THE SECRET TO PERFECT SKIN: THE CHEMICAL PEEL



A BIT OF HISTORY

Considered one of the most effective and minimally invasive cosmetic procedures available, the chemical peel is a key player in today's beauty industry for skin resurfacing. In actual fact, it's been going strong for well over 150 years!

It dropped off for a few years in the 1990s due to the introduction of laser technologies and complications caused by side effects. But made a swift comeback in the new millennium thanks to a pioneering plastic surgeon who created newer, safer formulas with lower acid concentrations.

Today many dermatologists and doctors prefer deep chemical peels over laser and surgical facelifts.



But let us rewind to the mid-1800s, to the creator of deep chemical peels, Ferdinand von Hebra. An Austrian scientist, physician and founder of the Vienna School of Dermatology, he was the first to apply scientific classifications to skin diseases. Hebra also developed groundbreaking treatments for skin resurfacing by combining caustic substances like phenol and nitric acid which would become todays chemical peel.

By the 1920s Hebra's chemical peel treatment had become a top-secret Hollywood star treatment. In 1946 an American plastic surgeon, Joseph Urkov introduced croton oil to the mix. He published an article claiming to of successfully treated 2,000 patients for various skin disorders. The phenol-croton peel was now a commercially viable product.



Deep phenol-croton peel before & after photo courtesy of The Parker Center


Renowned plastic surgeons and dermatologists Thomas Baker and Howard Gordon legitimized the phenol-croton peel in the 1960s by discussing and demonstrating its impressive results at their Annual Baker Gordon Educational Symposium

But by the 90s chemical peels had fallen out of favour due to some serious complications, risky side effects, but mostly due to the introduction of new laser skin therapy technologies like C02 therapy


It wasn't long before a new generation of doctors put the phenol peel back on the map when pioneering plastic surgeon, Gregory Hetter MD gave it a major do-over. He had been studying phenol acid and croton oil for nearly twenty years and believed there was a far better, safer way to perform deep medical peels.


He published his discoveries in 2000 showing that the old formulas created by Baker and Gordon using 55% phenol and 2.1% croton oil were significantly higher than needed, leading to unnecessary risk for the patient. He also found that the active ingredient that rejuvenates the skin, was the croton oil, not phenol acid. The Hetter Peel is used today in many doctors offices.



TCA peel for acne before & after photo 


WHAT DOES A CHEMICAL PEEL DO?


I know the words 'chemical' and 'acid' can sound a bit daunting when you are applying them to your face! But a ton of studies have been documented by doctors treating various skin conditions with exfoliating acids, some of which like Hydroxy Acids are naturally derived. 

A BLEMISH-FREE, WRINKLE-FREE, FLAWLESS COMPLEXION IS LYING JUST BENEATH THE SURFACE OF YOUR SKIN

The peel is applied to the face for anywhere from  2-10 minutes depending on the type and depth. Doesn't sound that bad, right? Did I mention that it stings...? Only slightly if you're having a light/superficial peel which commonly contains a combination of fruit enzymes and acids like alpha-hydroxy acid, beta-hydroxy acid or retinoic acid. A medium to deep peel is going to be a bit more intense depending on your pain threshold!


This stinging sensation means a lot of really good activity is going on in the skin as the acids interact with proteins which causes deep exfoliation and peeling of the outer layers of skin. New skin cell regeneration is stimulated during this resurfacing process, with collagen and elastin production boosted.



The end result is reduced acne scars, sunspots, hyper-pigmentation and melasma. The collagen boost has a plumping effect on the face, smoothing out wrinkles and giving an all-round more youthful, even-toned complexion. Click here for more before & after shots.


Some exfoliating acids used in peels, like retinoic, lactic, glycolic and salicylic acid are also very helpful ingredients in everyday anti-aging skincare products like toners and serums.








WHAT TYPE OF PEEL DO I CHOOSE?

Chemical face peels are categorized according to how deep they penetrate the skin, and the job they do once inside the skin. For instance, salicylic acid is an oil-loving molecule which is able to get deep into and unclog pores from the inside out which makes it a powerful acne-fighting skincare ingredient.

Depending on which type of peel you choose it can either help control acne breakouts, reduce wrinkles, lift saggy skin or fade acne scars and melasma. 







Superficial peels penetrate and act on the epidermis, the outermost layers of the skin. With continued treatment (most doctors offices recommend a course of 5-6) these peels will even out the skin tone by reducing surface marks like acne scars, freckles, melasma and sunspots. 

Medium and Deep grade peels go much deeper by penetrating the dermis at various levels depending on the concentration and application time. These peels give significant results for aging, more mature skin. They can have a lifting effect and will reduce deep wrinkles and atrophic acne scars.




Retinoic Acid/Tretinoin Peel 

Retinoic Acid or tretinoin is a metabolite of vitamin A. Studies in 2004 showed 1% tretinoin peel was just as effective at reducing pigmentation and melasma in dark-skinned patients as 70% glycolic acid. The tretinoin peel is classed as superficial and has a ton of studies showing their effectiveness with acne and antiaging concerns.  It is chemically similar to Retin-A and has a similar effect on fibroblasts cells (collagen-producing cells). This peel stimulates active skin cells division and contributes to sealing moisture into the skin at the deepest level. It also has antiseptic properties which is why it's effective on acne. Other studies published in the Indian Dermatology Journal showed that 91.4% of patients with acne scars showed improvement when treated with a combination of retinoic and glycolic acid



Glycolic and TCA peel before & after photo courtesy of Dr Ten 20

Hydroxy Acid Peel


Hydroxy Acids are a group of naturally occurring acids derived from sugars in particular plants and fruit that are split into 2 groups - Alpha-Hydroxy Acids (AHAs) and Beta-Hydroxy Acids (BHAs). For example; Glycolic Acid (sugar cane), Lactic Acid (sour milk and tomatoes), Tartaric Acid (grapes), Citric Acid (citrus fruits), Salicylic Acid (willow bark), Malic Acid (apples), Mandelic Acid (bitter almonds). Glycolic, Salicylic and Lactic acid are most commonly used in light/superficial peels and you generally need a course of 4-6 of them in order to get results. These peels are great in treating acne and pigmentation marks caused by acne scars, freckles and melasma. It's a well-known fact that the ancient Egyptian women bathed in sour milk which contains lactic acid.




TCA Peel

Trichloroacetic Acid (TCA) is a non-toxic acid related to acetic acid which is derived from vinegar. This peel has been around for over 20 years and is classed as medium to deep depending on its concentration, with slightly longer recovery times. TCA peels up to 50% can be bought online for at-home use, but it is strongly advised that these peels be carried out by a professional. They reduce deeper wrinkles, atrophic scarring and pigmentation caused by sun exposure.



Chemical peel results for melasma. Before & after photo courtesy of Eden Health & Wellness


Phenol-Croton Peel

The Phenol Acid and Croton Oil peel is the grandaddy of chemical peels. When the phenol acid reacts with the active croton oil it causes an intense exfoliating action in the skin. The formula has been reworked quite a bit since it's creation in the 1800s. Depending on the concentration and how long it is left on the skin, the is a super deep peel that needs to be performed with a topical anaesthetic by a physician only. This type of peel is suitable for more mature skin and has a reputation for giving spectacular results similar to that of a facelift.

PLAN YOUR PEEL!  

The most important part about a chemical peel is to prepare. If you are doing an at-home peel for the first time research everything before you start. You need to know which products/ingredients to avoid before and after using exfoliating acids. Research which type of peel is most suitable for your skin type.


The first few days after a chemical peel are of the utmost importance! The brand new skin your body is generating is extremely sensitive to the sun. So planning ahead is vital to avoid damage! When booking a course of peels at a med spa, or doing it yourself at home make sure you can stay out of the sun after your peel. And when you do go out wear a high factor mineral (physical) sunscreen, NOT a chemical sunscreen.

My favourite one right now is Shade, from Not The Norm, especially after a minimally invasive treatment like micro-needling or a peel, because its made from only 4 organic ingredients, coconut oil, shea butter, beeswax and non-nano zinc oxide. It won quite a few beauty awards and is a sunscreen that's actually good for your skin!

Clean and natural skincare products are super important post-peel too!!



THE ORDINARY AHA PEEL REVIEW

COMING SOON



I'm a big fan of AHAs and BHAs in my daily skincare regime and have also done a few at-home 40% glycolic acid peels in the past. It's been a while since I did one, so I'm way overdue! This one from The Ordinary has been sitting on my desk for about 2 weeks now and I'm going to be trying it out twice a week for the next three months. It is a 30% glycolic acid and 2% salicylic acid, which doesn't give me high hopes for it reducing my melasma, but it has some great reviews so I'm excited to try it.. stay tuned!