Chemical peels:

In ancient Egypt, Cleopatra used sour milk, now known to contain lactic acid, an alpha hydroxy acid while French women used old wine containing tartaric acid, to enhance the appearance of the skin. Chemical peeling is a common office procedure that has evolved over the years, using the scientific knowledge of wound healing after controlled chemical skin injury.

Mechanism:

Chemical peeling is the application of a chemical agent to the skin, which causes controlled destruction of a part or entire epidermis, with or without the dermis, leading to exfoliation, removal of superficial lesions, followed by regeneration of new epidermal and dermal tissues.

Indications of Chemical Peels:

Pigmentary disorders

  • Melasma
  • Postinflammatory hyperpigmentation
  • Freckles
  • Lentigines
  • Facial melanoses

Acne

  • Superficial acne scars
  • Postacne pigmentation
  • Comedonal acne
  • Acne excoriιe
  • Acne vulgaris-mild to moderately severe acne

Aesthetic

  • Photoaging
  • Fine superficial wrinkling
  • Dilated pores
  • Superficial scars

Epidermal growths

  • Seborrheic and Actinic keratoses
  • Warts
  • Milia
  • Sebaceous hyperplasia
  • Dermatoses papulosa nigra

Types of peels:

  1. Very Superficial light peels: Necrosis up to the level of stratum corneum. Agents used: TCA 10%, GA 30-50%, Salicylic acid 20-30%, Jessner’s solution 1-3 coats, Tretinoin 1-5%
  2. Superficial light peels: Necrosis through the entire epidermis up to basal layer. Agents used: TCA 10-30%, GA 50-70%, Jessner’s solution 4-7 coats
  3. Medium depth peels: Necrosis up to upper reticular dermis. Agents used: TCA 35-50%, GA 70% plus TCA 35%, 88% phenol un-occluded, Jessner’s solution plus TCA 35%, solid CO 2 plus TCA 35%
  4. Deep peels: Necrosis up to mid-reticular dermis. Agents used: Baker-Gordon phenol peel

Frequently Asked Questions

What chemical peel does is, it resurfaces and eliminates the superficial layer by inducing a controlled wound there by reducing dark spots.

Chemical peel exfoliates epidermis and increases collagen as well as elastin formation in the dermis. It reverses the effect of sun damage thereby preventing skin cancer.

It depends on the peel type and strength. Th e peeling typically lasts for 3-5 days post treatment.