CODE AFA Practitioner Articles
Chemical peels
Chemical peels have a perennial appeal. Figures from the American Society of Plastic Surgeons show a very steady and significant demand for them over the last eight years and they remain an effective way to refresh the skin, remove fine lines and wrinkles and give the skin an even tone and colour. The idea of them is not new, of course, and the origins of the use of chemical peels to soften and improve the appearance of the skin dates back over 3,500 years to the ancient Egyptians, who used animal oils, salt, and alabaster to smooth the skin, and sour milk or fermented grape skins from the bottom of wine barrels to enhance beauty. What they were benefiting from was the superficial skin peeling effects of hydroxy acids which remove the outer layers of the skin. These acids have now been identified as lactic acid in milk and tartaric acid in grape skins and can be found in a wide range of modern beauty products.
Today, numerous forms of acid have been identified which can be used to induce beneficial changes for the skin. Facial peels have grown enormously in popularity over the last few years and it is now the 3rd commonest non-surgical cosmetic procedure in the US, according to the American Society for Plastic Surgery (ASPS). Here in the UK there is evidence that treatments are growing rapidly.
A chemical peel can restore a more youthful appearance to wrinkled, unevenly pigmented, sun-damaged, or blotchy skin. All chemical peels involve applying a chemical solution to remove the outer layers of skin so that a smoother, more evenly pigmented, glowing layer of skin can appear. These chemicals change the composition of the skin, essentially delivering a very controlled type of superficial tissue destruction.
There are three basic categories of chemical peels. Each type works differently, and produces different results.
Light peels: Alphahydroxy acids (AHAs), Betahydroxy acids (BHAs)
Light or "lunch hour" peels are the mildest of the chemical peels. These peels include glycolic, lactic, and fruit acid peels (AHA) or salicylic acid (BHA). They aim to remove only the outer layers of the skin to smooth out fine wrinkles and/or rough, dry skin, or to improve the texture of sun-damaged skin, balance out skin pigmentation, or diminish some types of acne scars. These peels are often repeated to achieve the desired results. For the patient, the application of AHA and Beta lift peels is relatively fast and simple. The procedure is quite comfortable and usually takes about 10 to 15 minutes.
Medium peels: Trichloroacetic acids (TCA)
A TCA solution is used for medium depth peels. This is generally used to treat skin with moderate sun damage, surface wrinkles, and/or uneven tone or pigment abnormalities. A full-face TCA peel takes approximately 15 minutes. Sometimes two or more TCA peel treatments, at intervals of one to two months, are necessary to achieve the desired results.
Deep peels: Phenol acid
Phenol acid is the strongest chemical peel solution, and it is used for the deepest possible chemical peel. Phenol peels are used to treat skin with coarse wrinkles and blotchiness. They may also be effectively used to treat patients with pre-cancerous growths.
Deeper phenol peels are only used with caution because they can cause permanent lightening of the skin and generally require anaesthesia. Phenol peels are only used once and create dramatic results. Full-face phenol peels may take between one and two hours but phenol peels for small portions of the face, such as the upper lip, may take only 10 to 15 minutes. A waterproof adhesive is often applied to the treated area after the session which is removed in 1-2 days. First a scab will form and, within 7-10 days, new skin will appear. While the skin will be red at first, the colour will lighten over a few weeks to a few months.
All types of peel are enjoying popularity with patients and can provide a useful source of income by attracting both new patients and offering an additional service to existing aesthetic patients; if you are not yet offering chemical peels in your practice why not join our next certification course?
The next peels course is in London on 3rd October 2009; for details and to book click here
