since the perioral area is a frequent rubbing area (due to the continuous use of napkins during meals, drying after brushing teeth, etc.), the application of cream and protector in that area should be repeated several times a day.
These areas of friction (as well as wings of the nose, periocular zone…) will probably show a more visible peeling during the days after the treatment. It is not something mathematical, but if there is visible peeling (there is always, but it is not always seen) it appears on the third day. The results of a more luminous, smooth skin with a closed pore appear between one week and 10 days later. It is very evident when applying makeup. When we apply powders or make-up in cream or mousse during the first days, we can show that peeling that maybe was “invisible”. After about 10 days, the makeup is perfectly blurred on the skin and the face much prettier than before the treatment.
The fact that the peeling is more or less obvious to the eye also depends on whether we are under a dry, humid environment, if our skin is more or less greasy initially, or if we are in an environment with stoves, air conditioning, etc.
Who is a candidate for a chemical peel?
- People with acne scars.
- People with crow’s feet.
- People with skin damaged by the sun.
- People with scars.
- People with wrinkles.
- People with flaccid skin.
Who is not a candidate for a chemical peel?
- Pregnant or lactating women.
- People who took accutane (isotretinoin, a medicine for acne) in the last 6 months.
- People suffering from psoriasis, rosacea, dermatitis or eczema.
- People who took a prescription medication for skin care in the last 48 hours.
Is there any risk associated to the application of a chemical peel?
As in any dermatological treatment there are risks, among which can occur in a chemical peel are the following:
- Oral herpes (if the patient has had a previous episode of herpes, it is essential to do a prophylactic treatment some days before the peeling).
- Hyperpigmentation (excessive colouring of the skin).
- Hypopigmentation (lack of pigmentation).
- Develop bacterial infections.
- Appearance of scabs, blisters, pain (it is very subjective).
- Damage and appearance of scars permanently if the peeling is not performed properly.
Generally, and all this will depend on what type of peeling is performed, there are red areas, there may be irritation, but these symptoms should disappear in maximum four days. If it exceeds that time or there are changes in the skin, there is fever, or any of the aforementioned points, it is necessary to go to the specialist who performed it, to assess whether to receive an additional treatment.
Recovery after chemical peeling
The recovery time of a chemical peel can vary. If a superficial one is performed, the recovery will be faster, it will only take one to two days. However, with a medium one, a minimum of ten days will be required as a recovery time with the care provided by the doctor, which mainly consists of not exposing oneself directly to the sun and / or limiting the use of certain creams or dermatological products.
In the case of a deep peel, it is necessary to consider that recovery is slower. The use of a TCA acid or phenol as a chemical to perform it will lead to the area (usually the face) being red and swollen. You may feel itchy skin or certain areas of it. It is necessary to take into account that during this recovery crusts or flaking will appear and should not be removed, but allow the organism to expel them naturally. The specialist will indicate the use of a suitable ointment or dermocosmetic to be applied on the face, which will allow the formation of a protective layer.
The results can be observed in stages, since at the beginning the skin will be reddened; after one or two months you will notice a change from pink to pale and there will be peeling. Therefore, if you choose to perform a deep chemical peel, you should consider about six months of full recovery.
Nowadays, this type of peelings is used less and less because, due to their depth, they can generate dyschromias since they destroy the melanocytes (cells responsible for the production of melanin) located at the level of the papillary dermis. With this type of peelings, it can happen that the colour of the face no longer returns to what it was, despite the improvement in the texture of the skin. There is an increasing of soft type peels use that, following an adequate protocol of regular application, and in addition to other treatments that are minimally invasive but very effective (microneedling with meso pen, mesotherapy, etc.) achieve very natural and lasting results.
[For the peeling user] Some recommendations
- Ask for advice and necessary information before submitting to a peel.
- The specialist must resolve all doubts and questions before and after applying the peel.
- The specialist, after a thorough review of your skin and knowledge of your medical history, can suggest the right type of peeling.
- If there are certain pathologies or diseases, they must be notified to the doctor.
- If you have undergone dermatological treatments and / or peeling sessions previously, you must inform the doctor.
- If you are pregnant or nursing, ask the doctor for advice before choosing to perform a peel.
- Go to a recognized specialist and assess the options before deciding to choose this treatment.
- Following the instructions properly will ensure that the results are good and that, in addition, the recovery process is good, avoiding the appearance of adverse side effects.
- Ask the dermatologist what type of makeup you can and / or should use to avoid alterations in the skin after having undergone a peel.
An adequate preparation before undergoing a type of chemical peel is fundamental. Some of the indications that must be followed are: not to expose oneself to the sun, to make deep cleanings of the skin, to suspend the use of creams or products that are not indicated or prescribed by a dermatologist. If there are allergies or some type of alteration in the skin, consult with the specialist before the application of thepeeling.
The chemical peel is an effective alternative to treat marks, wrinkles, spots. This type of treatment is indicated to improve the appearance of the skin, does not guarantee the elimination or permanent results. It is not an indicated treatment to eliminate flaccidity or to eliminate deep scars.
[For the peeling user] What is the price of a chemical peeling treatment?
The price of a chemical peel will depend on the type, in each city and country the prices vary. In addition, an important factor to consider is the fees of the specialist and / or clinic where it is performed.
In Spain, a complete treatment is, more or less, between 80 and 500 euros (depending on whether all appointments are included, number of sessions, products and the consultations that are required).
Approximately the prices for a session can be (in euros):
- Surface peeling: 80- 180
- Medium peeling: 300-600
- Deep peeling: 1000- 1800
In the case of superficial peels, several sessions may be needed, whether the treatment is paid in full or each session. If you opt for a medium peel, fewer sessions, these are approximately every two or three months as indicated by the specialist. In a deep peel, it is usually just a session.
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