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Procedures
Treatment for:
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Restoring Youthful Appearance With Our Variety Of Safe And Effective Chemical Peels
What Is Chemical Peel? Chemical peels are a method of resurfacing the skin. By inducing a chemical reaction to the skin, chemical peels replace part or all of the epidermis and can induce collagen remodeling which helps to improve sun damage, wrinkles, pigmentation (spots), and scarring. Such skin damage can be treated with a chemical peel, a non-invasive procedure designed to promote cell growth and produce smoother, clearer skin. Chemical peels are divided into three categories depending upon the depth of the wound created by the peel.
Chemical peels can be performed on the face, neck, chest, arms, hands, and legs.
Am I A Candidate For Chemical Peel? You will be evaluated extensively to determine the appropriate peel for your skin type. Patients with a history of herpes simplex virus would be treated prophylactically to prevent an outbreak of herpes. Patients infected with HIV are poor candidates for a peel because their suppressed immune system would delay wound healing and increase the risk of wound infection and subsequent scarring. Patients who have been treated with oral isotretinoin need to wait for 12 months before having a peel due to risk of infection and post peel scarring. Also, patients who had a recent facelift or browlift should wait for 6-12 months before undergoing a medium or deep peel. Other factors that need to be considered to determine if patient can have chemical peel include history of keloid (scarring) formation, previous X-ray therapy of the skin and nicotine use. You will be examined for your skin type and degree of photodamage using both Glogau photoaging classification and the Fitzpatrick skin type scale. The provider would also note the oiliness/ dryness of the skin and the presence of any inflammatory skin disorders, such seborrheic dermatitis or psoriasis. Patients with very oily skin may need additional prepeel degreasing of the skin in order to achieve the desired depth of penetration of the peel.
What Product is Contained in Chemical Peels? There are three basic categories of chemical peels (Superficial, Medium and Deep peels). Each type works differently, and produces different results. Dr. Lee may choose from the following three types of chemical peel, or she may tailor the treatment to the needs of your skin. In general, the stronger the chemical, the deeper the peel, will give more impressive results. However, the deeper the peel, the more pain you’re likely to experience and the longer the recovery time will be.
What Are The Complications or Side Effects Of Chemical Peels? Superficial peels: Glycolic, lactic or salicylic peels can cause some flaking, redness and dryness, hyperpigmentation or skin irritation. These side effects diminish over time. Post peel hyperpigmentation or inflammation can be treated with topical hydroquinone or topical steroids. Once the body heals itself naturally, the outer layer of skin will fall away. Patients are usually able to engage in normal public activities the day after an AHA peel. Medium peels: Trichloroacetic acids (TCA) peels may cause significant swelling, depending on the potency of the chemical solution that was used. Swelling should diminish after the first week. The skin may be pink initially, feel tight, and peel in 2-3 days and continue peeling for up to 1 week. The skin will heal sufficiently to resume normal activities in approximately 7-10 days. After TCA peels, some patients also have outbreaks of small whiteheads, called milia, which are formed in obstructed facial glands. Generally, these disappear with washing, but in some cases a doctor will need to remove them. Deep peels: Phenol acid peel can cause swelling, redness, uneven results, infections, hyperpigmentation, acneiform eruptions, scarring, hypopigmentation, systemic toxicity and drug interaction. Your doctor may prescribe a mild pain medication to relieve any discomfort. If a waterproof adhesive is applied to the treated area, it will be removed in 1-2 days, and you’ll be instructed to cover the area with antiseptic powder several times a day. A scab will form and, within 7-10 days, new skin will form. See Chemical Peel Before and After Photos!
Chemical Peel Glossary
Acneiform eruptions: Acneiform eruptions are breakouts of comedones, papulopustules, cysts, or nodules that resemble acne vulgaris. Occasionally, this may lead to their initial misdiagnoses. It occurs from a wide variety of diseases, including infections, growth anomalies, and drug reactions.
Actinic keratoses (AKs): AKs are precancerous scaly gray-to-dark-pink patches on sun-exposed skin, including the face, scalp, and backs of the hands. The sandpaper-like surface is often easier to feel than to see. If left unattended, actinic keratoses may evolve into skin cancer.
Alpha-hydroxy acids (AHAs): Alpha-hydroxy acids are naturally occurring acids, derived from the sugars in particular plants. Some examples are Glycolic Acid (Sugar Cane), Lactic Acid (Milk), Tartaric Acid (Grapes), Citric Acid (Citrus Fruits), Malic Acid (Apples), and Mandelic Acid (Bitter Almonds). These acids work at the very base of the stratum corneum of the skin, dissolving the cement that holds dead skin cells together. This increases cell turnover and influences the structure of new stratum corneum being made. This results in skin that is more flexible, smoother, and more even in tone.
Beta Hydroxy acids (BHAs): Beta Hydroxy Acid or BHA is a derivative of aspirin and is often used in skin care products to accelerate skin cell turnover and help clear pores. It can penetrate more deeply than Alpha Hydroxy Acid and is gentler. Beta Hydroxy Acid is salicylic acid. This occurs in nature in sweet birch and in wintergreen leaves. Its effect on the epidermis and upper dermis are similar to those of Retin-A, but with less irritation. It is soluble in oil and can exfoliate oily skin areas, even within oil-rich pores. Therefore, it has a beneficial effect on acne, pigmentary disturbances, and sun damaged skin
Dermis: The lower or inner layer of the two main layers of cells that make up the skin. The dermis contains blood vessels, lymph vessels, hair follicles, and glands that produce sweat, which helps regulate body temperature, and sebum, an oily substance that helps keep the skin from drying out. Sweat and sebum reach the skin's surface through tiny openings in the skin that act as pores.
Epidermis: The outer layer of the skin. Unlike the dermis, the epidermis does not contain nerve endings or blood vessels.
Glogau photoaging classification:
Isotretinoin: A medication used for the treatment of severe acne. It is sometimes used in prevention of certain skin cancers. It is a retinoid, meaning it is derived from vitamin A and is found in small quantities naturally in the body. Oral isotretinoin is marketed under various trade names, most commonly Accutane; while topical isotretinoin is most commonly marketed under the trade names such as RetinA.
Melasma: Melasma (also known as chloasma) is a skin condition in which brown patches occur primarily on the cheekbones, forehead and upper lip. It also may develop on the nose chin, lower cheeks and sides of the neck. The dark patches usually have distinct edges. Melasma is seen most frequently in young women taking birth control pills and also occurs commonly during pregnancy. It may develop in association with menopause, hormonal imbalance and ovarian disorders. Melasma may also be triggered by a medication called Dilantin (phenytoin). In many cases, it occurs without any of these predisposing factors and is occasionally seen in men. The keys to melasma prevention and treatment are sun avoidance/protection and skin lightening products
Milia: Milia are deep seeded white bumps that form when skin cells and sebaceous matter become trapped rather than exfoliate naturally.
Post-inflammatory hyperpigmentation (PIH): Postinflammatory hyperpigmentation (PIH) is a frequently encountered problem and is the result of various skin disorders or skin treatments. This acquired skin darkening can be caused by different disease processes that affect the skin; these processes include infections, allergic reactions, mechanical injuries, reactions to medications, phototoxic eruptions, trauma (eg, burns), and inflammatory diseases (eg, lichen planus, lupus erythematosus, atopic dermatitis).
Psoriasis: A chronic, noncontagious disease that occurs when the growth of new skin cells rapidly accelerates, resulting in thick, red, scaly, inflamed patches on the skin surface. There is currently no cure for psoriasis, but many treatment options are available. It is considered an auto-immune disease.
Seborrheic dermatitis: A chronic inflammatory disease of the skin of unknown cause or origin, characterized by moderate redness; dry, moist, or greasy scaling; and yellow crusted patches on various areas, including the midparts of the face, ears, forehead, umbilicus (the navel), genitalia, and especially the scalp.
Solar lentigines: Solar lentigines are a form of skin damage caused by years of cumulative sun exposure. They are benign, flat, lesions which may be round or oval with a distinct border.
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