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Chemical Peel:

A chemical peel is a form of controlled wounding body treatment procedure employed to improve and smooth the texture of the facial skin using a chemical acid mask that encourage blistering and peeling and induces the dead skin to slough off and eventually peel off. Smoothness of the rejuvenated skin is more and less wrinkled than the old skin. This chemical peel or chemexfoliation or derma-peeling eventually improve the appearance of the facial skin. The new skin will be temporarily more sensitive to the sun. The commonest use of chemical peels is to improve the appearance of sun damaged skin on the face, or the backs of the hands.
Chemical peel is neither an alternative for surgery, nor will it avert or slow down the aging process. Chemical peeling helps to remove dead skin cells and unclogs pores. Unclogging of pores help in releasing whiteheads and blackheads and prevent the recurrence. It may help to soften acne facial scars and even control acne since the outer layer of the skin is peeled. A chemical peel can reduce the dry skin or illuminate the face, but they don't guarantee a cure for dry skin. It is for facial blemishes, wrinkles and uneven skin pigmentation. Chemical peel may remove pre-cancerous skin growths. They are used to reduce fine lines under the eyes and around the mouth. The chemical peel results are not permanent, like plastic surgery. Skin will be again sensitive to damages. Fair-skinned and light-haired patients are better candidates for chemical peels. Darker skin types may also have good results, depending upon the type of issues. Chemical peeling may be combined with laser resurfacing, dermabrasion or soft tissue fillers to achieve cost-effective skin rejuvenation customized to individual patient's needs.

Facial skin treatments are done in many layers. They are;

Superficial peels: Remove the epidermal layers of the skin. They are the commonest types of chemical peels and most are some form of hydroxy acid, which cause exfoliation when applied to the surface of the skin. These include alpha hydroxy acids, such as lactic acid and tartaric acid. The beta hydroxy acid, salicylic acid is unique that it can penetrate deeper oil glands of face and scalp causing exfoliation.

Glycolic acid is another hydroxyl acid in use. Jessner's peel is a combination of different hydroxy acids such as lactic acid and salicylic acid, which are used as superficial peels. Superficial peels can reduce rough skin texture, dry or flaking skin, fine lines and age spots due to sun damage, mild acne marks, and balancing irregular skin tones.

Medium depth peels: Both the epidermal layers and upper dermal layers are removed here. Medium depth chemical peels can reduce acne scars, small wrinkle lines and certain pigmentation problems. This involves the use of stronger peeling solutions. The commonest of these is higher strength T.C.A.or Trichloroacetic acid. TCA in combination with glycolic acid or other solutions give a more controlled and correct depth peeling.

Deep chemical peels: Extended peeling extends deeper into the lower dermal layer of the skin. They can help to reduce the appearance of deeper lines, wrinkles and scars. These are generally executed using phenol, or 40% TCA. Phenol is the strongest of the chemical solutions and brings about deep skin peel. Persistent results are seen in phenol chemical peeling. Although deeper peels are very effective for the right patient, there are a number of potential risks associated with this procedure. Phenol peels help correct blotches caused by sun exposure or aging, smooth out coarse deep wrinkles or remove precancerous growths.

The skin is thoroughly cleansed with glycolic acid chemical peels, TCA (trichloroacetic acid) peels, salicylic acid peels, lactic acid peels, or phenol peels, and removes excess oils and the eyes and hair are protected. Depending upon the type of chemical peel, a reaction similar to sunburn occurs following the procedure. Peeling usually involves redness, followed by scaling that ends within three to seven days. The amount of skin removed will depend on the type of chemical used, the strength of the product (superficial, medium depth and deep) and how long it is left on the skin. Private costs for chemical peels depend upon the type of peel and problem being treated.

Chemical peel for acne:

Chemical peeling helps diminish the intensity & number of pimples & decrease chances of post acne scarring. Deep chemical peels help treat the signs of aging and used in the treatment of acne and acne scarring. The results seem to be mixed, and are individual specific. The potency of chemical peels depends on the type of acne, the severity of the acne or scarring, and the skin type.

Recovery can take several days to weeks depending on the layer of peeling used, individual's condition and any post-treatment complications.

Complications of Chemical Peels:

The complications are more in deeper peels. The possible complications include prolonged erythema, pigmentary changes, white heads, skin atrophy and textural changes. Mild stinging sensation when superficial peels are used. The face is often pink or may be a faintish white discoloration in some areas, or a blotchy appearance to the skin. Side effects or risks of superficial and medium peels can be hyperpigmentation and a high factor sunscreen can reduce the potential for this problem. In rare cases, an infection in the skin or cold sores is experienced by patients. With medium peels the face may swell post application and turn pink, with some burning and stinging of the skin. Hyperpigmentation or brown spots may occur. Bleaching creams may be used to help reduce the brown areas. Very rarely, some patients may develop scarring following a medium depth peel. This can occasionally be permanent, but are extremely unlikely. However, sags, bulges, and more severe wrinkles show unresponsiveness to chemical peels. They may require other types of cosmetic surgical procedures, such as laser resurfacing, a facelift, brow lift, eyelid lift, or soft tissue filler. A dermatologic surgeon can help determine the most appropriate type of treatment for each individual case.

Patients often feel unwell for several hours after the use of deep peeling procedure. Moderate to severe pain can be expected for several days but can control with pain-killers.

The swelling of the face will subcide in a week, redness may take 3 to 4 months to disappear. Small raised cysts or white spots on the face (Milia) usually occur during the first 6 to 8 weeks post peeling, and may last from a few days to many weeks. Permanent hypopigmentation is the commonest problem associated with deep phenol peels. Some patients may also develop hyperpigmentation problems.
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