SHEDDING THE FACTS

A peel refers to an agent that is applied to the skin which will cause exfoliation or shedding of the skin and the subsequent stimulation of new skin growth. In a sense, a peel is resurfacing the 'old skin' leaving a fresher new skin surface.

In general, the deeper the peel penetrates the skin the better the result. The commonest or most available peels are the superficial to medium depth peels. These can peel just the superficial layer of skin called the epidermis, or can penetrate deeper down t just within the dermis, as is the case with the medium depth peels.

Peels can be used to treat a variety of skin problems, some of the main uses are:

• Mild to moderate sun damaged skin
• Fine lines
• Some pigmentation, blemishes
• Smoothening some skin texture problems eg. open pores
• Some acne

Deep chemical peels, which work all the way down, deep in the dermis, have all but been abandoned now. These peels have been largely replaced by the resurfacing lasers, which have introduced a remarkable degree of control for working at these deeper skin depths as well as giving more reliable results and having less complications.

The skin peels can be grouped as:

LIGHT/SUPERFICIAL PEELS

The light AHA peels are often called fruit acid peels because many of these acids are found naturally in certain fruits eg glycolic acid exists in sugar cane. These peel are available from beauty therapists and doctors specialising in skin and cosmetic medicine, though doctors are able to use higher strength acids.

They are very safe and pain free, but require a number of peels performed at 1-4 weekly intervals to achieve results.

The AHA breaks the adhesions holding the outer epidermal skin layers, thus enabling the skin layers to shed. A fresher complexion is then revealed. The AHA can further stimulate new collagen production in the skin to help further refine the complexion.

This shedding of skin is generally quite subtle and most will notice just come redness of the skin afterwards. Hence, this peel is ideal for people unable to interrupt their work.

LIGHT/MEDIUM PEELS

The Jessner peel is a deeper acting peel than the AHA’s and thus one sees more rapid results. Jessner is solution of lactic acid, salicylic acid and resorcinol. All are peeling agents and especially useful for acne, more severe sun damage and pigmentation problems. People allergic to asprin are not suitable because it contains salicylic acid.

Some Asian and darker skin may also be not suitable, as there could be greater risk of creating new pigmentation after peeling.

There is more redness and visible peeling or flaking of the skin afterwards than AHA, some people may need to take a few days off work if peeling is marked. Thus this peel may not be suitable a ‘lunch hour’ procedure. This peel can be repeated depending on the outcome.

MEDIUM DEPTH PEELS

The main medium depth peeling agent is the TCA peel or ‘the Chemical’ peel. It is particularly suitable for older people and or severe skin problems. Compared to the other peels it can give more reliable and longer lasting results. On the down side, it can be quite, painful for a few minutes whilst the TCA peel is being applied.

Afterwards, the peeling process is quite a noticeable affair taking 7-10 days. Most people will need to schedule this time off work. On a positive note people will generally require only one peel to achieve the desired results.

Again, people with darker, olive skin may not be suitable because of the increased risk of pigmentation changes.

POTENTIAL SIDE EFFECTS

With all peels the potential risks are the same namely scarring, loss of pigmentation or temporary increase of pigmentation. Thankfully, with the light and medium depth peels scarring and loss of pigmentation are very rarely seen. However, temporary increase in pigmentation can be seen especially in darker skin types eg olive skin and Asians.

Peels do not thin the skin. On the contrary, repeated peels will generate more collagen ensuring that the skin will remain rejuvenated and in optimal condition.

For pigmentation problems, peels are usually done in combination with skin fading agents eg hydroquinone.

In conclusion, skin peels are s till very useful, safe and inexpensive procedure in cosmetic medicine. They can be ideal treatment for a younger person with less severe skin problems.