Retinoic yellow peeling done by Hollywood stars

What are the contraindications?

The procedure is a type of aggressive effect on the epidermis, so it is not allowed for everyone. Contraindications include:

• stage of exacerbation of infectious, viral, bacterial, fungal processes on the skin;
• unhealed wounds, cuts, abrasions, scratches;
• tendency to form keloid scars;
• tanning 2 weeks or less old;
• chronic diseases in the relapse stage;
• oncological pathologies;
• intolerance to the components of peeling preparations;
• pregnancy and lactation;
• recent laser procedures;
• large moles;
• unstable mental state.

The procedure is not performed if the patient is not feeling well: with fever, pain, high blood pressure, colds, or other ailments.

What should be the care after retinoic yellow peeling?

The most important thing for the skin after any chemical procedure is to recover quickly and without consequences. The post-peeling period is a serious time that requires a more careful attitude towards the face and the fulfillment of certain requirements. For the first two weeks, you should not use cosmetics containing retinoids. It is also best to avoid any other treatments, chemical or cosmetic, such as hair coloring or perming.

You can take care of the skin when swelling, various irritations or painful symptoms appear with the help of anti-inflammatory and regenerating drugs, such as a special balm consisting of borage and shea butters, copper peptides, panthenol, fireweed extract, licorice and horse chestnut. This remedy has a calming effect. As a result, the skin quickly returns to its normal state. A special balm is recommended to be used together with aerosols, the basis of which is deuterium (heavy) water, which has strong antibacterial and protective properties.

Two days after peeling, you can start using your usual cleansers. Only they should not contain harsh surfactants, and their base should consist of either water or gel, that is, be fat-free.

Three to four days after the retinoic yellow peeling procedure, characteristic peeling appears on the face. In order for the epidermis to quickly get rid of unnecessary layers, cosmetologists advise applying a mask rich in lactic acid and cranberry enzymes. It has antioxidant, antihistamine and antiviral properties, thanks to which flaky skin returns to its normal state much faster.

How does acid affect the skin?

To obtain the effect of acid peeling, different components are used, depending on the patient’s age, the condition of his skin, the depth and volume of defects. Each acid has its own mechanisms of action:

1. Almond – gently penetrates into tissues, capable of breaking down fats. Reduces the appearance of defects, fights free radicals, and has antibacterial properties. Used to treat post-acne and acne scars. Mostly suitable for superficial peeling.
2. Milk – optimal moisturizing and whitening. Restores skin turgor and elasticity, removes inflammation, reduces the depth of wrinkles.
3. Retinoic – promotes collagen synthesis in the body, removes pigmentation. Smoothes out fine wrinkles and improves skin texture.
4. Malic acid is a universal acid used to moisturize and saturate cells with oxygen and nutrients. Stimulates microcirculation.
5. Glycolic – care for oily skin. Helps with scars, scars, post-acne, eliminates signs of age-related aging. Evens out the texture and tightens pores.
6. Ferulic – helps eliminate the effects of ultraviolet exposure. Gently penetrates the dermis, inhibits the inflammatory process, and prevents redness.
7. Salicylic acid – dissolves dead epidermal cells, provides deep cleaning of pores. Normalizes the functioning of the sebaceous glands, activates the production of collagen and elastin.

The type of composition for acid peeling, concentration, and exposure time are determined individually by the cosmetologist, depending on the condition of the skin and the age of the patient.

There are three main types of peeling:

• superficial – shallow effect on the epidermis (fruit, glycolic, almond, retinoic, milk);
• median – affects the dermis (salicylic acid, trichloroacetic acid, azelaic acid);
• deep - affects all layers of the skin, down to connective tissue and fiber (phenolic).

Penetrating into the epidermis, the acid burns damaged, old and keratinized tissue, while simultaneously stimulating high activity of regeneration, cell division and the appearance of new structures. Also, chemical exfoliation of the stratum corneum promotes the accelerated production of your own collagen and elastin.

Important! A deep type of cleansing effect is carried out exclusively in special clinic conditions by a cosmetologist. The use of anesthesia and monitoring of the patient's health condition is required.

Advantages of this procedure

Acid peeling has many advantages:

• effective at any age, provided the correct composition is selected;
• stimulates cell renewal, promotes rejuvenation;
• activates tissue regeneration;
• helps reduce the depth of scars and cicatrices;
• effective in the treatment of acne, acne, comedones;
• restores the structure and oval of the face;
• removes hyperpigmentation, freckles, age spots;
• normalizes a healthy complexion;
• promotes collagen production, thereby increasing skin elasticity and firmness;
• inhibits fading processes;
• reduces the depth of wrinkles, fights sagging;
• reduces pores, normalizes sebum production;
• controls water balance;
• provides full access of oxygen and nutrients to cells;
• stimulates blood circulation and microcirculation;
• restores velvety and smoothness of the skin.

Chemical exfoliation is one of the effective ways to rejuvenate and heal the skin. The technique provides the fastest possible results; it is an excellent alternative to surgical interventions and plastic surgery.

Disadvantages of this procedure

Since exposure to acids on the skin is an aggressive process, this technique has disadvantages:

• a large list of contraindications;
• painful sensations due to chemical burns of the skin;
• long rehabilitation period - for superficial and medium penetration of acids is 10 - 14 days, for deep penetration - up to 2 months;
• possible appearance of hyper- or hypopigmentation - dark or light areas on the skin;
• Usually one procedure is not enough - treatment and rejuvenation must be carried out over a course;
• acids can cause allergies, even if there were no complaints of a reaction before the procedure.

After the session, you should not sunbathe for a long time under the sun or in a solarium, since ultraviolet radiation can cause complications. Therefore, acid exfoliation is not recommended in the summer; it is better in the cold season.

Why chemical peels (retinoic yellow) are in great demand

Safety

The body will not negatively accept retinoic acid because it is similar to vitamin A. Other acids included in the peel only enhance its effect.

Efficiency

Most experts are of the opinion that it is best to start the rejuvenation process with this type of peeling. The result after two procedures lasts up to four months, which in itself is equal to the effect that a course of ten sessions of peeling with glycolic acid gives.

Gentle impact

The Superficial Retinoic Yellow Peel provides effective results similar to those achieved with a Medium Peel. And at the same time, the impact occurs in a more gentle way.

Short recovery period

Everyone knows that the usual time for recovery processes is one to two weeks. After undergoing the yellow peeling procedure, the skin takes on a healthy appearance in one to two days. Of course, peeling and redness will appear during this period. This is a normal skin reaction to the use of chemicals. But after 48 hours the face will be completely fine.

But it is always worth remembering that each case is individual. And in order to avoid disruption of plans, it is not recommended to resort to such procedures at the very last moment. For example, a cosmetologist will not conduct a peeling session if the client has just returned from vacation and has a fresh tan.

Read material on the topic: Facial mesotherapy procedure: pros and cons

How is this peeling done?

The first consultation with a cosmetologist includes taking an anamnesis, examination, and identifying contraindications. After this, the specialist selects the acid composition, determines its dosage and exposure time. The doctor also gives recommendations on preparing for the session:

1. 20-30 days before the procedure, you need to apply a low-acid composition to the skin, which will be recommended by a specialist - this will help the skin get used to the product, become more receptive, but not experience serious stress. A week before the session, use of the product is stopped.
2. Scrubbing should not be used 7 days before the procedure. Such procedures can damage the skin and leave tiny abrasions on it, which can cause complications.
3. You must stop tanning within 14 days. Go outside only after applying a cream with a high SPF content.
4. People prone to herpes symptoms are recommended to take antiviral drugs.

Then it’s time for the procedure itself:

1. Applying products (according to skin type) that remove dirt, dust and degreasing agents.
2. The use of local anesthetics - anesthetics in the form of a spray or solution.
3. Treatment with a special composition that prepares the surface of the skin for acid to soften the upper layer of the epidermis.
4. Applying the preparation with fruit acid - in one or several layers for a certain time.
5. Neutralization of acid composition with special means.
6. Treatment of the skin with moisturizing, toning, soothing preparations.

The effect will be noticeable after the skin has recovered from exposure to acids. The number of sessions is from 3 to 10 with a weekly interval. The results obtained last for six months with proper care. Subsequently, maintenance procedures may be needed, no more than 2 courses per year.

The problem of complications after peelings (chemical, mechanical, laser) is quite multifactorial. Complications can be caused by both endogenous causes (chronic diseases of blood vessels, heart, kidneys, liver, diabetes mellitus, etc.) and exogenous (incorrect choice of depth of exposure, incorrect preparation for the procedure, etc.)

Therefore, the main rule of a specialist to minimize risks is to carefully collect anamnesis and follow the procedure protocol, taking into account the individual characteristics of the patient. The task of any peeling (chemical, laser, mechanical) is to remove the surface layers of the skin to stimulate its regeneration processes, smooth out the relief, increase the level of moisture, etc.

And the complications after all types of peelings are essentially the same.

PREDICTED OR EXPECTED COMPLICATIONS

These complications are often called side effects, since their development after peeling is considered as a natural reaction of the body to skin trauma.

Erythema

Erythema is a marked redness caused by dilation of superficial blood vessels at the site of inflammation. Depending on the depth and aggressiveness of the effect, it can last from several hours (for example, after superficial peelings with α-hydroxy acids - no more than 3 hours) to several days (after medium peels, microdermabrasion it can last up to 5 days). Physiologically, erythema plays a protective role: due to increased microcirculation in the injured area, the process of removing toxins and tissue regeneration occurs faster.

An increase in the duration of erythema compared to expected may be considered a complication called persistent erythema.

Peeling skin

If after superficial peelings (almond, milk) peeling is practically not noticeable, and after superficial-medium peeling small-plate peeling can be observed (especially on the forehead and in the T-zone), then medium, and especially mid-deep, peelings are accompanied by large-plate desquamation and formation fibrin film. The patient must be warned about this and given recommendations on proper skin care.

To reduce the severity of peeling and correct the course of the rehabilitation period, moisturizing preparations, “Panthenol” cream or spray, “Bepanten” cream are prescribed.

Pastosity and swelling of the skin

Pastosity and swelling of the skin are the result of an inflammatory reaction in response to its damage. Swelling occurs due to increased permeability of small vessels and the release of a certain amount of liquid blood (plasma) into the tissue. It may appear 1–3 days after exposure and persist for up to several days (up to 5–7). More often it occurs after manipulations with the use of retinoids, laser and mechanical peels.

UNEXPECTED COMPLICATIONS

Immediate allergic reactions

Allergic reactions occur after chemical peels as the body’s response to contact with a particular acid. Erythema, itching, and increasing swelling up to Quincke's edema appear.

If the doctor has even minimal doubts about the patient’s allergy status, it makes sense to conduct an allergy test in the area behind the ear.

Formulations with retinol, ascorbic and kojic acids have the greatest allergenic potential. At the other pole is glycolic acid, which extremely rarely causes the complication under discussion.

Herpes after peeling.

Herpetic rashes

This complication may be the result of an incorrectly collected medical history, when the doctor does not take into account the frequency of exacerbations (if 2-3 times a year, this should alert the specialist). It is necessary to prescribe antiherpetic medications 3-4 days before the procedure and for the same time after peeling, or choose another technique that can solve the problem with which the patient came.

Herpetic eruptions can lead to the formation of atrophic scars, so preventing their development is an extremely important task.

Excess crust

Too thick a crust can form after medium-deep peels or dermabrasion. I note that to prevent its occurrence, the course of the recovery period should be assessed in time. Therefore, the patient must definitely come to see the doctor a week after the procedure.

If peeling is not yet observed, and the crust is very pronounced, then it may be necessary to prescribe physiotherapeutic procedures (for example, microcurrent therapy to enhance lymphatic drainage processes under the formed crust), reparative drugs (“Solcoseryl” gel, “Panthenol” cream or spray, “ Bepanten" cream for softening and moisturizing the crust).

Ointment products are not used because they create a film, a greenhouse effect, as a result of which the crust may come off prematurely.

The use of these drugs reduces the risk of cracking of the crust and resulting skin scars.

Skin sensitivity

Skin sensitivity may increase during a prolonged rehabilitation period. This may be caused by an incorrectly selected peeling composition, incorrectly selected laser intensity, or insufficient time between procedures when the skin has not yet had time to fully rehabilitate.

An increase in sensitivity should be a signal for the doctor to stop the course until the skin is completely restored.

Hypersensitivity of the skin is expressed in an excessive reaction to temperature, pain, mechanical influences or sunlight. This complication resolves on its own after 1–2 weeks, but

can persist for up to 1 year even with timely prescribed therapy.

Persistent erythema on the face after peeling.

DELAYED COMPLICATIONS

Persistent or persistent erythema

Persistent erythema more often occurs in patients with closely located vessels: in the presence of rosacea and telangiectasia, a tendency to hyperemia.

This complication can also appear on normal skin due to incorrectly selected peeling composition, exposure factor, or non-compliance with the procedure protocol. Foci of redness periodically appear and disappear. Their formation can be provoked by a variety of reasons: a change in cosmetic product, a change in air temperature. The presence of persistent erythema is an absolute contraindication for continuing the course of any peeling for a long time.

To correct persistent erythema, angioprotectors are prescribed (at least a month, depending on the result of use), cold lotions with chamomile, celandine, chlorhexidine digluconate (no longer than 2 weeks, so as not to dry out the skin), cosmeceuticals (at least a month, depending on the result of use) , the action of which is aimed at strengthening the walls of blood vessels.

In addition, a correction of the diet is required, which involves excluding spicy and pickled foods and alcohol from the diet.

If the doctor has any doubts, light peels with low concentrations of acids and close to neutral pH should be prescribed to assess the condition of the capillary bed.

The use of fractional lasers is the method of choice in the presence of an expanded capillary network and telangiectasia.

Hyperpigmentation

It is necessary to distinguish between false hyperpigmentation and true post-inflammatory. The first is a normal reaction of the body to aggressive influences and represents areas of “dried” grayish skin that peels off over time.

The second occurs as a result of an inadequate cellular response of melanocytes to the damaging effects of peeling. The most susceptible to these complications are patients with a tendency to develop pigment spots, with a history of endocrine or reproductive system problems, with skin phototypes IV–V, Mongoloid and Negroid races, as well as fair-skinned patients with various types of dyschromia. The risk increases with midline chemical peels and laser resurfacing.

To reduce the risk factor for the formation of post-inflammatory hyperpigmentation, careful selection of patients and correct pre-peeling preparation are necessary. Thus, when preparing the skin for chemical peels, tyrosinase inhibitor drugs are used: retinoic, kojic, azelaic acid, arbutin, ascorbic acid, etc. It is also advisable to perform the first professional procedure using a light superficial peel, which will prepare the skin for the effects of stronger compounds.

If we are talking about laser resurfacing, then the first procedures show the test (minimum) power of exposure using the method of selective photothermolysis.

During the post-peeling period, the doctor must prescribe adequate anti-inflammatory therapy, including tyrosinase inhibitors.

If hyperpigmentation does occur, you should first make sure whether it is post-inflammatory in nature or caused by sun exposure and ignoring sunscreens.

“Solar” pigmentation may gradually disappear if the patient begins to regularly use drugs with a high level of photoprotection. Therefore, it makes sense to wait two weeks before starting more serious manipulations.

If the doctor is dealing with pigmentation of traumatic origin, then the methods of choice may be whitening mesotherapy procedures or IPL technologies.

Scarring

Atrophic scars most often occur as a complication after chemical peels and dermabrasion, hypertrophic scars - after laser resurfacing.

There are two main reasons: the first is incomplete history taking (perhaps the doctor did not take into account the patient’s tendency to form scars), the second is non-compliance with the procedure protocol (incorrect choice of acid exposure duration, laser power, depth of exposure - affecting the papillary dermis layer).

The tendency to form scars is, in fact, a contraindication for serious effects. In such cases, it makes sense to offer the patient a course of superficial peels. And although the duration of such therapy will be much longer, tissue fibrosis will be avoided.

If scars do form, then their treatment tactics are usual: hypertrophic scars can be corrected using cryotherapy, fractional photothermolysis, and hormone injections; atrophic - by introducing hyaluronic acid, collagen, using a dermaroller.

Decreased skin turgor

The inflammatory process that occurs after medium and medium-deep peels can lead to degenerative changes in the dermis, manifested by a sharp decrease in turgor. The development of this complication is explained by the incorrect choice of impact force and incorrect assessment of the regenerative capabilities of the patient’s skin. To avoid this complication, peelings can be combined with biorevitalization, which is carried out in the intervals between peeling procedures. This will speed up the rehabilitation process, increase skin turgor, elasticity and moisture.

Demarcation line

The cause of this complication is considered to be a doctor’s error when performing chemical peels. It manifests itself as a clear line separating the area of ​​skin on which the peeling composition was applied from the intact area. More often it appears in the parotid region, along the hairline, along the edge of the lower jaw.

To avoid such an unpleasant phenomenon, you should reduce the exposure time of peeling in areas adjacent to skin that has not been treated with a chemical composition. In other words, the acid here should be neutralized a little earlier than on the rest of the face.

In some cases, the demarcation line disappears on its own within 1.5–2 months. You can speed up this process with a course of superficial whitening peels and whitening preparations for home care.

Some complications are associated with insufficiently careful selection of patients for peeling procedures. Others are the result of incorrectly carried out pre-peel and post-peel measures. Complications can also arise through the fault of the patients themselves - if they do not follow the recommendations of a specialist or conceal from the doctor certain diseases that are an absolute or relative contraindication to invasive procedures.

Polina Uspenskaya, Ph.D., dermatologist, cosmetologist, head. Department of Cosmetology, Federal State Budgetary Institution Polyclinic No. 1, Administration of the President of the Russian Federation, Moscow