Types of peelings
Depending on the concentration of acids included in the peels and pH, peels are divided into superficial, medium and deep.
Superficial peeling
is the “softest” variation of the procedure - it affects the upper stratum corneum. It uses acids that work superficially - mandelic, salicylic and fruit acids. The light composition helps to open and cleanse pores of sebum, as well as get rid of blackheads and the effects of acne.
With medium chemical peeling
the acid concentration is much higher. Medium chemical peels are excellent at combating wrinkles and scars due to their effect on the epidermal layer of the skin. It provokes the production of collagen and elastin, which visually tighten the skin and smooth out wrinkles.
Deep chemical peeling
It is carried out only in a hospital setting under the supervision of specialists. It affects all layers of the skin down to the basement membrane. The rehabilitation period is up to several months.
Only a doctor should prescribe a peel, taking into account the concentration of acids, the pH environment, the pharmacological effect of the peel, skin problems and phototype.
My history
“Look, no matter how much you have to walk under a veil all your life,” I received such friendly parting words several years ago, when I decided to try fractional laser rejuvenation.
“Well, stay with your strawberry and cucumber masks,” I joked. I did not believe at all in their miraculous power, capable of smoothing out wrinkles and tightening the face. On the contrary, she believed in high technology. And it was this technique, studied far and wide, that seemed to me the best choice. The procedure was done by the best specialist, in late autumn. The result exceeded all expectations. However, summer came, the sun warmed up, and it was discovered... Even if not a veil, but a wide-brimmed hat and “sun protection” of at least SPF 50 - that’s my lot. But even they are unable to prevent the fact that the previously even and golden tan has now been replaced by light spotting. In some places it is lighter, in others it is darker. And the whole face (toned up and without wrinkles) generally looks motley due to pigmentation disorders. In a word, beauty, and nothing more. After taking a closer look and talking with those around me, I discovered that I was not the only one facing this problem. “The Motley Case” can be safely opened in relation to resurfacing, dermabrasion and chemical peels, which are very popular today. And the latter, by the way, are recommended today as an off-season procedure. “Pigmentation after peeling and other procedures does occur, and quite often,” explains Natalia Polonskaya. – Even if some traumatic procedure was done before summer, the skin still remains activated for a long time - it is characterized by increased activity of melanocytes. These skin cells, which produce the pigment melanin, can react to increasing heat, climate change and other factors. And if the procedure takes place during a period of high solar activity, the risk of pigmentation disorders increases even more. Therefore, with regard to many technologies that injure the skin (electrical, laser and photoepilation, laser resurfacing, photorejuvenation, effects on blood vessels, etc.), an immutable rule applies - their season begins in October and ends in March. As for pigmentation after peeling, you need to clearly understand their classification according to the depth of impact. Peels that damage living epidermal cells in the sunny season can only be done if there are compelling reasons, after weighing the possible risks and benefits. Peels with exfoliation within the stratum corneum of the epidermis can be done without a summer break, but with an interval of at least 7-14 days.
Post-peeling care
Peeling always means damage to the skin. Under the influence of various types of acids, the skin has been traumatized to one degree or another, so it needs some time to restore its natural functions and renew itself. This period is called rehabilitation. It includes a series of care procedures that are prescribed to you by your doctor.
It is a true statement that half of the success and excellent result of the peeling depends on the correctness of the actions of the doctor and the patient in the postoperative period, the duration of which is directly related to the depth of the effect performed, as well as the type of skin. On average it ranges from several weeks to 3-4 months.
Care after peeling is aimed primarily at returning the epidermis to its protective properties, reducing signs of skin sensitivity, as well as preventing the formation of scars and other defects.
Necessary recommendations
In the first 5-7 days after peeling, the skin, as usual, peels a lot, so a smart solution to restore its barrier function would be to use moisturizing and nourishing products. The restoration of intercellular lipids is facilitated by the unsaturated fatty acids and ceramides contained in the creams. After some time, a crust forms on the treated areas, which cannot be damaged in any way, including mechanically.
If you experience discomfort and signs of erythema, you should include preparations for sensitive skin in your daily care. They act gently and safely.
After chemical peeling of the face for about 30 days, it is highly recommended not to expose your skin to ultraviolet irradiation: do not sunbathe in the open sun and refrain from going to the solarium. When going outside, especially in the spring and summer, you should use sunscreen with a filter of at least 30, and to prevent re-pigmentation - 50+.
Decorative cosmetics are also contraindicated for at least 10 days after the procedure. It should be used in minimal quantities, choosing anti-allergenic products for particularly sensitive skin. The recovery period requires strict adherence to hygiene rules, which is the key to eliminating complications.
Restoration by type of peeling
All types of peelings require daily care after the event. In general, it consists of treating the skin with moisturizing, toning and sunscreen products.
The method of skin care during the post-peeling period depends on the depth to which the acid was exposed, as well as the type of skin. And, if the superficial type of peeling is more gentle on the skin, then the middle and deep ones require a more careful and serious post-procedural approach.
For superficial peeling
, after removing the stratum corneum, the skin actively peels off. Recommended products: sun protection (index no less than 15), as well as moisturizing creams.
Medium peeling
involves an effect on the epidermal layer, recovery lasts up to one month. You should use sedatives that contain antioxidants; anti-UV rays (index from 30). It is also better not to engage in strenuous physical activity, as the sweat produced will irritate damaged skin.
Deep peeling
, being an aggressive method of exposure, most of all injures the skin, causing it a significant burn, as a result of which rehabilitation will last from 2 to 3 months. In addition to all the above mentioned products, it is also necessary to use drugs to reduce itching; choose sun protection creams with a filter of 30 or more.
Sun traps
According to Natalia Polonskaya, it is still wrong to draw direct parallels between anti-aging procedures, the sun and skin pigmentation disorders. There are people who do not give such a reaction, even immediately after peeling when exposed to the sun. For others, the first rays of sunlight are enough for the appearance of freckles and spots. There are several main reasons for the appearance of pigmentation disorders.
— Skin phototype
Whether or not pigmentation appears after peeling or another procedure primarily depends on the skin phototype. With the first phototype (very fair skin, blond or red hair, blue eyes), the risk of pigmentation is close to zero. With the second phototype (fair skin, brown hair, green, gray or blue eyes), it increases. And starting from the third (normal skin, with a natural color, hair - from dark blond to light brown, brown eyes) its probability is quite high. The situation is aggravated if the woman is in a group that constantly uses contraceptives. Their intake, like hormonal disorders, increases the activity of melanocytes. Hereditary predisposition to pigmentation also plays an important role.
— Penetration depth
Uneven tanning or pigmentation disorders may be associated with the depth of the treatment. When peeling, the penetration of the active substance is not the same everywhere: somewhere it penetrates deeply, and somewhere it acts more superficially. In different areas, the skin has different thickness and other characteristics. As a result, in some places it regenerates quickly and completely, while in others, rehabilitation after peeling takes longer.
— Individual skin characteristics
Different people have different areas of skin that are prone to pigmentation differently. For example, chloasma or melasma (a disorder of skin pigmentation resulting from increased production of pigment) appears in different places: for some on the cheekbones, for others on the forehead, etc. Sometimes peelings can trigger the onset of melasma.
— External reasons
The appearance or intensification of hyperpigmentation can also be caused by external reasons. For example, pigmentation disorders often occur around the mouth: this may be due to the use of lipstick or the ingestion of juice droplets and food particles that act as irritants and photosensitizers. Deeper penetration of peeling and the appearance of pigment spots in the eye area can provoke tears, which appear both with various emotions and when the breeze blows.
We act without fanaticism
So, procedures are by no means always the only cause of pigmentation disorders. But they add this risk. Therefore, even when peeling within the stratum corneum, it is important to act “without fanaticism.” If you get too carried away and practice such peels every day, pigmentation may eventually appear. For well-groomed skin, one procedure per month is quite enough. And to reduce pores, you can use not only peelings, but also special masks, creams and lotions.
“We must really understand that it is impossible to make the skin fundamentally better than what nature intended,” warns Natalia Polonskaya. - There is no need to traumatize and tease her endlessly. If you really want to take care of yourself, in addition to traumatic manipulations, there are massages, gymnastics, and fairly effective non-traumatic cosmetic procedures. Yes, the arsenal of cosmetic products has expanded. We began to take better care of ourselves. But at the same time, getting carried away, trying to escape from age and problems, sometimes we do a lot of unnecessary things. As a result, we encounter not only skin pigmentation disorders, but also dilated blood vessels, dehydration, and increased skin sensitivity. Alas, no global miracle has happened yet. It is impossible to stop time and replace old skin with new one. This must be accepted and stopped in time. So that later you don’t have to cover up the traces of intensive self-care with a thick layer of makeup.”
Precautionary measures
Skin preparation and rehabilitation help to avoid pigmentation after peeling or other procedures. In my case there were none. Moreover, no one offered them to me. And, as it turned out, here again I was not alone. The importance of such precautions is underestimated not only by patients, but also by cosmetologists themselves; many prefer to save on them.
“If the procedure, in particular peeling, damages the skin only within the stratum corneum, preparation and rehabilitation after peeling are not necessary,” explains Natalia Polonskaya. – In this case, competent and balanced home care is important. So that, for example, the patient does not come home after the procedure and rub his skin with sea salt. When peeling with damage to living cells, timely care for restoration and protection significantly reduces the risk of damage from the sun and other factors.
To prepare the skin for chemical peeling in order to prevent pigmentation disorders, drugs that inhibit melanin synthesis can be used in advance, for two to three weeks (such substances include hydroquinone, arbutin, kojic acid, glabridin, etc.) Rehabilitation after peeling, like me I have already said that it consists of measures for emergency restoration and protection of the skin. Our clinic has developed a universal technique that, in various modifications, can be used after any skin damage (burns, frostbite, chapping, laser exposure, herpes, abrasions, etc.) and consists of home care products and, if necessary, professional procedures. The home care includes a cleanser that gently removes flakes without damaging the skin, an alcohol-free soothing lotion, a revitalizing gel and a revitalizing cream with SPF. This is the minimum set that promotes skin regeneration. If the procedure causes significant peeling, in-clinic care may be required. It is necessary to relieve discomfort, gently remove scales, and reduce irritation and redness of the skin. To do this, an enzymatic peeling based on whey is applied to the skin, and then drugs that promote rehabilitation after peeling. In an unusual situation, rehabilitation is adjusted. Sometimes you may need antiseptic drugs or (for a herpetic infection) drying antiherpetic drugs, for a dense crust - drugs that facilitate the separation of the scab, for severe inflammation - anti-inflammatory and decongestant drugs. The number of procedures also depends on the problem: it ranges from one to five.
If you are doing a fairly traumatic procedure, play it safe. No one knows how the skin will react to it. Today the result may be good, but tomorrow it may not be so good. Yes, these are additional costs. But they are not as big as subsequent treatment and combating the problem.
The most effective ways to combat skin pigmentation disorders today include the use of drugs based on hydroquinone, arbutin, azelaic and kojic acids, and phototherapy. It is often necessary to combine different methods of influence. And it is very important to remember that 1) not all pigmentation can be lightened completely; 2) pigmentation is prone to recurrence, 3) sun protection only partially prevents the increase in pigmentation; 4) prevention of increased pigmentation is not a one-time event, but an ongoing process. With post-traumatic pigmentation, the pigment lies in different layers of the skin, therefore, in addition to bleaching agents, it is necessary to use absorbable drugs and improve metabolic processes.
