On the Internet you can often find negative reviews about deep chemical facial peels . Both doctors and their patients are aware of the complications that can arise after this procedure is performed by an insufficiently qualified cosmetologist.
But when handled correctly, phenol peeling provides simply amazing results that last for a long time.
In this article, estet - portal . com provides depth review of the deep chemical peel procedure by Dr. Xavier Goodarzian .
- What is a deep chemical peel?
- Phenol peeling: indications and contraindications
- Preparing for a deep chemical peel
- Protocol for the phenol peeling procedure
- Recovery after deep chemical peeling
- Recommendations for skin care after peeling with phenol
The acid peeling procedure is carried out in 4 stages:
1. PREV
- peeling preparation: makeup removal, scrubbing, degreasing
2. Peeling procedure: application of acid
3. Neutralization of acid action
4. FAST
- peeling care - cosmetics in the salon and recommendations for home care
INDICATIONS FOR ACIDS PEELING:
The superficial chemical peel procedure can be performed on any area of the skin. Most often, chemical peeling is performed on the face, neck, back, décolleté and hands.
Depending on the type of drug, superficial chemical peels are used to correct cosmetic defects:
- Age-related changes
- Photoaging
- Pigmentation
- Hyperkeratosis
- Dull complexion, uneven skin tone
- Problem skin (acne, post-acne)
- Oily skin, increased sebum production
- Uneven skin texture, enlarged pores, scars, scars
- Prevention of premature aging
Also, superficial chemical peels are used to prepare for medium and deep peels, plastic surgeries, and injection procedures.
Extent of skin damage during peeling
may be different:
- exfoliation of the stratum corneum,
- destruction of the epidermis,
- damage to the dermis.
Therefore, according to the criteria, peelings are divided into:
- superficial
, pH of the composition is not lower than 3.5 with an acid concentration of no more than 10%, does not require neutralization, is washed off with water.
- superficial-median
, the pH of the composition is below 3.5 with an acid concentration of more than 10% - requires neutralization.
- average
(median),
- deep
.
SUPERFICIAL CHEMICAL PEELING
Superficial peeling is the most common procedure and has the lowest rate of complications. Damage within the stratum corneum, to the granular layer of the epidermis.
REHABILITATION PERIOD:
1-3 days - minor hyperemia and peeling, which do not affect the patient’s lifestyle. The damage in this case is shallow, but it affects a very important area from a biological point of view - the stratum corneum, and is already stressful for the skin.
MEDIUM CHEMICAL PEELING
With a deeper impact, when the entire epidermis is damaged down to the dermis. Damage to the basal layer of the epidermis, coagulative necrosis can reach the capillary layer of the dermis.
REHABILITATION PERIOD:
about 7 days - hyperemia, swelling, noticeable peeling. Moderate hyperemia may persist for 2 weeks.
DEEP CHEMICAL PEELING
Complete destruction of the epidermis, coagulative necrosis to the middle of the reticular layer of the dermis.
REHABILITATION PERIOD:
2-4 weeks.
The time for complete epithelization of the wound surface is 6-10 days. Depending on the peeling, erythema persists for up to 4 months.
ONLINE TRAINING Online courses Piercing. Video course cosmetology.
The given data can be considered conditional
, since the effect depends on the pH of the drug used, the exposure of the drug on the skin, the amount of solution applied, the condition of the patient’s skin and other factors.
Chemical peeling is essentially a chemical burn to the skin. In order to minimize complications and side effects, modern formulations have been developed that allow maximum control over the course of the procedure.
Also, strict adherence to the protocol of procedures, pre-peel preparation and post-peel care will help to avoid unforeseen negative consequences.
What happens during acid peeling?
A complex sequence of interconnected events unfolds in the skin, some of which ultimately lead to an improvement in the structure of the skin, while others can cause complications:
1. Any stress stimulus causes skin cells to release many different signaling molecules. These are growth factors, inflammatory mediators, vasoactive substances, etc.
The ability to secrete signaling molecules allows skin cells to act as a single whole, but it also creates problems for cosmetologists, since it is sometimes impossible to predict which cellular elements will be affected by a particular impact and what processes are launched.
For example, keratinocytes that experience stress release substances that stimulate pigmentation. Because of this, any aggressive impact can lead to hyperpigmentation.
2. In response to stress, enzymes are activated that destroy the intercellular substance. This leads to a positive result - a restructuring of skin structures, when new molecules are quickly synthesized to replace destroyed collagen and glycosaminoglycans. In general, cells in the damaged area secrete many different enzymes, with the help of which they dissolve both necrotic tissue and various temporary structures created during the restoration work.
3. The growth of new blood vessels begins, which are necessary for the delivery of building materials, cellular elements, and the removal of metabolites to the area of restoration work.
4. Cells capable of absorbing bacterial cells and foreign particles—macrophages—accumulate in the area of damage. Macrophages migrate into damaged tissue from the bloodstream. These are very important participants in the restoration process, coordinating the activity of all skin cells. Macrophages secrete growth factors, cytokines, reactive oxygen species, enzymes, and synthesize other biologically active substances.
5. Under the influence of growth factors produced by keratinocytes and macrophages, fibroblasts are activated, which begin to build a collagen framework. This framework facilitates the movement of keratinocytes that restore the epidermis. The activating effect of growth factors on fibroblasts is of great importance - there is an increased synthesis of new components of the intercellular substance of the dermis (collagen, elastin) to replace the destroyed ones, which leads to the disappearance of fine wrinkles, smoothing of the skin, increasing its firmness and elasticity.
6. Growth factors and cytokines cause division of basal keratinocytes and their migration to the damaged area. Basal keratinocytes repair the damaged basement membrane and then begin to divide, rebuilding the epidermis.
If regeneration occurs normally:
then the skin after peeling looks better than before damage by acids,
- stratum corneum
becomes thinner and more uniform, complexion and skin condition improves,
- epidermis
denser and thicker
- A dermis
more elastic, and this is the firmness and elasticity of the skin,
- As a result of the increased synthesis of epidermal lipids, the structure of the epidermal barrier is restored, which leads to an increase in the moisture-holding capacity of the skin, the face is hydrated and radiant!
But this doesn't always happen!
This result can rather be attributed to Superficial peelings and Medium peelings.
Deep
peeling
- damages the dermis down to the mesh layer, to the so-called “blood dew” . This manipulation is carried out exclusively in medical centers. The patient is given anesthesia, and the procedure itself is carried out under the supervision of an anesthesiologist-rheumatologist. Deep peeling requires a long rehabilitation period (6 to 10 months). Under the influence of acid, the entire stratum corneum of the skin is burned, and with it wrinkles, scars, signs of sagging and sagging skin.
Advantages
It has a high penetrating ability and a pronounced exfoliating and stimulating effect.
Keratopeel, pH 1.4
A preparation for superficial chemical peeling based on the alpha & beta complex - a combination of AHA (glycolic acid 40%) and BHA (salicylic acid 2%). Due to the rather high content of glycolic acid in combination with the low pH of the composition, KERATOPEEL has a stimulating effect on the dermis, activating the synthesis of collagen and glycosaminoglycans. Salicylic acid is a well-known keratolytic that enhances the penetration of glycolic acid and has a pronounced proliferative effect. The basis of the drug is isopropyl alcohol, which has excellent keratolytic and degreasing properties. The technique of this peeling, as an independent procedure, is not much different from the usual GLYCOLICPEEL, however, it should be taken into account that, due to its properties, KERATOPEEL penetrates the epidermis more aggressively. It is possible to obtain a spot frost effect.
In addition, KERATOPEEL can be used as a keratolytic agent during the retinoic peeling procedure Block Age Peel Cream to ensure good penetration of retinoids in rough skin with severe signs of hyperkeratosis. In this case, the exposure time of KERATOPEEL on the skin should not exceed 15-20 seconds, after which the composition is neutralized using a neutralizer (Neutralizator). The patient washes, the skin is dried and then Block Age Peel Cream is applied according to his protocol. Glycolic peeling with salicylic acid.
The structure of human skin
The skin consists of three main layers:
- epidermis
- dermis (corium)
- hypodermis (subcutis) or subcutaneous fatty tissue
In turn, each layer of skin consists of its own individual structures and cells. We study the structure of each layer in more detail at our training seminars. This is important to understand when choosing not only peeling with acids, but also with hardware methods, and simply so that the result of any procedure meets our expectations.
Read also:
Learn more about skin types and skin structure.
Effective and safe facial peeling with glycolic acid in professional Dermopeel care
The Italian brand Dermophisiologique has developed a line of products, the consistent use of which allows you to renew your skin. The procedure helps exfoliate the surface layer of the skin, removing impurities and dead cells. Excellent for mature skin, for the management of patients with hyperkeratosis (thickening of the epidermis) and age spots. The procedure improves skin color and texture, stimulates the production of new collagen and elastin fibers. The Dermopeel medium peeling procedure increases the elasticity of mature atonic skin, smoothes the surface of scar tissue, improves hydration and elasticity of the skin, and promotes overall rejuvenation.
Professional Dermopeel care – variations of procedures that allow the cosmetologist to carry out effective and safe cosmetic peeling.
What is the frost effect?
The frost effect or frost effect is a white dense coating that appears on the skin shortly after applying the chemical composition. White plaque is nothing more than denaturation of the protein structure of living epidermal cells, which are affected during medium peeling. After the frost effect appears, the acid is neutralized with a special neutralizer and removed. At the end of the procedure, a mask is applied, with which the peeling effect is consolidated. Over the next 10-14 days, the crust peels off and gradually disappears from the treated areas.
What is a deep chemical peel?
Deep is called chemical peeling , which is carried out using phenol.
There are several formulations on the market with different percentages of phenol and croton oil , which enhances its penetration. The higher the concentration of croton oil, the deeper the phenol peeling affects the skin.
The targets for phenol peeling can be both individual areas and the face as a whole.
Deep peels are performed exclusively on the face and are not intended for other parts of the body due to the increased risk of scarring. Target areas can be either individual areas or the face as a whole.
In his practice, Dr. Gudarzyan prefers to work with the entire face, but in some cases it is more advisable to work on particularly problematic areas .
Rice. 1: patient before and 3 months after phenol full face peel (photo by Dr. Xavier Goudarzian)
Why there is no peeling after peeling: reasons
Peeling involves peeling. When should we expect and when will the recovery process take place without obvious peeling? It is intensive exfoliation followed by skin restoration that is the key goal of peeling. However, it often happens that the procedure is completed, but peeling does not occur at all. Could this be the norm?
The skin after peeling does not always peel off. And, that = normal!
The epidermis undergoes a natural exfoliation process every day. The skin is renewed, cells die off and in most cases they are removed during showering, washing or using homemade scrubs. Any peeling, one way or another, is aimed at accelerating this process. After intense peeling, we will see a fresh and rejuvenated face. This is why a lot of questions arise if the skin does not peel off after peeling. This can happen for several reasons.
1. Individual skin characteristics
There is no skin that is not affected by acids at all. However, everyone's sensitivity to drugs is different. That's why the same peeling for one woman may be accompanied by burning and severe redness, but for another it will be completely painless. The genetic characteristics of the skin are directly related to sensitivity to peelings. And indirect reasons are how well the peeling is chosen, the age and condition of the skin, preparation for the procedure... there are many reasons, so the cosmetologist conducts a survey and diagnoses the patient’s skin so that his expectations are met!
Products used in the procedure and pre-peeling preparation
Glycolic peeling 50% ph 1.2
Action: professional medium peeling to effectively combat signs of aging, wrinkles, loss of tone. Stimulates the regeneration of skin cells, renews the epidermis, eliminates the accumulation of melanin, and fights pigmentation. Cleanses closed pores, normalizes sebum secretion, increases the activity of fibroblasts, increases the production of collagen and elastin. Improves skin texture, smoothes wrinkles, skin becomes fresh and elastic.
Figure modeling and stimulation of skin immunity – Fangomassagio procedure
Post-peeling neutralizing lotion pH 8
Action: neutralizes the effect of chemical peeling, restores the physiological pH of the skin. Aloe ferox juice, rich in vitamins, minerals and essential amino acids, intensely soothes and stimulates the regeneration of the epidermis.
Revitalizing mask with lift effect / Resurface Mask
Action: creates a protective film on the skin, restores healthy physiology of the skin, restores the water barrier of the skin, restores the composition of the hydrolipid film and intercorneocyte cement, performs a softening and restorative effect with a lifting effect.
Active ingredients : almond oil, shea butter, urea, jojoba oil, cross-linked hyaluronic acid.
No peeling - just a little time has passed since peeling
Exfoliation after peeling never occurs immediately: simply, for physiological reasons. After a controlled chemical burn, time must pass for the damaged layer of skin to begin to shed. As a rule, this takes 2-3 days. Some people may experience peeling every other day. This is individual and depends on skin type, condition and pre-peel preparation. Less prepared skin, with a lot of unevenness, post-acne spots, acne, as well as thick, aging skin with keratosis, will give you abundant peeling! Even if the skin has not started to peel, there will still be some skin reaction after peeling. It becomes tense, with more active acids, it is possible that the face will be unpleasant to touch, and strong folds will form at the slightest facial expression. Such manifestations indicate that peeling will begin soon.
Contraindications
- Individual intolerance to peeling ingredients
- Violation of the integrity of the skin
- Active inflammatory process on the skin
- Herpes in active phase
- Pregnancy and lactation
Preparations for pre-peeling preparation and post-peeling period for home use
- Cleanser Mousse and Gentle Cleanser Mousse
- Prepeel Light cream (or Prepeel Medium, Prepeel Active)
- Vegefarma Revitalizing Cream
- Post-peel cream Postpeel Light (or Postpeel Medium, Postpeel Active)
- Sunscreen Mediscreen spf 85
Have you done a superficial peel?
Superficial peeling is often part of your usual care routine. It can be done either in courses or once a week. After most superficial peels, there will be no pronounced peeling at all, however, as well as a rehabilitation period. Of course, an enhanced exfoliation process will occur, but there is no talk of large-plate peeling. After superficial peeling, the skin peels off very delicately. If you adhere to the protocol and wear serums, creams, make masks 2-3 times a week, then most likely you will not notice peeling, which will and will quietly remove dead scales. In some cases, especially in the absence of post-peeling care (the scheme described above), the peeling will not be more intense, but more noticeable! The foundation will emphasize it or lie unevenly, but you won’t see anything critical after superficial peelings.
You have done medium or deep peeling - there will be peeling
The most effective types of medium peeling are accompanied by pronounced exfoliation. Most often, the skin comes off in large layers, replacing the old one with a new layer - an even, smooth, “porcelain” complexion. If the peeling is severe, you will have to fall out of life to some extent for several days: you cannot remove the crusts after peeling, there is no talk of any makeup, physical activity must also be kept to a minimum. You may have to take a “vacation” for a few days. With deep peeling, you are under the supervision of a doctor, preferably the first days in the clinic.
5. Your face has become accustomed to acids - proper pre-peeling preparation has been carried out
Before carrying out superficial-medium or medium peels, pre-peel preparation is recommended. This could be one of the options:
- Using home care with acids (the best option is from the same cosmetic line that will perform the peeling);
- Carrying out superficial peeling (or a course of such procedures) several weeks before the main session.
The main goal is to prepare the skin for more uniform penetration of active acids, reduce negative skin reactions during mid-peeling and reduce the risk of irritation. And the peeling itself, especially in low concentration, no longer leads to severe exfoliation.
For many patients, for some reason, peeling is almost the main indicator of the effectiveness of acid peeling! Although, from experience I can say that such a prejudice occurs only at the beginning, when 1-2 procedures are done. After a course of peeling, as well as regular use, this prejudice disappears. The skin becomes firmer, hydrated, rejuvenated, elastic, the depth of wrinkles and age spots decreases! And it doesn’t matter anymore whether it peels off or not. And peeling objectively decreases, the layers of the epidermis are leveled, the stratum corneum fulfills its protective function, and this is the result when our expectations are fulfilled!
BUT, if you are just starting acid peels, then you are concerned about the following question:
Protocol for the phenol peeling procedure
The patient, who arrives at least an hour before the procedure, is offered painkillers and benzodiazepines for the purpose of relaxation.
Then, half a liter of saline is slowly given through the IV line, sometimes with additional IV NSAIDs, for pain relief and hydration.
A week or two before phenol peeling, the author prefers to perform botulinum therapy on the entire face in order to prevent the formation of facial wrinkles in the future.
During the procedure, blood pressure, pulse and oxygen saturation are monitored. A small heart monitor can also be used to measure your heart rate.
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The peeling procedure is as follows:
- The patient's face is cleaned, disinfected and degreased with alcohol and acetone.
- A local anesthetic block is performed to numb most of the face - this allows the procedure to be performed without sedation or general anesthetics, which significantly increase the risk of arrhythmia during the peel.
- The face is divided into several cosmetic areas and marked.
- After this, the peeling process begins: phenol is applied in certain quantities and in a certain number of layers to each area at least 10 minutes apart to ensure detoxification of the phenol and to avoid cardiac side effects.
For the eyelid area, the author uses two layers, and for the upper lip - 3 or 4.
- After treating the entire face, you can apply an occlusive dressing for 12-24 hours. This will ensure maceration of the epidermis and further penetration of phenol.
Rice. 3: patient before and 3 months after phenol peeling around the eyes (photo by Dr. Xavier Goudarzian)
How long does it take for your face to peel? How many days does the face “peele” after peeling?
There is no one answer for all skin types, skin conditions, ages...Everyone's skin reacts differently. The duration and intensity of peeling depend on several factors:
- Individual sensitivity.
- Skin sensitivity.
- Depth of impact. For example, superficial acids cause tissue peeling for 1-3 days, and medium or deep acids last for 5-14 days. In any case, such a “fringe” usually appears only 2-3 days after the procedure.
- Type of peeling: small-plate and large-plate. Simply put, “gentle” procedures peel off the skin in scales, and deep ones peel off in large flaps.
- Post-peeling care. Provides 80% effectiveness of the entire procedure.
- Skin type.
- Type of aging and age-related changes.
It is not surprising that following or ignoring the cosmetologist’s instructions can have a significant impact on the period of tissue renewal.
Can pigment spots darken after peeling with acids? You have noticed that after the procedure, your pigment spots have darkened even more in some places, for example, above the cheekbones, on the forehead or on the chin. You are in a panic! It happens!
This is typical and normal, but only for aggressive medium and deep peels.
How does this happen?
After 2-3 days, the spots darken, then the skin becomes covered with crusts, which come off during the process of exfoliation and washing. The main thing is not to touch with your hands and not to tear off the crusts. Within 10-14 days, they will disappear on their own. After this, red spots may (and usually will) remain in these areas for some time. This is also natural. After such peelings (as, for example, with frostbite on the face), the skin heals for about a month. But, depending on your skin type, it will actively react to temperature changes. For the process to be successful, it is important to follow an enhanced care regimen: avoid direct sunlight, do not visit the sauna, bathhouse, swimming pool, and do not use scrubs. Until this period has expired, it is too early to talk about side effects or pigmentation. The same TCA peeling (with a concentration of 25%) acts quite aggressively, and your cosmetologist should warn you about such a skin reaction and possible consequences.
Superficial peelings gently exfoliate and prepare the skin for deeper penetration of whitening cosmetics: masks, serums, and even creams. The recovery period occurs, subject to post-peeling care, quite comfortably.
Types of glycolic facial peels
Gliсopeel has an exfoliating effect - cleanses, adds shine, increases the synthesis of collagen, elastin and glycosaminoglycans (GAG), improves skin condition, reduces wrinkles, increases the permeability of the epidermis (helps the penetration of active components deep into the skin, treats acne, tightens pores, relieves acne symptoms, pigmentation spots;
GLICOPEEL Classic
Composition: 45% - partially neutralized glycolic acid. GLICO PEEL K
Ingredients: 33% - glycolic acid, 10% - kojic acid, 10% - citric acid, 9% - lactic acid, 5% - salicylic acid, epilobium, bearberry extract. Application: Optimal for people aged 25-30 with oily skin. Seborrheic dermatitis. Note. 6-8 procedures. Interval 14 days. You can't sunbathe, even covering your face. Recommended cream protection with SPF is 80. GLICO PEEL KH
Composition: 44% - glycolic acid, 10% - citric acid, 10% - lactic acid, 5% - kojic acid, 2% - hydroquinone, 3% - salicylic acid. Application: For the treatment of hyperpigmentation, as an intermediate peeling before mid-peelings. Note. 6-8 procedures. Interval 14 days. You can't sunbathe, even covering your face. The recommended protection of the cream with SPF is 80.
