CHEMICAL PEELS

A chemical peel refers to the application of one or more chemicals to the face or hands which induce accelerated exfoliation or controlled skin damage. As the skin damage is repaired by the natural healing process of the body, the skin's appearance will improve with due time.

The most common candidates for a chemical peels are patients with pigmentary disorders (e.g melasma, freckles, solar lentiginoses and post-inflammatory hyperpigmentation), acne vulgaris, acne scars, photo-aging, wrinkles, seborrheic keratoses and actinic keratoses.

Pre-treatments may include tretinoin, alpha hydroxy acid and hydroquinone containing creams. They will improve the results seen from chemical peeling. First the skin is thoroughly cleansed to remove make-up and surface residue. The chemical solution is then applied for several minutes, usually 5-6 minutes. A stinging sensation will be experienced and this will depend on the concentration and duration of the application. The chemical solution is then either removed with saline solution or neutralised by an alkaline agent.

Chemical peels are broadly defined by the depth of skin damage they produce. They are categorized as superficial, medium, and deep. We use only medium depth peels in our practice e.g trichloroacetic acid, lactic acid, salicylic acid, Jessner's and retinoic acid peels. Medium depth peels result in moderate inflammation and swelling, which resolve within a week.

Complications are uncommon if performed properly. These may include comedones, secondary infection, scarring and patchy pigmentation. Persistent actinic keratoses may require additional treatment with cryotherapy, 5-Fluorouracil cream, Ingenol mebutate gel or even a biopsy of a lesion in case a skin cancer is suspected.


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