CHEMICAL PEELING

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    CLASSIFICATION OF MESOESTHETIC PEELS

  • Alpha & Beta Hydroxyacids
  • a. Glycolic
    b. Mandelic
    c. Lactic
    d. Salicylic

  • Combination Peels
  • a. Mesopeel Azelan – Contains Salicylic acid 20% & Acelaic acid 20%.
    b. Mesopeel Jessner – Contains Salicylic acid 14%, Lactic acid 14% & Citric acid 8%.
    c. Melanostop peel – Contains Azelaic acid 20%,Resorcinol 20% & Phytic acid 6%.
    d. Pyruvex peel – Contains Pyruvic acid 40% & Lactic acid 10%.

  • Trichloroacetic acid peels
  • a. Mesopeel TCA soft
    b. Mesopeel TCA


    B. FACTORS MODIFYING DEPTH OF PEELS

  • Peeling Agent
  • The peeling agent and its concentration is the most important factor in determining the peel depth. However peeling agents can be combined at lower concentrations, to achieve greater depths, reducing side effects associated with higher concentrations.

  • Availability of free Acid
  • It is important to check the pH of the peeling agent before doing the procedure. If a product eg. Glycolic acid 50% of a company with lower pH will have greater depth than Glycolic acid 50% with higher pH of another company.

  • Duration of contract
  • For AHA peels such as glycolic acid, prolonging the duration of the contact increases the depth of the peel. Hence timing of the peel is as important as the concentration. This is not required for agents such as TCA and salicylic acid, where concentration is important.
    The application of low concentrations of glycolic acid, tretinoin or salicylic acid during the period pre-peel priming thins stratum corneum, causing a uniform, even and greater penetration of the chemical agent.

  • Method of priming the patiant
  • In thick oily skin, penetration is less as compared to thin dry skin. The level of photodamage, actinic damage and presence of irregular superficial lesions such as seborrheic keratosis, dermatoses papulosa nigra, lentigo, etc can cause irregular penetration of peeling agent.

  • Characteristics of patiant's skin
  • A facial peel will show greater depth as compared to a nonfacial peel, where skin is thicker.


    C. ADVANTAGES OF PEELING

  • Advantages of peeling
  • 1. It is a simple office procedure, and does not require any elaborate OT setup
    2. The procedure is easy to learn and practice, with a short learning curve, particularly for beginners.
    3. It is safe and effective with minimal complications.
    4. Superficial peels are noninvasive and can be used as lunchtime procedures.
    5. No significant postoperative care is required, except for deep peels.
    6. There is no risk of systemic toxicity except for phenol peels
    7. Chemical agents are easy to procure and are stable
    8. There is a wide array of chemical agents that can be used for peeling, hence treatment can be individualized , according to skin type.
    9. Procedure and chemicals are inexpensive and easily affordable to most patients.
    10. Chemical peeling has been well studied and there is vast long-term experience with peeling agents.


    D. INDICATIONS

  • Based on Skin condition
  • All purpose – Glycolic acid Oily and pigmented – Mandelic acid Dry and sensitive – Lactic acid Antibacterial – Salicylic acid

  • Based on Aesthetic concern
  • Acne – Mesopeel Azelan (Salicylic acid 20%, Azelaic acid 20%)
    Post acne pigmentation – Mesopeel Jessner (Salicylic acid14%, Lactic acid 14%, Citric acid 8%)
    Melasma / Hyperpigmentation – Melanostop peel (Azelaic acid 20%, Resorcinol 20%, Phytic acid 6%)
    Photaging / Antiaging – Pyruvex peel (Pyruvic acid 40%, Lactic acid10%)


    E. CONTRAINDICATIONS

  • Contraindications
  • a) Herpes simplex
    b) Viral warts
    c) Molluscum contagiosum
    d) Open wounds


    F. PROCEDURE DETAILS

  • Procedure Details
  • cometic-units-of-face

    1. Contact lenses should be removed before the peel.
    2. The customer is asked to wash the face with soap and water, to remove makeup, dirt and grime.
    3. The hair is pulled back with a hair band or cap.
    4. The customer lies down with head elevated to 45 degree and eyes closed.
    5. Inspect the skin to see that there are no abrasions or inflammations.
    6. Remove the make up with mesoesthetic hydramilk clenser.
    7. Apply mesoesthetic hydratonic lotion.
    8. Remove excess oil in the skin with mesoesthetic professional degreasing lotion.
    9. Sensitive areas like inner canthus of the eye and naso-labial folds are protected with Vaseline.
    10. Apply the chosen peel over the surface of the skin with brush or two ear buds as per cosmetic units of the face.
    11. Keep the peel for adequate time of exposure.
    12. Remove the peel with abundant water and spray the surface with neutralizer.
    13. Apply post peel collagen / arbutin mask & keep for 20 minutes. Remove the mask & apply Momentasone cream.
    14. Apply sunscreen lotion.

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