Yesterday evening Evolutions Medical Spa hosted an educational event about chemical peels and how beneficial they are for all skin conditions and skin types. Santa Barbara cosmetic surgeon, Dr. Terry Perkins, the founder and Medical Director of Evolutions, explained and demystified chemical peels. Following is a recap of his presentation:
How Skin Turnover Works
An understanding of skin will lead to a better understanding of how chemical peels work to freshen the skin. Skin cells are created in the basal layer and move upwards. Cells die as they get closer to skin surface and naturally slough off. Most people in their youth have skin turnover every 28 days or so. That is why young children and young adults usually have glowing, voluminous skin. As we age cell turnover can slow to 40-45 days coupled with the fact that collagen and elastin naturally decrease and we are left with skin that is “relaxed” and saggy. Chemical peels help expedite the skin turnover process so that new cells can move to the surface for a result of more normal-looking skin.
What Do Chemical Peels Do?
A chemical peel creates a controlled depth injury to outer layers of skin. The injured tissue then exfoliates or peels and new cells replace the exfoliated cells at a faster rate. Collagen and elastin production is increased. There are several different types of peels, from light to deep:
- Lighter peels affect the epidermis: typically this is the type of peel you will get at a day spa or this is the layer that is affected by micodermabrasion
- Medium peels affect the papillary dermis: these more aggressive peels are usually done in a doctor’s office or at a medical spa; you may see improvement in lines, wrinkles, and pigmentation
- Deep peels affect midway in the dermis: chemabrasion is an example of a deep peel and is done at Cosmetic Surgery Center in the operating room.
Deeper peels have more downtime, but more downtime yields better results.
Benefits of a Chemical Peel
- Peels can lighten, tighten, brighten (more luminosity to the skin)
- They smooth skin and improve texture and color uniformity
- Peels can bring out healthier skin; often any precancerous/abnormal skin may peel off
- Consistent peels can keep your skin younger-looking skin throughout your lifetime
Do peels hurt?
The stronger and deeper it is, the more likely you will have some discomfort. Deeper peels feel hot because of the acid on the skin. At Evolutions, we have a hand-held cooling device so the patient can direct cool air where it feels hot.
Will skin peel off?
This depends on what you are doing. Some of the enzyme peels and the Flash Peel will increase cell turnover with no peeling. In general, most peels do cause sloughing, some degree of peeling skin. We don’t recommend you do a peel right before a big event. Plan to do a peel three to four weeks prior to any special occasion.
Where can peels be done?
Virtually any part of the body: face, neck, chest, hands are all treatable. You don’t need to do the same peel everywhere, for example, a less aggressive peel can be done below the jawline because skin turnover is less fast, while a more aggressive peel can be done on the face.
Are peels mainly done for aging skin?
Peels can be done for aging skin and there are also peels that can be done to help control acne and slough off the dark pigmentation that some people get after the acne lesion is gone.
Are peels as effective as laser treatments?
Yes, in general. Lasers use light energy to penetrate the skin while chemical peels use acid to reach deeply into the dermis.
Peels Available at Evolutions
Pumpkin Antioxidant Facial: this pumpkin peel is an enzyme type peel. Pumpkin contains high concentrations of vitamin A, vitamin C, and beta-carotene found in any fruit or vegetable. This facial and peel combination exfoliates and draws out impurities while introducing vitamins, enzymes, and nutrients. There is no downtime, no pain, and no peeling. A very relaxing experience.
* NEW! Flash Peel: this peel is a combination of glycolic, lactic, and salicylic acid that can be customized depending on the client’s skin. It can be a little tingly because of the alpha hydroxy acid. A mask is applied and massaged into the skin which gives the skin added hydration and nourishment. The service is a quick 30 minutes (easily done on your lunch hour). There is little to no peeling and yet the result is clear, rejuvenated skin.
* NEW! Jessner’s Peel: this peel has stood the test of time. Dr. Max Jessner, a dermatologist, came up with this in the early 1900s. He used resorcinol (a cousin to phenol) and mixed it with lactic and salicylic acid to create a peel that is not all that aggressive. It can be done in multiple layers and as you do more layers, you get a white tinge to the skin, known as “frosting” or “blanching” which means proteins in the skin are starting to denature. It won’t get as deep as the Obagi blue peel because it’s not a strong acid which is why we classify it as a light peel to medium peel. Jessner’s Peel is especially helpful for acneic and/or oily skin. It contains lycopene and red wine (antioxidants for the skin) and is anti-inflammatory and anti-microbial. Good for all for people of all skin types who want to freshen the skin.
Clay Mask Peel (Advanced Acne Facial): this peel is excellent for people with oily or acne-prone skin. The AFA (amino fruit acids) clay mask works to draw out oils and impurities and offers optimal exfoliation.
Alpha Beta Peel: our most popular peel at evolutions! This peel combines alpha hydroxy and beta hydroxy acids into one powerful peel. We can vary the strength by applying it in 2-4 layers. A great choice for clients who want to see results quickly. Typically skin will begin to peel two to four days after the peel is applied and the skin will peel for approximately two to four days after that.
Obagi Blue Peel: the Obagi peel is our most aggressive peel available. The peel comes from a kit made by the medical grade skincare company Obagi. The peel is available in concentrations of 15% or 20% TCA. We tend to do 20% so the client gets the best result. It is excellent for pigmentation issues. The Obagi Blue Peel is only available through a physicians office. Downtime is about seven to ten days total. Usually the peeling process occurs four to five days post application of the peel.
More Aggressive Options
These peels are only available at Dr. Perkins’ office – Cosmetic Surgery Center in Santa Barbara, just two blocks from Cottage Hospital. For questions or to schedule a consultation about one of these options, call his office directly 805-563-0000.
Comfort Peel: the Comfort Peel is the strongest peel with 23% TCA. It is similar to blue peel but has a topical anesthetic in it so the first layer stings a bit but the second layer stings less because of the numbing agent in it.
Phenol Peel: this peel can dramatically take care of sun damage and wrinkles. Dr. Perkins estimates that it can get rid of 95% of wrinkles in one treatment. The downside is that phenol is toxic to melanocytes so the patient may have permanent lightening of the skin. The Phenol Peel is not commonly done anymore because of the lightening side effect.
Chemabrasion: this procedure combines a medium depth TCA peel (35% augmented TCA that has penetrating agents mixed in) with a light dermabrasion. It is done under anesthetic in the operating room. The downtime is about seven to ten days. Chemabrasion can get rid of 75-80% of wrinkles with one treatment. Post-op care is like caring for a wound – wash in the morning and evening; keep covered with ointment. This is also a great treatment for acne scarring.
Improving Peel Results
You can improve the result of your peel by:
- Doing a home care pre-treatment (recommended for more aggressive peels); the staff at Evolutions can suggest what product(s) to use in the weeks prior to treatment
- Vibraderm prep: a physical exfoliation that will allow the peel to penetrate evenly and more deeply
- Stem cell add-on: from the skincare company DNA, the addition of stem cells helps augment the wound heeling
- Multiwave LED – light therapy: multiple wavelengths of light speed the wound heeling and may shorten the time that you do not look good
- Peel series: doing a series of light peels will give you a better result than just doing one; strong peels don’t need to be done in a series but, in some cases, a second follow up peel can be done if the client wants to see even greater results
- Laser / Light-based treatment combined: we offer the FotoPeel which alternates between Fotofacials and chemical peels. A great option for sun damage. This series makes people look really good really fast!
- Ongoing home care / maintenance: we always encourage our clients to use effective products for ongoing home care; Dr. Perkins has hand picked products from some of the top medical-grade skin care lines to upkeep your skin in between treatments. We also recommend periodic peels for good maintenance.
Chemical peels are an important component (along with home care and possibly light-based treatments) in improving and maintaining the quality of your skin throughout your life. There are many types of peels for many different purposes. Remember that you don’t need to peel after a peel and all areas of the body can be treated.
To schedule a peel or a complimentary consultation, call us at 805-687-0212.