A
chemical peel is a body treatment technique used to improve and smooth the texture of the facial
skinThe skin is the outer covering of the body. In humans, it is the largest organ of the integumentary system made up of multiple layers of mesodermal tissue, and guards the underlying muscles, bones, ligaments and internal organs. Skin of a different nature exists in amphibians, reptiles, birds...
using a chemical solution that causes the dead skin to slough off and eventually peel off. The regenerated skin is usually smoother and less wrinkled than the old skin. Thus the term chemical peel is derived. Some types of chemical peels can be purchased and administered without a medical license, however people are advised to seek professional help from a dermatologist, plastic surgeon, maxillofacial surgeon, or otolaryngologist on a specific type of chemical peel before a procedure is performed.
Alpha hydroxy acidα-hydroxy acids, or alpha hydroxy acids , are a class of chemical compounds that consist of a carboxylic acid substituted with a hydroxy group on the adjacent carbon. They may be either naturally occurring or synthetic. AHAs are well-known for their use in the cosmetics industry...
s (AHAs) are naturally occurring organic carboxylic acids such as
glycolic acidGlycolic acid is the smallest α-hydroxy acid . This colorless, odorless, and hygroscopic crystalline solid is highly soluble in water. It is used in various skin-care products. Glycolic acid is found in some sugar-crops....
, a natural constituent of sugar cane juice and
lactic acidLactic acid , also known as milk acid, is a chemical compound that plays a role in several biochemical processes. It was first isolated in 1780 by a Swedish chemist, Carl Wilhelm Scheele, and is a carboxylic acid with a chemical formula of C
3H
6O
3...
, found in sour milk and tomato juice.
A
chemical peel is a body treatment technique used to improve and smooth the texture of the facial
skinThe skin is the outer covering of the body. In humans, it is the largest organ of the integumentary system made up of multiple layers of mesodermal tissue, and guards the underlying muscles, bones, ligaments and internal organs. Skin of a different nature exists in amphibians, reptiles, birds...
using a chemical solution that causes the dead skin to slough off and eventually peel off. The regenerated skin is usually smoother and less wrinkled than the old skin. Thus the term chemical peel is derived. Some types of chemical peels can be purchased and administered without a medical license, however people are advised to seek professional help from a dermatologist, plastic surgeon, maxillofacial surgeon, or otolaryngologist on a specific type of chemical peel before a procedure is performed.
Alpha hydroxy acid peels
Alpha hydroxy acidα-hydroxy acids, or alpha hydroxy acids , are a class of chemical compounds that consist of a carboxylic acid substituted with a hydroxy group on the adjacent carbon. They may be either naturally occurring or synthetic. AHAs are well-known for their use in the cosmetics industry...
s (AHAs) are naturally occurring organic carboxylic acids such as
glycolic acidGlycolic acid is the smallest α-hydroxy acid . This colorless, odorless, and hygroscopic crystalline solid is highly soluble in water. It is used in various skin-care products. Glycolic acid is found in some sugar-crops....
, a natural constituent of sugar cane juice and
lactic acidLactic acid , also known as milk acid, is a chemical compound that plays a role in several biochemical processes. It was first isolated in 1780 by a Swedish chemist, Carl Wilhelm Scheele, and is a carboxylic acid with a chemical formula of C
3H
6O
3...
, found in sour milk and tomato juice. This is the mildest of the peel formulas and produces light peels for treatment of fine wrinkles, areas of dryness, uneven pigmentation and acne. Alpha hydroxy acids can also be mixed with a facial wash or cream in lesser concentrations as part of a daily skin-care regimen to improve the skin's texture.
AHA peels are used to:
- reduce fine wrinkling
- treat areas of dryness
- reduce uneven pigmentation
- aid in the control of acne
Acne vulgaris is a common skin condition, caused by changes in pilosebaceous units, skin structures consisting of a hair follicle and its associated sebaceous gland, via androgen stimulation. It is characterized by noninflammatory follicular papules or comedones and by inflammatory papules,...
- smooth rough dry skin
- improve the texture of sun-damaged skin
AHA peels may:
- cause stinging
- cause skin redness
- cause mild skin irritation
- cause dryness
- take multiple treatments for desired results
Beta hydroxy acid peels
It is becoming common for
beta hydroxy acidA beta hydroxy acid is an organic compound which contains a carboxylic acid functional group and hydroxy functional group separated by two carbon atoms...
(BHA) peels to be used instead of the stronger alpha hydroxy acid (AHA) peels due to BHA's ability to get deeper into the pore than AHA. Studies show that BHA peels control oil, acne as well as remove dead skin cells to a certain extent better than AHAs due to AHAs only working on the surface of the skin.
Salicylic acidSalicylic acid is a beta hydroxy acid. This colorless crystalline organic acid is widely used in organic synthesis and functions as a plant hormone. It is derived from the metabolism of salicin...
(from the Latin
Salix meaning:
willow tree) is a
biosynthesizedBiosynthesis is an enzyme-catalyzed process in cells of living organisms by which substrates are converted to more complex products. The biosynthesis process often consists of several enzymatic steps in which the product of one step is used as substrate in the following step...
, organic, beta hydroxy acid that is often used. Sodium salicylate is converted by treating sodium phenolate (the sodium salt of phenol) with carbon dioxide at high pressure and temperature. Acidification of the product with sulfuric acid gives salicylic acid. Alternativly, it can be prepared by the hydrolysis of Aspirin (acetylsalicylic acid) or Oil of Wintergreen (
methyl salicylateMethyl salicylate is a natural product of many species of plants. Some of the plants producing it are called wintergreens, hence the common name.-Botanical background:...
) with a strong acid or base.
Jessner's peel
Jessner's peel solution, formerly known as the Coombe's formula, is a combination of salicylic and lactic acids, and resorcinol. It is thought to break intracellular bridges between keratinocytes.
Retinoic acid peel
Retinoic acid is derived from retinoids; which is denatured vitamin A. It is chemically similar to Retin-A. This type of facial peel is also performed in the office of a plastic surgeon or a dermatologist or Med Spa setting. This is a deeper peel than the Beta Acid peel and is used to remove scars as well as wrinkles and pigmentation problems. It is usually performed in conjunction with a Jessner; which is performed right before, in order to open up the skin, so the retinoic can penetrate on a deeper level.
The client leaves with the chemical peel solution on their face. The peeling process takes place on the third day. So, they will basically look okay to go to work on the first two days and have to take only the third day off. In order to see real changes in the skin, it is necessary to have a series of these peels.
Trichloroacetic acid peels
Trichloroacetic acidTrichloroacetic acid is an analogue of acetic acid in which the three hydrogen atoms of the methyl group have all been replaced by chlorine atoms....
(TCA) is used as an intermediate to deep peeling agent in concentrations ranging from 20-50%. Depth of penetration is increased as concentration increases, with 50% TCA penetrating into the reticular dermis. Concentrations higher than 35% are not recommended because of the high risk of
scarScars are areas of fibrous tissue that replace normal skin after injury. A scar results from the biologic process of wound repair in the skin and other tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound Scars (also...
ring.
Trichloroacetic acid peels:
- are preferred for darker-skinned patients over Phenol
- smooth out fine surface wrinkles
- remove superficial blemishes
- correct skin pigment problems
Trichloroacetic acid peels may:
- require pre-treatment with Retin-A or AHA creams
- require repeat treatment to maintain results
- require the use of sunblock for several months (this is a must)
- take several days to heal depending on the peel depth
Phenol peels
PhenolPhenol, also known as carbolic acid, is a toxic, white crystalline solid. Its chemical formula is C6H5OH and its structure is that of a hydroxyl group bonded to a phenyl ring, making it an aromatic compound.-Phenols:...
is the strongest of the chemical solutions and produces a deep skin peel. Recent studies suggest that phenol is most likely only the carrier for another active component in the solution, namely
croton oilCroton oil is an oil prepared from the seeds of Croton tiglium, a tree belonging to the natural order Euphorbiales and family Euphorbiaceae, and native or cultivated in India and the Malay Archipelago. Small doses taken internally cause diarrhea. Externally, the oil can cause irritation and swelling...
. In fact, phenol alone produces only a light peel which is ineffective for restructuring the deeper dermal structures (such as wrinkles). The term
Phenol/Croton oil peel has been proposed as a more accurate descriptor, but the established terminology
phenol peel continues to be of dominant usage, as the role of croton oil in the mix is not as widely understood.
Effects of a phenol chemical peel are long lasting, and in some cases are still readily apparent up to 20 years following the procedure. Improvements in the patient’s skin can be quite dramatic. A single treatment usually achieves the desired result.
Phenol peels are used to:
- correct blotches caused by sun exposure or aging
- smooth out coarse deep wrinkles
- remove precancerous growths
Phenol peels may:
- pose a risk for patients with heart problems
- permanently remove facial freckles
- cause permanent skin lightening by reducing the ability to produce pigment
- take several months to heal
- require increased protection from the sun for life
Anesthesia
Light chemical peels like AHA and glycolic acid peels are usually done in dermatologists’or plastic surgeons' offices. There is minimal
discomfortDiscomfort may refer to:* pain, an unpleasant sensation* suffering, an unpleasant feeling or emotion....
so usually no anesthetic is given because the patient feels only a slight stinging when the
solutionIn chemistry, a solution is a homogeneous mixture composed of two or more substances. In such a mixture, a solute is dissolved in another substance, known as a solvent. Gases may dissolve in liquids, for example, carbon dioxide or oxygen in water. Liquids may dissolve in other liquids. Gases can...
is applied. If a patient were to request something for
painPhysical Pain is the unpleasant feeling common to a headache and a stubbed toe. It typically consists of negative affect and aversion, and has location, duration, intensity and a distinctive quality...
, an oral pain pill like Tylenol with codeine would be appropriate.
Medium peels like TCA are also performed in the doctor’s office or in an
ambulatory surgery centerAmbulatory surgery centers are also known as outpatient surgery centers or same day surgery centers. Medical facilities where surgical procedures not requiring an overnight hospital stay are performed are sometimes called surgicenters. Such surgery is commonly less complicated than that...
as an outpatient procedure and are a bit more painful. Frequently, the combination of a
tranquilizerA tranquilizer, or tranquiliser , is a drug that induces tranquillity in an individual.The term "tranquilizer" is imprecise, and is usually qualified, or replaced with more precise terms:...
like Valium and a pain pill usually suffice. TCA peels often do not require anesthesia because the solution itself has a numbing effect on the skin. The
patientA patient is any person who receives medical attention, care, or treatment. The person is most often ill or injured and in need of treatment by a physician or other health care professional, although one who is visiting a physician for a routine check-up may also be viewed as a patient.The word...
usually feels a warm or burning sensation.
Phenol is the classic deep chemical peel. The application is very painful and most practitioners will perform it under either general anesthesia, administered by an MD-anesthesiologist or nurse anesthetist. Less often, the procedure is done using very heavy
sedationSedation is a medical procedure involving the administration of sedative drugs, generally to facilitate a medical procedure with local anaesthesia.- Uses :...
, usually intravenous or intramuscular. But that approach is less desirable for several reasons including possible adverse influences of the phenol upon the
heartThe heart is a muscular organ found in all vertebrates that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...
.