Everything you need to know about Chemical peels

I still meet clients in my practice who have not had a facial yet and they turned 50.

Chemical Peels seemed to be the luxury of the rich until the boomers medi-spas that transformed everything into possible.

Not only can you get a chemical peel in pretty much any spa but also you might be able to also get Botox or Fillers.

Chemical Peels are a very old treatment used by Asians with severe hyper pigmentation 1000 years ago or close. It wasn’t the grapefruit peel or any other AHA peel they used but the “pidgeon’s poop” which seemed to contain acidic enzymes that could brake down the epidermal cells inducing skin regeneration.

 How does it work?

That is exactly the purpose of a chemical peel: by chemical reactions they bind to the desmosomes that form the outer first layer of the epidermis, break down the bridges between desmosomes and superficial epidermal cells with no structural support are being sloughed off. So what happens to the denuded epidermis? The epidermal skin has 5 layers of cells and the natural turnover of the body incorporates a mechanism similar to a chemical peels where the outmost layer of epidermis is continually “recycling” itself every 20-45 days depending on how young or old you are. In other words Chemical Peels only do what the aging body is forgetting to do or is too slow and ineffective to keep up with the demands of wrinkles, pigmentation, scars, large pores, that unfortunately are so popular as we turn 40.

Are Chemical Peels dangerous?

Chemical peels sold online can be dangerous: the concentration of the peel renders the depth of the epidermis and sometimes the dermis to which they penetrate; and the type of peel Glycolic or TCA for example determines a continuous reaction over few days (Glycolic) or a one time reaction that is controlled by the concentration( TCA).

Even though they replace a natural “beauty” mechanism of the body, Chemical Peels must be administered into a spa, doctor’s office or alike that guarantees safety and efficacy.

We do not encourage you to by over the counter or online chemical peels. 

Who should get a Chemical Peel ?

Anyone who wants to maintain a beautifully, young skin should get on a regular basis a chemical peel.

Am I to young to have a chemical peel? Or too old?

Even though a beauty treatment for most of its applications, Chemical peels more and more are internalized into doctors treatments of severe acne, scars, melasma.

So if you are not aging but have a skin condition that requires deep exfoliation and regeneration of the dermal-epidermal junction, you are a good candidate. It is a decision for you to reach together with a very well trained professional or aesthetic physician/dermatologist. At the other end if you show advanced signs of aging and never exposed your skin to a chemical peel, you may want to be cautious and be under the supervision of a physician for your first peel.

Best age to start regenerating your skin is late twenties. Your skin turnover is probably around 25 days at that time so you only need 2-3 peels/year unless you suffer from acne or have residual acne scars. The best peels for this age group are AHA( alpha hydroxyl acids) or BHA( Beta hydroxyl acids) which are naturally found in fruits and have a very low concentration usually 8%. These peels are very common in day spas settings and any licensed esthetician should know how to apply it.

What types of Peels are popular?

The most popular are probably glycolic peels, which range in concentration from 8%-60%.

Most popular concentration is 20% in day spas and 30% in Medi-spas with higher concentrations available only under the care of specialized estheticians/physicians/nurses.

Glycolic peels are best for dry skins or mixed to dry skin but they can be used on any type of skin with excellent results. Glycolic peels are recommended for beauty intense maintenance but they showed great results in our practice for acne treatments as well. We actually have incorporated glycolic peel with benzoyl peroxide into an Acne Serum available in Dr. Kerns Skin Care line for $44.

Similar to Glycolic peel is the Mandelic Peel that we use in 30% concentration from Vivant Pharmaceuticals to treat especially large pores, blemished skin, or oily prone skin. We often incorporated it in our acne treatments as well after we exfoliate the skin.

TCA( trichlor acetic) Peels come in concentration from 7.5% to 15% most encountered in professional settings or even some high end spas with trained personnel. In higher concentration of 30% to 60% are very rare and they are used as deep peels excellent to resurface entire skin,only by Plastic Surgeons or some Dermatologists.

Chemical peels come in 3 forms: mild, moderate and deep. Most over the counter, online products or spa related peels are mild (superficial). They only exfoliate 1-2 layers of epidermis. Moderate peels are the most popular in doctors’ offices or Medical Spas and they tend to resurface all 5 layers of the epidermis and in certain concentrations or mixtures even superficial dermis. Deep peels resurface the entire epidermis and most of the dermis. They have significant downtime, need special after care and are prone to complications, but in trained hands they do give amazing results.

At Orchid Aesthetics Medical Spa we like 30% concentration of Mandelic/Glycolic peels and 7.5-15% for TCA peels.

We are pleased to have recently added the VI Peel a physician supervised exclusively treatment, which consists of a mixture of Glycolic, Phenol and TCA peel. The VI Peel promises deeper penetration with no downtime, no side effects and moderate peeling time( up to one week).

How long should I expect to peel my skin?

Some peels are superficial and mild and you might not notice a significant sloughing of the skin after their application. With most moderate peels you are expected to peel your skin for a few days 3-4 days, while TCA or the VI Peel are associated with longer and more intense sloughing of the epidermis and dead skin cells (up to 7 days) and need more intensive after care. But all mild and moderate peels have no downtime and you will not encounter any disruption of your daily activities, nor do you need time off from work Unless given special instructions or specific skin care regimen by your professional, the basic skin care after a peel consists of: moisturizer, sun screen SPF 45 or higher for 7-10 days, no direct sun exposure, no retinol based products for one week. No contraindications to make-up applications.

Contraindications to Chemical peels

You may want to defer a chemical peel if you have been recently in the sun, have a sunburn, eczema of the skin, rashes of known or unknown origin, and allergies to prior similar applications. Or if you plan a trip in the next few days or would like to sun bathe in the near future.

Botox and Chemical Peel or Filler and Chemical Peel: Which one goes first?

If your doctor or professional recommends you to have same day both procedures the sequence of treatments might be important in limiting the downtime or complications.

With mild peels and most of the moderate peels sometimes and in experienced hands the sequence is not significant.  But if in doubt having the chemical peel first is safer. Any swelling or inflammation, redness or bruises associated with injections might limit the possibility of an immediate chemical peel application. One of the requirements prior to getting a peel is to have the skin free of abrasions, eczema, and rashes.

How about Laser or Microdermabrasion?

For other procedures like Laser you want to apply the chemical peel last. If you practitioner recommends microdermabrasion at the same time we prefer to apply the peel first, completely dry the skin and proceed with microdermabrasion after. At our New York Medical Spa, an aesthetic physician supervises and trains estheticians in all procedures and skin care products. The philosophy of a chemical peel to precede a microdemabrasion is dual: first better results, by breaking down the desmosomes between dead-skin-cells they are more easily removed by the mechanical abrasion that follows with the aluminum oxide salts or microdiamond tips; secondly, the aluminum salts can sometimes irritate the skin if applied before the peel. 

Excellency comes through non-stop research and hard work. Peels have been around for long time and we continue to perfect them. Dr. Kerns is very experienced with chemical peels applications and very successful in providing excellent result.

Take home message: use the moisturizer at home and have the peel under the care of a professional!