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05-05-09 | Posted by


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A Peel Primer

Beginning in the 1980s, there was an explosion of peeling agents of varying depths that deliver an improved skin appearance, acne reduction, decreased pigmentation and irregularities, and smoother texture.

Although they are not as sexy or high tech as lasers, superficial peels are most commonly performed with alpha-hydroxy acids (AHAs), such as salicylic acid and glycolic acid. These work for acne, melasma, superficial scarring, skin texture, clarity, and tone.  A course of light peels are usually administered in a series of six to eight sessions, each peel given anywhere from 1 to 4 weeks apart. Often referred to “lunchtime” peels, these are done by dermatologists, nurses, and aestheticians. Salons and spas usually use more buffered solutions of up to 30% concentration, whereas medical offices will use more potent peeling solutions or mix their own formulations for each individual client.

Superficial chemical peeling has several benefits and minimal risks or side effects. Peels can be used to reduce fine wrinkles and skin roughness caused by sun damage, and to reduce scaly skin patches that become actinic keratoses. Alpha-hydroxy acids, such as glycolic acid and lactic acid, are the most common superficial peeling agents.

The spectrum of superficial to medium peels includes AHAs, such as glycolic and lactic; salicylic, or beta-hydroxy acid (BHA); Jessner’s solution, a combination of lactic, salicylic, alcohol, and resorcinol; and mild TCA. In almost all cases, you will get better results if you precondition your skin at home before embarking on a peel program.  Most people can tolerate a program of monthly superficial peels, which can be adjusted to suit your skin type.

Medium-depth peels may be done at 6- to 12-month intervals as needed, or just one time if you prefer. These are typically performed with trichloracetic acid (TCA), and can work on coarser wrinkles and precancerous lesions. This type of peel has an extended recovery time that has made it much less appealing since the advancement of laser- and light-based technologies. For example, a 35% TCA peel may involve a week’s worth of downtime where you skin will go from red to brown and eventually peel off to reveal a younger, fresher, clearer complexion.

Combination therapy may include a variety of peels in increasing concentrations, as well as a home care regimen and prescription topicals such as Retin-A. Despite the advent of laser- and light-based technologies, peeling agents still work well. For rejuvenation in the context of a larger regimen that includes light-based devices, peels may be offered in-between sessions to facilitate the other treatments.

How do you know what peel is right for your skin?

The key is to choose a skin care professional who can select the right peeling agent for your skin type and condition, apply it correctly and neutralize it efficiently, and explain your post peel instructions carefully.

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