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 American 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 discoloration 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 need additional treatment for complete removal.
Skin that is thin and fragile and sun-damaged, even bald scalp skin, 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 anesthetic, 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. An ointment type of cream 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 moisturizers 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 therefore 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.
Consistent use of anti-aging skincare regimes, good nutrition, water consumption, sunscreen, exercise, and adequate rest act to counteract skin damage.