Transcript Chp 19 Chemical Peels

Types of Peeling Agents
Chemical Peel Techniques
©2003 Texas Trade and Industrial Education
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Chemical Peels
A chemical peel is an accelerated form of
exfoliation
 It uses an enzyme to help speed up the
breakdown of keratin, which is the protein in
skin
 The stronger the strength of the peel, the deeper
or more layers of the skin are affected
 Most chemical peels do not penetrate the
dermis layer of skin.
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Ingredients of Peels
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Two of the more common enzymes
Papain (puh-PAY-in)
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Pancreatin (pan-KREE-uh-tin)
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which is derived from the juice of the papaya fruit
which is derived from beef by-products
Another product are the alphahydroxy acids
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These are derived from plants, mostly fruits
These AHA peels are safe for all skin types
They help prevent excessive build-up of dead skin cells.
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Skin Types
Skin Types
1
Skin Color
white
2
white
3
white
4
white
5
brown
6
black
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Characteristics
always burns, never
tans
usually burns, tans
less than average
sometimes burns,
tans average
rarely burns, tans
more than average
rarely burns, tans
profusely
never burns, deeply
pigmented
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Skin Types
 Skin types can be easily classified by asking what
happens with sun exposure
 Generally, clients with skin types 1-3 do not develop
post-inflammatory condition
 Nor do they tend to have increased hyper pigmentation
 Clients with skin types 4-6 have a greater risk of these
factors
 This does not mean they cannot receive the treatment;
they are at higher risk for developing these
abnormalities or should use AHA acids
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Occasions for a Chemical Peel
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Oily, clogged skin with
blackheads &
whiteheads
Superficial wrinkles on
the face, neck, upper
chest, arms, etc.
Enlarged facial pores
Age spots
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Superficial facial scars
Dry, dehydrated skin
Dull, lifeless-looking
skin
Uneven pigmentation
Those desiring a
smoother skin
appearance
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Chemical Peel Steps
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Cleanse face and throat thoroughly.
Exfoliate skin with a scrub.
Directions:
Cleanse face with an oil-free cleanser or a foaming gel
cleanser and pat dry.
Apply enough exfoliator to cover the area - Avoid eyes,
lips, and mucous membranes. Do not rub into skin.
Leave on for 4 - 6 minutes depending on skin sensitivity.
Rinse well with luke warm water
Apply Moisturizer containing Sunscreen (SPF 15).
Repeat every week
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Chemical Peel Steps
Apply freshener/ toner to all areas
1.
. Witch Hazel extract Versus SD Alcohol:
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2.
Unlike some other Peel products which may contain SD alcohol, we
use Witch Hazel which is derived from natural sources. SD alcohol is a
denatured alcohol which is toxic if taken internally and we feel it had
no place in our products. Since the skin does have a tendency to
absorb, it would make sense to use a more natural and gentle
substance than SD alcohol (ask your supplier for ingredients).
Witch Hazel is an astringent with the following properties:
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Reduces the Skin's Pore Size
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Prevents Irritation and Inflammation
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Soothes and Calms the skin
Apply peel (25-40% strength) to areas using cotton swabs or a masque
brush according to manufacturer’s directions. For the first treatment,
usually peel is applied for 5-10 minutes.
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Peel Steps
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Subsequent treatments may require longer
application timing or applying more layers of
peel to the skin. ALWAYS follow the
manufacturer’s directions.
Cleanse off treated areas, rinsing thoroughly.
Apply freshener.
Apply skin guard/ and or rejuvenating crème to
the areas. Follow manufacturer’s directions and
products recommended.
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Peel Steps
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Apply skin guard/ and or rejuvenating crème to
the areas.
Follow manufacturer’s directions and products
recommended.
Apply gauze mask and treat with warm paraffin.
Allow to dry then peel off.
Apply proper moisturizer and makeup if desired.
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After Care Steps
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Clients will experience a stinging sensation
during the first few minutes of application
Clients will receive this treatment only
once per week
Clients will use a mild solution (5 %) in
home during the week
Always provide directions for clients for
this at-home procedure.
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After Care Steps
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Clients should allow 10 weekly treatments in
order to see maximum results
Clients will continue with the 5% treatment at
home
Clients must allow at least 30 days before
resuming treatments.
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After Care Steps
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During this waiting period, clients should
continue their 5% treatments at home
Clients should achieve maximum results after
a series of treatments
Recommend a peel once every three months to
maintain results
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Types of Peeling Agents
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Many different types of peeling agents have been produced
Among the familiar agents are glycolic acid, Jessner’s solution,
salicylic acid, TCA, and phenol
Each agent has its own advantages and disadvantages as a peeling
agent
Additionally, each one is technique sensitive, meaning that the end
result is dependent on the knowledge and kill of the technician
As in any procedure, the more often you perform the procedure, the
better you get at the process of the treatment and as such the end
result for the client
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Types of Peeling Agents
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Each peeling agent has a specific action on the skin and therefore
may be best indicated in certain conditions
Knowing the available peel solutions, their actions, and your client’s
skin will decrease the variability of peeling
When you analyze your client, the skin condition or problem, skin
type and aging analysis, you will be able to determine which peeling
solution will best suit the situation
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Glycolic Acid
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Glycolic acid is a fruit acid derived from sugar cane
Three basic strengths
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Just as important as the % of the acid is the pH of the product
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30%, 50%,70%
Solution for peeling should be at a pH of 2 or less
Glycolic acid is indicted for the use of
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Photodamage
Exhibited as dyschromias (Pigment disorders, discolorations of the skin)
Fine lines
Rough textures
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Glycolic Acid
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Pure Glycolic Acid
It works by stimulating new growth of skin and
collagen by decreasing the bond that holds dead
skin cells on the surface.
This allows dead cells to be removed gradually,
leaving behind a layer of smoother and softer
skin.
Glycolic Acid may also be used to treat:
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Acne, Acne Scars, Blackheads/Whiteheads, Dry
Skin, Sun-damaged Skin, Blotchy Pigmentation,
Fine Wrinkles, Loss of Elasticity, Large Pores,
Bumps, Age Spots/Dark Spots, Eczema, Seborrhea
Keratosis, Hyperkeratosis, and Actinic Keratosis.
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Glycolic Acid
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Please select a strength of Glycolic Acid below (all
peels can be used on Acne Prone skin):
50% Glycolic Acid (pH 2.0) Great for mature/aging skin.
This is our strongest peel and will give the fastest results,
but if you are new to peels, I recommend you to start at at
our 40% Glycolic Acid.
40% Glycolic Acid (pH 2.2) Used on dry, dehydrated, and
normal skin.
30% Glycolic Acid (pH 2.3) Used on sensitive, dry, oily, or
dehydrated skin. This is our weakest peel and will give the
same results as the stronger peels, but is a more gradual
process.
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Glycolic Acid
Doctors Strength
 These non-buffered Glycolic Acids are only for
Doctors or Dermatologists.
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If you have Rosacea or sensitive skin, then Lactic
Acid may be the better choice.
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Jessner’s Peel
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Solution is a combination of three different acids
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14% salicylic acid
14% resorcinol
14% lactic acid in an ethanol base
Superficial peel, focusing on exfoliating and digestion of the debris
Great choice for the acne client
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Salicylic Acid (Beta) Peel
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Hydroxybenzoic acid
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Two strengths
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Found in willow bark, but manufactured synthetically from sodium
phenolate
20%,30%
Effective for treatment of acne
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Salicylic Acid (Beta) Peel
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Chemical peeling continues to be the gold standard in
cosmetic enhancement of facial skin.
Chemical peeling of the face has been performed for many
years.
The ancient Egyptians used particles of alabaster mixed
with milk and honey to abrade facial skin to create
tightening.
In Egypt Cleopatra is said to have bathed in sour milk,
while French women have applied fermented wine to their
faces to improve the quality of the skin.
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Salicylic Acid (Beta) Peel
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In 1882, Unna, a German dermatologist, reported the use
of salicylic acid, resorcinol, phenol and trichloracetic acid for
chemical peels.
In the early 1990's, Swineheart reported satisfactory
results using 50% salicylic acid on the hands and forearms
of patients with actinically induced pigmentary changes.
Although the literature is replete (full of information) with
the use of alpha hydroxy acids as peeling agents, there is
dearth (inadequate supply) of published data regarding the
efficacy and safety of salicylic acid peels.
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Salicylic Acid (Beta) Peel
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Classification
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Salicylic acid is a beta-hydroxy acid.
It is a hydroxyl derivative of benzoic acid and represents a
carboxylic acid attached to an aromatic alcohol, phenol.
Salicylic acid is the only member of the beta-hydroxy acid
family, so named because the aromatic canboxylic acid has a
hydroxy group in the beta position
Salicylic acid is derived from willow bark, wintergreen leaves
and sweet birch.
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Salicylic Acid (Beta) Peel
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Mechanism of action
Salicylic acid is an excellent keratolytic agent.
It is thought to function through solubilization of
intercellular cement, thereby reducing corneocyte (horny)
adhesion.
Because of its lipophilic nature, salicylic acid has a strong
comedolytic effect.
Salicylic acid affects the arachidonic cascade and thus
exhibits anti-inflammatory capabilities
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Salicylic Acid (Beta) Peel
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Indications
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These include acne vulgaris, enlarged pores, rough and oily skin,
melasma, post-inflammatory hyperpigmentation, and photoaging
Contraindications
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A history of allergy to aspirin, and pregnancy and lactation are
contraindications
Formulations
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1. 20-30%
2. 2% solution as skin cleanser, and in acne washes
3. Salicylic acid peel
4. Salicylic acid paste (salicylic acid powder USP 50% methyl salicylate 16
drops, Aquaphor 112 g)
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Salicylic Acid (Beta) Peel
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Preparation
As in any other chemical peel, patient selection is
important. A good history taking and examination with
relevance to peels is mandatory.
Photo documentation and a written consent are
recommended
Priming
Patients are pretreated for 2 weeks with 4%
hydroquinone for hyperpigmentary disorders and
with an alpha-hydroxy acid for acne and
photoaging.
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Salicylic Acid (Beta) Peel
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Peel procedure
Cleanse the face to remove dirt and grime.
A surgical cap is used to pull back the hair and
cover the ears.
The face is degreased by scrubbing with a cotton
gauze piece soaked with ethanol or a pre-peel
cleanser
Sensitive areas of the face such as the lips and
the nasal-alar cheek junction are protected with a
thin layer of petrolatum.
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Salicylic Acid (Beta) Peel
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The salicylic acid is applied using a cotton-tipped
applicator or a wedge sponge in a predetermined
manner on to the facial cosmetic units
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Starting from the forehead and progressing to the
zygomatic cheeks, chin, upper lip, nose and lower
eyelids.
The whole procedure should be completed within
30 sec.
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Salicylic Acid (Beta) Peel
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At this point the subject experiences a stinging
and burning sensation which increases over the
next 2 minutes, reaches a crescendo at 3 min
and then rapidly decreases to baseline over the
next minute; this is considered the end point of
the peel.
As the hydroethanolic vehicle evaporates, it
leaves behind a white precipitate of salicylic acid
on the surface of the face which is termed as
salicylic acid frost.
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Salicylic Acid (Beta) Peel
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There is very little penetration of the active agent
once the vehicle has volatilized.(vapor)
At this point there is no burning or stinging as
the agent causes a superficial anesthesia to light
touch.
Wash face with water and pat the face dry.
Patients are then sent home with a moisturizer
and instructed to limit sun exposure and use
sunscreens appropriately.
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Salicylic Acid (Beta) Peel
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Post-peel
Patients report a tightness and smoothness
immediately post-peel.
Peeling usually begins 2 days post-peel and can
extend up to 7 days post-peel.
Transient hyperpigmentation and superficial
crusting may be seen in areas of inflammatory
acne.
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Salicylic Acid (Beta) Peel
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Patients with Fitzpatrick skin type III may
experience darkening during desquamation due
to increased melanin sloughing.
Minor side effects include superficial crusting,
edema (abnormal accumulation of watery fluid in
connective tissue) and transient (not lasting long)
purpura (the appearance of red or purple
discolorations on the skin)
in the lower eyelid areas, hypopigmentation,
transient dryness and hyperpigmentation, which
resolves quickly.
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Salicylic Acid (Beta) Peel
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Intervals of application
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Peels can be repeated once in 2 weeks for 5-6 sessions
Discussion
Salicylic acid peel is a superficial chemical peel which is
gaining popularity.
It has been found to be safe and effective in darker skinned
racial ethnic groups
Given the predictability, less downtime and efficacy
compared with glycolic acid peels, salicylic acid peels are
likely to become more popular in future.
However, in light of the recognized tendency of darker skin
to develop dyschromias(Pigment disorders, discolorations of the
skin,) superficial peeling should be approached with care
and caution.
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Lactic Acid
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Is a component of the natural moisturizing factor (NMF)
Increases the glycosaminoglycans (GAGs)(mucopolysaccharides)
connective tissue and the ground substance of the skin
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Lactic Acid Peel
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Lactic Acid Peel
Lactic Acid is derived from sour milk, and is much milder on
the skin versus other peels.
The peeling process is very similar to how Glycolic Acid
works.
It has many important qualities, number one being that it is
milder than other peels as mentioned above, so people with
sensitive skin can apply this peel and see the same results
as stronger peels.
If you have Rosacea, this is a better peel for you than
Glycolic Acid.
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Lactic Acid Peel
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Also, if you are new to acid peels this may be the one for
you.
It also can be used for the following:
Acne, Acne Scars, Blackheads/Whiteheads, Dry Skin,
Sun-damaged Skin, Blotchy Pigmentation, Fine
Wrinkles, Loss of Elasticity, Large Pores, Bumps, Age
Spots, Eczema, Seborrheic Keratosis, Hyperkeratosis,
Actinic Keratosis, and Rosacea.
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Cosmetology I: Chemical Peel Techniques
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Lactic Acid Peel
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50% Lactic Acid
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(pH 2.0) Great for Wrinkles/Mature skin, as well as all skin
types.
strongest peel and will show the fastest results, but if you are
new to acid peels, we recommend to use the 40% Lactic Acid
first.
40% Lactic Acid
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(pH 2.2) Used on dry, dehydrated, and normal skin.
Perfect for first time Acid Peel users.
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Lactic Acid Peel
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30% Lactic Acid
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(pH 2.3) Used on sensitive, dry, oily, acne prone, or
dehydrated skin
weakest peel and will show the same results as the
above peels, but is a more gradual process.
If you have red, sensitive skin, and it is your first peel, I
suggest this strength.
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