Patient Information — Chemical Peels and Dermabrasion

How do peels reduce or eliminate wrinkles and lines?

Peels target the outermost layer of skin causing it to peel off. The regenerated skin is smoother and appears more youthful and healthy. Chemical peels, usually acids (fruit acids or trichloroacetic acid = TCA), employ chemical formulas to remove specific layers of the skin. The depth of the skin removed can be varied by the concentration and the time the solution is allowed to work.

Peels are suitable for the treatment of fine lines, rough skin texture and pigmentation (liver spots, etc.). Since the skin is more sensitive to sunlight after the peels are preformed, it is better to have them done during the cold times of the year.

What are chemical peels?

Chemical peels are carefully controlled chemically assisted peeling of the skin with the objective of producing fresh, newly regenerated skin.

The depth and length of the peels are subject to the specific needs of the individuals. Different substances and techniques are used, depending on the skin layer that is to be treated.

Most frequently used are gentle superficial peels (also referred to as “soft peels” or “lunch peels”), which induce a reconstruction with improved skin quality. Brief in their duration, they can be easily performed during lunch and the patient can return to normal daily activities without any downtime. Deeper acting peels that have more effect on the skin structure (to correct wrinkles, pigmentation problems, etc.) are also available. Peels are always comprised of three essential phases: preparation, actual peel and follow-up. Plan on a duration of three months for effective peel treatments.

Fruit derived peels (soft peels)

Fruit acids, chemically speaking, are called alpha hydroxy acids, explaining the abbreviation “AHA”. They occur in fruits and in metabolic products found in the human body. Useful for superficial soft peels, they usually do not limit the patient’s leisure and work activities following the peel.
In most cases, the fruit derived acids are produced from organic substances (grapes, apples, lemons, sugarcane, milk, etc.). Glycol acid, obtained from sugarcane, is the most frequently used and the fruit acid that is most backed by research. Due to its particularly small molecule size, it is especially effective at penetrating into the skin.

Explanation of what AHAs do

  • Exfoliation: AHAs dissolve the adhesive substance between the keratinocytes, softening, smoothing and clarifying the complexion while making the thin horny epidermis layer appear more compact. In addition, exfoliation increases the skin’s protection and facilitates moisture retention.
  • Cell stimulation: APAs’ proliferation facilitating action leads to the revitalization of the epidermis. Connective tissue cells increase in number, hydration improves significantly and the depth of wrinkles is reduced.
  • Qualitative boost: AHAs improve skin qualities thanks to the increase of the active, vital cells and reduction of dead skin cells.
  • Protection: AHAs support the physiological protection of the skin, assisting the acid mantel in combating bacteria, viruses and other potential contaminants that might penetrate the skin.
  • Door opener: APAs open the “door” for subsequent substances.

What AHAs can achieve:

  • Smoother, firmer skin appearance
  • Reduced pore size and hyperpigmentation
  • Improved skin structure

Medium peels
The fruit derived acid concentrations can be increased and the preparations made stronger to increase the depth of the peel. The acids (Jessner’s solution, TCA solution) can be mixed to produce stronger effects. Medium peels are applied to produce a more intense renewal of the skin layers. Since the exfoliation is greater and subsequently more visible (large sections of skin will peel off and scabs or crust may form), plan on 7 to 10 days to heal.

What is meant by dermabrasion (skin planing)?

Lasers or chemical peel substances are not the only means available for the removal of superficial skin layers. Dermabrasion is a mechanical technique that uses a very small, rapidly vibrating burr device specially designed for the precise removal of targeted skin layers. The procedure is similar to sanding or planing and is suitable for defined areas, for example, the removal of fine lines around the mouth. Local anaesthetic is necessary.

What kind of complications can occur after skin removal procedures or treatments to eliminate wrinkles (laser, peels, dermabrasion)?

We recommend patients who are particularly susceptible to herpes labialis (fever sores) or infection take medication that will provide them with the necessary protection. Because the newly generated skin is very photo sensitive, patients need to protect themselves very well against the sun for approximately three weeks after the procedure to avoid excessive pigmentation. Great care must be exercised when using all of the techniques to avoid injuring deeper skin layers, which could cause pigmentation or even scarring. For this reason, it is imperative that the procedure be performed only by qualified physicians who have experience with the specific technique.

What condition is the skin in and how long does it take the skin to heal after peeling or dermabrasion has been performed to treat wrinkles?

Immediately after the treatment, the skin appears red or pink and may weep, similar to an abrasion wound. The new skin layers require between 5 and 10 days to regenerate. How long the newly formed skin remains red is relative to the technique used: chemical peels and dermabrasion usually require 3 - 6 weeks; laser treatments up to 6 — 12 weeks, sometimes even longer. After 7 — 10 days, the red colouring can be effectively covered with makeup.