What are Chemical Peels?
Since the 1980’s the aesthetic industry has seen a dramatic increase in the use of exfoliators in both the spa and clinical setting. In addition, many consumers direct products now contain some form of alpha hydroxyl acid.
Chemical peels are formulas that have been specially prepared to encourage the skin to desquamate or shed the top layer of the epidermis (stratum corneum). They are made from various chemicals which each react in a different way on the skin, but all are considered chemical exfoliators (chemoexfoliation). Reconstructive surgery dates back to ancient work. Physicians were utilizing skin grafts for reconstructive surgery as early as 8BC.
Chemical peeling is the application of a chemical agent to the skin, which causes controlled destruction of a part of or the entire epidermis, with or without the dermis, leading to exfoliation and removal of superficial lesions, followed by regeneration of new epidermal and dermal tissues. Indications for chemical peeling include pigmentary disorders, superficial acne scars, ageing skin changes, and benign epidermal growths. the process of wound healing, the technique as well as the identification and management of complications.
There are 4 stages of wound healing which include:
- Vascular response
- Inflammatory Response
- Proliferative phase the active growth phase
- Maturation phase
Chemical peels are used to create an injury of a specific skin depth with the goal of stimulating new skin growth and improving surface texture and appearance. The exfoliative effect of chemical peels stimulates new epidermal growth and collagen with more evenly distributed melanin.
The Cell Renewal Process
The skin naturally renews itself every 28 days. However, during certain parts of our life, the skin renewal process can be disrupted by hormones, menopause and adolescent time. These changes can cause open pores, oily skin and slower skin renewal time.
What are the mechanisms of action for Chemical peels?
The dermis layer of skin has three crucial components: collagen, elastin, and glycosaminoglycans (GAG’s). They form the bulk of an important support system called the Extracellular Matrix (ECM). The matrix consists of structural proteins (collagen and elastin), glycosaminoglycans, and proteoglycans. Glycosaminoglycans (GAG’s) are polysaccharides, also called amino sugars (a sugar linked with a protein). Together with water, they create a fluid that fills the space between the collagen and elastin fibres in the dermis, giving it turgidity. This gel-like fluid is called the ground substance. There are various glycosaminoglycans in the dermis. The most common ones are hyaluronic acid, chondroitin sulfate, keratin sulfate, dermatan sulfate, heparin sulfate, and heparin. The key thing to know about glycosaminoglycans is that they are water-binding substances. The GAG’s in the ground substance of the dermis attract water (brought to the dermis by blood vessels). Water in the dermis also diffuses to the lower layers of the epidermis, and eventually migrates upward through the epidermal layers.
Fitzpatrick Skin typing
It is very important with chemical peels to know the Fitzpatrick skin type you are treating. Knowing the Fitzpatrick skin types allows the therapist to get the correct peel and the strength of the peel. Higher Fitzpatrick is more prone to hypo and hyperpigmentation.
The classification known as the Fitzpatrick skin type (or phototype) depends on the amount of melanin pigment in the skin. This is determined by constitutional colour (white, brown or black skin) and the result of exposure to ultraviolet radiation (tanning). Pale or white skin burns easily and tans slowly and poorly: it needs more protection against sun exposure. Darker skin burns less and tans more easily. It is also more prone to develop pigmentation after injury (brown marks).
PIHP – Inflammation (such as after acne, eczema, lichen planus, allergic reactions) or trauma to the skin (such as surgery, incorrect use of microdermabrasion, lasers or chemical peels) causes the release of inflammatory cells that cause melanocytes (pigment cells) to produce more pigment in the skin.
Chemical Peel Classifications
Chemical peels come in many various PH levels and strengths. Each chemical peel is designed to treat a specific concern. These concerns can be discussed with the therapist who will be able to select the appropriate peel and strength. Chemical peels can be classified into 4 levels, depending on the depth of the skin, which in turn correlates with the nature and intensity of the lesions to be treated.
The main objectives of chemical peels are below:
- Oxygenate the skin
- Improve skin texture and minimise pores
- Increase epidermal integrity
- Soften lines and wrinkles
- Clear skin tone and make the skin tone uniform
- Correct pigmentation concerns
- Help control sebum levels
- Control acne
Highly Superficial peels – Improve skin tone appearance and luminosity of the skin
Superficial Peels – Superficial peels stimulate epidermal growth factors by removing the stratum corneum the first layer of the skin which is visible. Some skin peeling may take place similar to sunburnt skin. Avoid picking and irritating the skin. Always follow the aftercare advice from the practitioner.
Medium Depth Peels – Medium Depth peels target the papillary layer – the peels remove epidermis which starts the wound healing process which in turn regenerates the collagen synthesis and elastin. Deep Peels- Deep peels penetrate into the reticular dermis which leads to an inflammatory response. Results in new collagen formation. Giving the skin brighter, healthier and new collagen.
Peels can come as a liquid or gel. The texture of the peel will depend on the type of peel that is being used. Liquid peels penetrate the skin quickly. Whilst gel peels offer a better application without any peel dripping. Some peels available
Glycolic – Glycolic peels come in many strengths and glycolic can be found in many toners which are available on the high street. Toners have a low percentage of glycolic. Glycolic peels help wrinkles and acne. Glycolic peels are a part of the AHA peels, Alpha-hydroxy peels. Glycolic peels are usually derived from sugar cane. Glycolic is known for its small molecular weight meaning a deeper penetration of the peel into the dermis layers of the skin.
Mandelic – Mandelic peels are usually made out of almonds. Always check for nut allergies. Mandelic peels adhere to the surface of the skin causing gentle exfoliation of old skin cells. Mandelic peels are generally safe to use even on sensitive skin. Mandelic similar to glycolic is also an AHA peel.
Salicylic Acid – Salicylic peels are made from white willow trees also known as aspirin. Always check for client allergies. Salicylic is a BHA Beta hydroxy acid. Comedolytic properties to clean out the skin and slough off the dead skin cell build-up. It is also anti-inflammatory which helps reduce the irritation of acne and minimise acne. Salicylic can also control the oil and sebum levels in the skin. Desmolytic help break down and shed the connective tissue this helps skin shedding and reduce pores.
Lactic – Mild peel, provides hydration and luminosity. Usually suitable for all skin types and a great starter peel. Lactic peels are made from sour milk. They are also a part of the AHA group of peels. Similar to Mandelic and glycolic. Lactic acid helps remove dead skin cells, reduce pores, germs which in turn make product penetration into the skin more effectively. Lactic acid also helps aid in maintaining the skins natural PH levels. Lactic acid also aids the skin tone clarity, skin brightness and has moisturising properties. Lactic acid is usually a mild peel and is great to start your peel journey with lactic acid.