NON-SURGICAL
FACE-LIFT (CHEMICAL PEELING)
REJUVENATION OF FACE AND HANDS
Your skin's appearance depends upon a combination of factors;
genetic predisposition, sun exposure, stress, gravity, and possibly,
diet. Cosmetic surgery can remove abundant skin and smooth wrinkles,
making you look and
feel better. Sometimes,
surgery alone is not the answer. Fine wrinkles, skin discolorations
and the overall quality of the skin will not be changed with surgery.
The
skin in which you live is the interface between your environment
and your internal structures. It must continually rejuvenate itself,
sloughing off old cells and replacing them with new ones. Skin
secretes lubricating oils which help protect it and keep it smooth.
Sloughed
skin, secreted oils, and microscopic particles of makeup and environmental
matter accumulate on the skin's surface and are often not adequately
removed by soap and cleansers. This debris clogs pores, interferes
with cell turnover and makes the skin look dull.
There
is, however, a series of treatments which can help the skin renew
itself. These treatments can be used on males and females of any
age and with almost any skin type.
Chemical
peeling is a time honored method for rejuvenation. A 3000 year
old manuscript discovered in Egypt is one of the earliest recordings
for dermatological prescriptions for caustic preparations used
to peel facial skin.
What
are the indications for chemical peels? There are many, including:
sun-damaged, aged, and wrinkled skin (wrinkles around the mouth
and the eyes respond especially well to chemical peeling), blotchy
spots of hyperpigmentation on the face or the hands, keratoses,
acne, post-acne scarring, and treatment of pre-cancerous skin
lesions.
Chemical
peeling is a technique that involves application of an irritant
chemical solution into the skin to remove the epidermis (outer
layer of the skin), and sometimes the upper part of the dermis
(inner layer of skin). In essence it is a controlled second-degree
chemical burn. Post peel, the skin looks YOUNGER
and FRESHER, and feels softer, and
is tighter. The ideal patient is one who has a light complexion,
dry skin, and fine wrinkles, although chemical peeling can be
used for patients who do not fulfill these criteria.
There
are 3 basic types of chemical peels-light, medium, and deep. These
types are defined by the type of the chemical agents and their
concentrations, and the depth of penetration into the skin.
LIGHT
PEELS affect the superficial layers of the skin,
it is the mildest form of peel. Light peels remove build-up of
dead skin, enhance overall appearance, refresh
the skin, and impart a "glow" to it. Some commonly used
agents are very low strength of Trichloroacetic acid (10-15%)
[a derivative of Acetic Acid], Salicylic Acid, Alpha Hydroxy Acids
[AHA] (e.g. Glycolic Acid & Lactic Acid), and Resorcinol,
to name a few.
There
are several drawbacks with AHA peels. In general they work very
slowly. The patient needs the discipline to apply special AHA
cream twice a day before and after the peel. AHAs improve fine
wrinkles only. And their overall costs may add up to be more than
the comparative Trichloroacetic peels.
MEDIUM
PEELS penetrate the outer layer of skin, and the
superficial layer of inner layer of skin. The most popular agent
used for this kind of a peel is Trichloracetic acid (35-40%) This
chemical is nontoxic and is not
absorbed into the body, and therefore is well
tolerated. However, a transient pain, burn, and stinging upon
application of the acid may occur.
More significant problems of peeling such as irregular pigmentation
and scarring can be minimized by repetitive peeling. Repetitive
peeling, separated by intervals of weeks to months, can result
in changes equivalent to a single, more concentrated, deep peel.
This
is an ideal peel
since it is non-toxic, it can remove deeper lines, and even produce
an up-lift like a face-lift.
DEEP
PEELS penetrate the deeper layer of the inner
skin. Thus, this peel is reserved for those with very deep and
numerous wrinkles. Phenol is the most widely used chemical for
this kind of peel.
Because some of the phenol may be absorbed into the body and if
not used by an expert physician and under carefully monitored
situation there may be some serious risks involved. People with
heart disease, kidney disease, or liver disease are not candidates
for this peel, however, they may be able to benefit from light
or medium peels.
What
is a "Spot Peel"?
A
spot peel is a customized peel
where two or more different acids are used to treat different
spots and wrinkles on a patient.
This
has recently become a very popular and a very effective peel.
In
short, chemical peeling is an effective, low risk, non-surgical
approach to rejuvenation.
Complications of Peels:
Infection-
Although trichloracetic acid and phenol are bactericidal (kill
bacteria), occlusive ointments may promote folliculitis (inflammation
& infection of hair follicles) which may be secondarily infected.
Milia
Formation-
Milia, sometimes called inclusion cysts or "whiteheads,"
appear as part of the healing process. Treatment of milia is very
simple and effective.
Persistent
Redness or Itching-
Redness after peeling usually disappears in about a week. However,
different patients may manifest longer or shorter times, especially
if they are using Retin A before and after peel. Topical hydrocortisone
lotion, oral antihistamines, and application of a green-color
foundation make-up can be helpful.
Pigmentary
Changes-
Hyperpigmentation of nevi (moles) does occur following chemical
peels.
Birth control pills, exogenous estrogens, sunlight, photosensitizing
drugs, and pregnancy within 6 months post peel may cause hyperpigmentation.
Scarring-
This is a very rare event. Racially dark individuals and people
with a family history of hypertrophic scars have a higher risk.
The neck, back of the hands, forearms, and arms are more prone
to scarring.
In
short, chemical peeling is an effective, low risk, non-surgical
approach to rejuvenation.
