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WHAT IS CHEMICAL PEELING?
Chemical Peeling is exactly what it
says - peeling of the skin using a chemical. A chemical
peel removes the outer layers of the skin. This freshens
the skin, removes some sunspots and rough scaly patches,
and reduces freckles and irregular pigmentation.
It also reduces fine wrinkles. There is some evidence
that it may reduce the risk of skin cancer. It is safest
and most effective on the face. Hands can be peeled
but the risk of scarring is higher and the results less
predictable.
WHAT IS THE HISTORY OF CHEMICAL
PEELING?
Cleopatra and the ancient Romans used
various food acids to peel their skin. In the early
1900s, European and Americal women underwent 'non-medical'
peels in salons with secret formulae, which were probably
mild acids. In the early 1950s, the phenol peel was
developed.
This was a fierce deep peel that could
remove years of wrinkles, but also gave peeling a reputation
for complications - pigmentation, depigmentation, scarring
and even abnormal heart rhythms due to absorption of
the chemicals. However, when done under controlled conditions
by an experienced physician phenol peeling is safe and
effective.
Trichloroacetic acid, being a more gentle
acid, has made a comeback in popularity because although
it will not make a 50 year old look 25 again, it rejuvenates
the skin without the risk of serious side effects. Other
agents used include combination peels and pyruvic acid.
WHO IS SUITABLE?
Fine wrinkling can be reduced, though deeper lines
will remain, (some of which can be improved by other
methods) with chemical peeling. Most brown marks, freckles
and pigmentation can be removed or lessened, especially
age and liver spots (lentigines).
However, pigment changes can be caused by a peel in
people prone to this complication due to their skin
type. Those known to develop brown discolouration after
injury such as a mild burn should have a test area peeled
first before undergoing a full face chemical peel. Scaly
patches and rough skin (keratoses) can be removed. Very
thick keratoses may needadditional treatment for complete
removal.
Skin that is thin and fragile eg sun-damaged skin,
bald scalpskin, can be significantly rejuvenated.
Chemical peeling is not a substitute for a facelift.
It does not tighten sagging skin, stimulate collagen
production or remove broken capillaries.
Chemical peeling is not appropriate for people who
will continue to have excessive sun exposure.
ARE THERE ANY COMPLICATIONS?
Scarring can occur with strong acids, but is unusual
with weaker ones. The most common causes of scarring
are infection, and pulling off the skin before it is
ready to peel. Both of these are avoidable.
Cold sores can be activated in those prone to this
kind of condition. Anti viral medication can prevent
this. Increased pigmentation may occur, and resolves
with time. It can be largely prevented by religious
use of sunscreen for three months after the peel.
WHAT IS THE PROCEDURE?
The skin may have had preparation with Vitamin A, Alpha
Hydroxy Acid or other preparations. Firstly the skin
is thoroughly cleansed with acetone or other cleanser.
The acid is then painted onto the face and monitored.
If burning or stinging is a problem, a cold pack may
be helpful. Usually the treatment is carried out in
sections. Patients who find it particularly uncomfortable
may choose intravenous anaesthetic, but then would not
be able to drive a car for several hours.
WHAT HAPPENS AFTERWARDS?
The skin will go red and swollen over the next 24 hours.
Once the initial burning has worn off it is not painful,
but feels tight. Over the next few days the skin dries
and looks like a brownish leather. Vaseline should be
applied several times a day to prevent cracking. Water
will do no harm but soap should be avoided.
The skin will begin to peel between 5 and 7 days later,
and must be left to come off at its own pace. As soon
as the skin has healed, make up may be applied over
the new, pink skin. Sometimes a secondary peel occurs
during the second week in the form of dry scaling skin.
Sunscreen is mandatory for at least three months, and
moisturisers are helpful. Chemical peeling can be repeated
after three months, but this is not usually necessary.
It can be repeated at any time in the future and will
not harm the skin.
The habitual use of sunscreen will prevent further sun
damage and therfore maintain the improved skin quality.
Additionally, the use of vitamin creams, AHA creams
or enzyme creams can continue to improve the skin texture
and reverse some of the effects caused by years of sun
exposure. |
