Chemical Peels

chemical-peel-472x266Chemical Peels are seeing a resurgence in use. Popular since the 1960’s and 70’s they took a backseat for a while with all the innovation in the laser and light industry but they are now making a comeback, due in large part to their safety and the large variety of peels available to treat all skin types.

Chemical Peels are of three types – superficial, medium and deep. These terms reflect how deep the peel penetrates into the skin. The skin has two layers that are of importance to us to understand peels – the epidermis and dermis. The epidermis is the thin superficial layer of the skin while the dermis is the thicker deeper layer.

The outermost layer of the epidermis, the Stratum Corneum, has an important bearing on how the skin looks. If the cells in this layer are more in number than normal or are disorganized, the skin will look rough, scaly or dull. Cells below this layer contain skin pigment scattered through them and the average turn over time of these cells is about a month. Pigment is produced by the lower layers and rises up through other cells of the skin as they move towards the surface ultimately dying and becoming cells of the Stratum Corneum.

The principal of ‘controlled damage’.

A peel helps in two ways
a) It breaks the bonds between the cells of the Stratum Corneum thereby making them easier to shed, and
b) It increases cell turnover by encouraging the production of new skin cells; these cells are less pigmented and better organized than the older cells and as long as they are protected from UV light with regular sunscreen use they will remain lesser pigmented thereby causing skin lightening. At higher concentrations peels also stimulate collagen formation.

So what does a peeling session entail?

A typical session takes just 10-15 minutes and consists of cleaning the skin followed by application of the peeling agent. There are various types of peels and the two most basic ones are glycolic acid peels and salicylic acid peels; the former being better for skin pigmentation and the latter for acne. The peeling agent is then left on for about 5 minutes (this will vary depending on your skin sensitivity and the number of peels you have had), and then neutralized with either water or a sodium bicarbonate solution (the salicylic peel is self-neutralizing and just needs to be wiped off). This is followed by the application of a skin recovery agent, typically a soothing cream, followed by a sunscreen. There are various other types of peels such as leave on peels (e.g. yellow peel, miami peel, ferric peels), combination peels, and sequential peels. A number of peeling agents are now available for treating all skin types.

Can I get a peel on my first visit to a doctor?

Yes you can but we prefer to prime the skin for about 14 days before starting peeling since this maximizes benefit. Also some peels need a test peel and waiting 7 days before performing a full face peel. A test peel involves the application of a small amount of peel to the area behind the ear and is done to check for any sensitivity or allergy to the peeling agent. This is essential with TCA peels.

How many peels does it take to see a difference?

This varies from patient to patient and the indication being treated, but expect to see visible improvement by the 3rd or 4th peel. Typically 4-6 peels are done at regular intervals of 10-14 days followed by maintenance peels every 4-6 weeks for a few months. I encourage my patients to think of peels as a lifestyle modification and not so much a treatment course.

I have heard that peels cause thinning of the skin, is this true?

No, quite the contrary. Regular peels cause an increase in the overall thickness of the living part of the epidermis and a decrease in thickness of the dead cells of the stratum corneum. Both of these are good things and overall the skin thickness is increased.

What skin problems can peeling help?

Peeling can help a number of problems – active acne, post-acne pigmentation and erythema, blackheads, open pores, fine lines, uneven skin tone, freckles, melasma, other superficial skin pigmentation, dark circles, and dull skin.

Can peeling help scarring?

It is true that certain deep peels (as were popular in the west for caucasian skin) can markedly improve acne scars, however these peels actually burn the skin and have a significant down time (4-6 weeks). These peels are not safe in darker skin types and are therefore almost never done in India and other Asian countries. Even for white skin these peels have been replaced by laser and other treatments due to more consistent results and less downtime. On occasion very superficial acne scars might improve but this is often because of the scars become lighter on account of the peels. So to answer the question – No, the most commonly used peels today have no significant benefit on acne scarring.

Are there any peels I can do at home?

Yes there are a few peels made for home use. These are typically low power peels with limited benefit and are best used as maintenance after 4-6 sessions of traditional peeling with your doctor. Home peels are available as lotions, soaked pads and masks. Glycolic acid is also available as leave on creams or gels which can be left on overnight.


Facial & Peels for Chemical Peels in Gurgaon

Dr Nair’s Skin Clinic is a one stop solution for all your skin related needs. Our goal is to provide quality medical and aesthetic dermatology in a boutique office setting. You can contact DNSC for Facial & Peels for Chemical Peels in Gurgaon.