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Chemical Peels

Softer or smoother?

A peel will provoke an accelerated exfoliation of the skin. It will smoothen the skin by inducing key activity at the skin “construction” level, the basal layer. Either a chemical agent (acid) can produce that effect or a natural acid found in fruits, trees or other natural elements.

The goal is : bringing a bright aspect back on the face, neck and hands by giving a smoother feel to the skin, a younger appearance and a more homogeneous color. The sun is unfortunately the main aging factor, often a very rapid one. A peel is a short procedure giving good results needing a close monitoring during the application process.

Three main peel categories:

- Superficial, or soft peels, also called “Lunch Peels”.

- Medium Peels

- Deep Peels

The most common active ingredients or acid types are:

- Superficial peels: Fruit derived acids (AHA or organic based)

- Medium and deep peels: TCA (trichloro-acetic Acid) from 15% up to 40%

- deep peels: Phenol

The follow-up period depends on the peel type:

- Back to normal daily activity right after the Lunch Peel

- Down time (not able to maintain normal activity for up to 2 weeks) during the resurfacing time after a medium or deep peel. The skin could remain pink for up to 3 months.

Peels accelerate skin renewal by external exfoliation. The superficial skin layer is taken away inducing a reconstruction with less irregularities and a smoother surface. Dilated pores are reduced, excess sebum is dried out, sunspots and blackheads are expelled as well.

The use of peels requires a lot of experience and care. Our skin has specific boundaries that could be easily and rapidly trespassed if a peel’s key steps are neglected. That’s why you must consult with an experienced professional who has developed an expertise in chemical peels of all types.

Do not misinterpret a peel offered in a beauty salon with a medical grade peel performed by an experienced professional. The beauty salon peels are comfortable and relaxing, the medical ones will be a bit harder but will provide you with much more significant results. They require precision and minutia.

Peel Descriptions:

1) Glycolic Acid Peels or “Lunch Peels” (30, 50 or 70% concentration)

Glycolic Acid peels (AHA or fruit acid peels) are the most popular because they do not leave marks on your skin. They are quick and easy, that is why they are called “Lunch Peels”. They can be done during your lunch break and nobody will notice. Their safety is well known. The Lunch Peel, doesn’t need a down time or a follow-up period. If you have 30 minutes in your busy schedule, this peel is right for you. You will like its results but to be totally sastisfied, you will need between 4 and 6 sessions over a 6-week period.

Other peels use chemical agents such as TCA (Trichloracetic Acid) or phenol. They are limited to physician’s use only. Be careful!

A Lunch Peel session has six major steps:

a) Make-up removal

b) Pre-peel solution is applied on the skin; it lowers skin pH to 4.5

c) Peel applied on the skin for a limited amount of time. Usually an increasing amount from session to session.

d) When the timer rings: neutralization occurs. It’s the important step. Without it, a peel would become dangerous. We have seen patients treated in centers where this step had been omitted: they were seriously burnt.

e) Isotonic spray applied on treated area

f) Anti-oxidant mask applied on treated area. Must be kept intact for 12 hours.

Finally, a lunch peel session lasts 30 minutes.

Key Indications: Dilated skin pores, blackheads, grayish skin tone, skin fatigue, superficial and fine wrinkles

Recommended Price per session: 95 €

2) TCA Peels (trichloracetic acid).

Several concentrations exist: 15%, 25%,30 and 40% ; Some are already prepared by cosmetic laboratories, ready to use. Physicians based on published formulas reconstitute others. Our centers use only laboratory manufactured and controlled peels.

a) 15% TCA:

This peel type gives a new freshness to your skin. It tightens skin pores quite efficiently giving a smoother feel to the skin. Perfect for fair skin individuals, it may be used year around but requires sunscreen for 3 months if applied during the summer season.

Key indications: 

- Brown/sunspots,

- Dilated skin pores

- Grayish skin tone

- Fine wrinkles

Treatment frequency:

Initial « attack » phase: 4 sessions every other week plus 1-2 sessions each month for 2 months month for a total of 6-8 sessions over 6 months.

Session Duration: 30 minutes

How is your face after a 15% TCA peel: Your face will be red for 2 days (like after a sunburn), then it will turn brown for 1 to 2 days and then your skin will fall off (large exfoliation sections like scabs) for up to 3-4 days. Then your skin may look pink for 7 to 10 days.

VERY IMPORTANT RECOMMENDATIONS:

a) Please do not expose your face directly to sunlight without sunscreen (SPF 40+, 60 is best) during the peel process.

b) Do not pull on scabs or bits of peeling skin. Let them or let your skin fall off by itself. If you pull on your skin you will get scars or long-term marks, even skin discoloration. So, no pulling, no itching, no sun without sunscreen.

Most frequently treated areas : face, neck, décolleté, hands and forearms.

Recommended Price : 240€.

b) 25% TCA :

Slightly more concentrated than the previous one, it is a stronger and harder peel and a bit more difficult in the follow-up phase. Only an experienced physician should perform TCA peels (Aesthetic Physician, Dermatologist or Cosmetic Surgeon).

This type of peel is often presented in kits including ingredients that make it more homogeneous and help minimize its irritating effects. The 25% TCA Peel lets us concentrate on the most affected areas by modulating its intensity based on their aspect.

Indications:

- Age spots / sunspots

- Freckles 

- Brown spots from a pregnancy (melasma)

- Keratosis (hardened skin) 

- Wrinkles and fine lines 

- certain scars (superficial ones, some acne scars)

Treatment protocol:

One session between November and March. Two sessions per year could be used if a particular effect is expected (i.e. reducing acne scars on chin, jaw or forehead) on scars or wrinkles.

Session Duration: 30 minutes

How is your face after a 15% TCA peel:

The initial phase is similar to the 15% TCA. But, here an edema appears during the first 48 hours and should last about one week. Since your face is not at its best for about 7 days, you should take a week off to manage the follow-up period. People who want to use this peel prefer to start a Friday so they are back to work the second Monday. A sunscreen is ABSOLUTELY necessary for the following three months.

Most frequently treated areas : face and neck

Recommended Price: 250-300 € (30%TCA).

30% and 40% TCA are stronger versions of the above-described peel. The follow-up phase is similar to the 25% peel but a bit more intense.

3) Phenol Peels :

imagepeel2
These peels use a lipophillic agent (phenol) to exfoliate the upper layer of the skin. More effective on oily skins, it is a very potent peel, one that requires great care and commitment to patients’ monitoring during the following week; It’s main indications:

- acne, acne scars,

- rosacea

- Wrinkles on upper lip and lower eyelid

Professionals who use Phenol Peels are able to modulate intensity based on the aspect of the target area. Skin exfoliation is consequently adjustable. It is crucial to monitor a phenol peel very closely to be able to neutralize it as soon as the appropriate layer in the skin has been reached (intense heat). The follow-up period of one week will bring the patient back to the clinic the next day and every other day up to day 7, to check on the skin status. When the skin falls off, a yellow powder (to prevent infections and to promote skin reconstruction) will be applied. Risks and side effects are similar to those observed in TCA 25%+ peels. A significant edema may be observed for 48-72 hours. For upper lip indications, a local anesthesia is usually recommended for added comfort.

In order to minimize the dual tone skin effect, a 15%TCA is usually added to the phenol treated areas (i.e. upper lip and lower eyelid).

A phenol peel takes about 45-60 minutes on Day 1. Another 30 minutes will be necessary on Day 2, 15 minutes on Day 4, 6 and 8. A patient who undergoes this type of peel should be invited to come back, at any time if he/she feels to.

The new skin, smooth and soft will be pink for 3 months (fades away) and will be sunscreen protected for up to 6 months with 40+ SPF.

Recommended Price: $780 (+ the cost of the 15% TCA at 120€)

Other Peels :

Some creams are available through retail or the net. Depending on your skin phototype or complexion and on the issue you wish to solve, at home kits may or may not provide a decent solution. Some preparations with pyruvate or resorcin or Unna preparation are acceptable but you should consult your physician first.

Elevated phototypes, darker skin people, could use Kruelig’s peel but should seek advice first to avoid any inconvenience.