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Chemical Peels in Santa Barbara: Evolutions Event Recap

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
Commonly Asked Questions about Chemical Peels

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.

Conclusions

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. 

 

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Evolutions Medical Spa Event Recap: “Brighten Up” with FotoFacials, Laser Facials, Peels and More

Santa Barbara cosmetic surgeon Dr. Terry Perkins – and founder of Evolutions Medical Spa – never ceases to amaze us with the knowledge he holds about the skin and skin care. Last night he shared with a captive audience how to get on the path to clear, bright skin. Here is the recap from the “Brighten Up” educational event at Evolutions.

What stands in the way of luminous skin? For many of us, it is an issue of pigmentation. Pigmentation, also referred to as age spots, “liver” spots, freckles, is caused by melanin.  Melanin is produced as a protection to the skin in response to sun exposure (a sun “tan” is actually a skin injury), trauma, or inflammation. Melanin can also be influenced by hormones, birth control pills, and pregnancy. Appearance problems occur when melanocytes are over stimulated such as post-inflammatory hyperpigmentation (from pimples) or melasma, which is a broad patch of pigmentation that can occur in the epidermal or dermal layers of the skin.

How do we get rid of pigmentation? Below are the options that Dr. Perkins outlined for us:

HOME CARE

While Evolutions offers a variety of services that are effective in the treatment of pigmentation problems, Dr. Perkins stressed that it is also important to practice diligent home care to prevent or lighten pigmentation. The #1 recommendation from Dr. Perkins is to wear your sunscreen daily! The fact is that more than half of UV exposure is “incidental” exposure such as sitting near a window, driving in your car, walking outside to chat with your neighbor, you get the picture! UVA actually goes through glass, so you aren’t protected in your car or at your window office.

Evolutions offers a variety of bleaching agents and hydroquinone (which stops the formation of pigment from being formed). Some product recommendations:

  • Obagi Clear and C-Rx Night: a product with hydroquinone as an active ingredient that helps to fade unwanted pigment
  • Revale Illuminating Serum: has the highest potency of antioxidants – good anti-oxidation helps skin repair
  • Nia24: helps skin repair at the DNA level which normalizes pigmentation
  • Retinoids (“Retin A”, “Tretinoin”): help normalize cell differentiation
  • Combination Prescription Products (“Firm and Fade”): offered exclusively at Evolutions that combines Retin-A, hydroquinone, and a low potency steroid (used to calm down inflammation)

In addition to using a brightening/lightening product, you may want to add in a product that encourages cell turnover. Products that contain alpha-hydroxy acids, amino fruit acids, and retinoids are all good choices.

VIBRADERM

Vibraderm is done using abrasive aluminum paddles that provide a gentle abrasion. It is faster than microdermabrasion and does not have a vacuum component (which can cause broken capillaries).  This physical exfoliation is used to treat superficial pigment problems with no downtime. It will improve the penetration of products / peels and is great as a stand alone service or in conjunction with a peel or facial.

LIGHT-BASED TREATMENTS : FOTOFACIAL RF

This “Gold Standard” treatment of pigmentation uses Intense Pulsed Light / Radiofrequency to target pigment and “red” areas. A FotoFacial works deeper than most chemical peels and can significantly improve your skin texture by reducing redness, age spots, sun damage, spider veins, fine lines (although not a treatment for wrinkles) and large pores. We offer the FotoFacial in a series or in combination with other treatments (FotoPeel, FotoPeel Plus, and FotoFacial Genesis Packages), depending on an individual’s needs.

CHEMICAL PEELS

Chemical peels are a “controlled” injury to the skin that causes a deep, even exfoliation. At Evolutions we offer different depths of peels (from light to medium to deep).

  • AFA Peels: the alpha-hydroxy peel is a “light” peel for those who want the benefits of a peels without a large amount of actual peeling. This peel can be done alone or in a series of five (recommended).
  • Alpha Beta Peel: this is the most popular peel at Evolutions. It is a medium-depth physical exfoliation and works well to get rid of superficial sun damage and is a great choice for clients who want to see results in 4-5 days.
  • Obagi Blue Peel: this is the deepest peel offered. It will significantly improve your complexion. You will have firmer, clearer, smoother, healthier skin.

LIGHT-BASED TREATMENTS: Q-SWITCHED LASER

This newest laser is used for our newest service – tattoo removal. It delivers laser energy so rapidly that it breaks up pigment without excessive heating of the surrounding tissue.  Currently we are testing how effectively it can treat stubborn brown pigmentation. Stay tuned at a later date for more information on the Q-Switched Laser!

SUBLATIVE REJUVENATION

This unique fractional resurfacing device uses radiofrequency energy instead of light to safely treat all skin types. Sublative Rejuvenation is used to treat wrinkles, pigment, acne scarring, skin laxity, tone and texture. There is less downtime and discomfort than older fractional laser devises (i.e. the Fraxel) and it can be combined with other light-based treatments (such as the FotoFacial RF or Total Tightening) for customizable treatment options.

CHEMABRASION

This surgical procedure done by Dr. Perkins at Cosmetic Surgery Center in Santa Barbara (near Cottage Hospital) combines a deep peel with dermabrasion (not microdermabrasion). It treats wrinkles, sun damage, and pigment. You will be very impressed with the results. For more information, contact Cosmetic Surgery Center at 805.563.0000.

CONCLUSION

The best way to treat sun damage is to prevent it by using your sunscreen daily (on your face, neck, and decolletage). When pigment issues arise, there are a number of treatment options available at Evolutions and “at home”. Pigmentation can be treated on all areas of the body.

At Evolutions we always offer a complimentary consultation. If you are interested in one of our medical spa services, or simply looking for a new home care routine, call us at 805.687.0212 to make an appointment (or book online).

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Evolutions Medical Spa’s Event Recap: All About Acne Management and Treatment

Evolutions Medical Spa Santa Barbara hosts events to educate clients and guests on select topics. The Evolutions Educational Event held this past Wednesday was titled “From Red to Ready” and addressed how it is possible to get rid of acne and rosacea! Since so much information was offered, this post is dedicated to acne.

 

Cosmetic surgeon Dr. Terry Perkins gave a very informative presentation including a better understanding of acne and , more importantly, tips on prevention and treatment!

If you are battling acne (and, surprisingly, acne can be a lifelong occurrence, not just part of the teen years), and you’d like a complimentary consultation with Dr. Perkins, please call Evolutions at 805.687.0212.

 

Acne Facts
    • Acne is one of the most common of all skin problems

 

    • Acne affects over 70 million people and 90% of all teens

 

    • Acne is an ongoing condition, often characterized by periodic flare-ups

 

  • It most commonly affects the face, upper chest and back

For most people it is a matter of “controlling” acne instead of curing it.

Types of Acne

    • Comedonal Acne: this type of acne usually consists of plugged pores with not a lot of bacterial activity, often seen as small bumps under the skin.

 

    • Papulopustular Acne: this type of acne has more bacterial activity and appears more as pimples with a whitehead and red surrounding area.

 

  • Cystic Acne: this type of acne is more deeply rooted, with the acne appearing as large bumps (like a marble under the skin) with, or without, whiteheads and may need to be treated systemically (with oral antibiotics or Accutane).

What Causes Acne?

    • Increased sebum or oil production – usually related to hormones

 

    • Obstruction of the pore

 

    • P. Acnes bacteria begin to grow in the sebum

 

  • Inflammation occurs when the sebum escapes into the surrounding skin

Treating Acne
Treating acne is an ongoing process because there is no “cure” your goal is to “control” what is going on. There are three overall goals:

    1. Prevent the blocking of the pores. Opening pores helps the skin function better. Keep the pores open through exfoliation, which promotes skin turnover. Use of retinoids (like Retin-A) and exfoliation through products are recommended for at-home skin care. It is also recommended to seek periodic professional treatments such as a chemical peel or Vibradermabrasion (a more physical way to open up the surface) to expedite exfoliation of the top layers of skin.

 

    1. Minimize inflammation. Salicyclic acid liquefies the sebum and helps to quiet the skin. A low percentage of salicyclic acid is okay to use on a regular basis and can help minimize the inflammation of acne.

 

  1. Prevent Scarring. Acne scarring or pitting remains long after the acne is gone which is why it is a good idea to learn how to get your acne under control.

Tips on the Treatment of Acne

    • Good hygiene: keep the skin clean. Dr. Perkins does not recommend washing the face more than two times per day. Washing the face more than that may cause an increase in oil production. Use a gentle foaming cleanser. The face wash does not need to be harsh or it may “strip” your skin – again causing increased oil production – especially if you are using other products such as salicyclic acid or retinoids. The Clarisonic skin care brush is highly recommended by Dr. Perkins. He touts this as the “best cleaning device” because the ultrasonic waves penetrate below the surface for a deep, yet gentle, cleanse.

 

    • Don’t “pick” and “pop”: this may increase the life of the pimple, making it larger or redder and /or increase your chances of scarring.

 

    • No oil based cosmetics: many store make-up brands are petroleum based, which is like putting putty in your pores. Over time, this clogs pores. Mineral make-up is more quieting to the skin.

 

    • Don’t go to sleep with make-up on: give your face a rest!

 

    • “Good” diet: consuming foods with a high iodine content (salt) tends to foster breakouts. In addition, a skin supplement that has worked for some Evolutions clients are the VitaMedica “Clear Skin Treatment”.

 

  • Stress management: Learn to manage your stress. Outbreaks can definitely be stress (and hormone) related.

How You Can Treat Your Acne

Treatment of acne can be done in many ways, from at-home topical treatments to professional treatments to oral medication. How acne is treated typically depends on your specific case of acne and it is recommended that you get a professional opinion on how to best proceed in managing your acne.

Topical Acne Treatments

    • Retinoids (Retin-A), exfoliants (AFA Exfoliating Gel), and amino fruit acids can be used topically to treat acne.

 

  • Although glycolic acid is very popular and found in many store products, it can be the most irritating of the alpha hyrdoxy acids and Dr. Perkins prefers mandelic acid (available at Evolutions) which is less irritating and has an anti-bacterial function to decrease the P. Acnes bacteria.

Oral / Systemic Therapy

  • Oral treatments include antibiotics and Accutane. Dr. Perkins prefers to try to treat the acne topically before prescribing an oral treatment.

Professional Procedures

    • Acne Facials professionally cleanse, exfoliate and extract keeping the pores open and the skin functioning normally.

 

    • Vibradermabrasion is a physical exfoliation that is similar to microdermabrasion without the suction. It has been found that the suction in microdermabrasion may affect the tiny blood vessels in the face, making the skin appear redder. Vibraderm is similar to “buffing” the skin, is comfortable, and the whole face can be done in 10 to 15 minutes as opposed to a 35 to 40 minute session of microdermabrasion.

 

    • AFA/Clay Mask Peel is an advanced amino fruit acid mask which exfoliates and opens up the pores. It is less irritating than alpha hydroxy acids.

 

    • Multiwave LED (Light Emitting Diode) therapy works in which energy is delivered to the skin and absorbed by the cells for therapeutic benefits through a process called “photo-stimulation.” The “blue” light kills the P. Acnes bacteria while the “red” light calms the skin and gets rid of inflammation. The Multiwave LED therapy can be done alone or often is part of a facial at Evolutions.

 

    • Levulan is similar to the oral drug Accutane, but is a topical treatment. Levulan causes the sebaceous cells to sink and people have seen dramatic changes in their skin from one treatment or through a series (which is often three treatments).

 

    • Cyst Injections are a topical way to treat cystic acne. Antibiotics are injected under the cystic acne to help bring done the bacterial infection.

 

  • Isolaz Deep Pore Therapy combines a vacuum with a light treatment. The vacuum purifies the pores from the inside out and the blue light kills the bacteria. A great treatment for persistent papulopustular acne.

There is no “magic bullet” that cures acne. It is important to create and execute a comprehensive “attack plan” that combines good home care with appropriate professional services. Generally it takes a few weeks (a “turnover cycle”) to start seeing results of a treatment, so patience is necessary.

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Santa Barbara Cosmetic Surgeon Shares Thoughts on Chemical Peels and What They Can Do For You

Evolutions Medical Spa’s August event – Skin Appeel – was dedicated to providing you with information on chemical peels, from mild to deep, and everything in between. Since chemical peels are one of the most common procedures at Evolutions, we thought we’d take the opportunity to share what Santa Barbara cosmetic surgeon Dr. Terry Perkins spoke about that evening.

How do chemical peels work and what do they do?

A chemical peel is a controlled-depth injury to the outer layers of the skin. The “injured” tissue exfoliates (“peels”) and new cells rapidly replace the exfoliated cells while collagen and elastin production is increased. Collagen works with elastin to support the body’s tissue – including your facial tissue – keeping your body firm and strong.

As we age, surface cell turnover decreases to 40 or more days (28 days is normal for younger people) coupled with a natural decline in collagen, makes facial skin more prone to sagging and wrinkles. A chemical peel assists in sloughing off older cells as well as increasing collagen and elastin, thereby lightening, tightening and brightening the skin. A chemical peel also smoothes skin and improves texture and color uniformity. Consistent chemical peels, along with great at-home skin care regimen, helps maintain healthier, younger-looking skin throughout your lifetime.

Chemical Peels Available at Evolutions Medical Spa

Evolutions Medical Spa offers a variety of peels because skin type is unique and there is not a “one-size-fits-all” chemical peel. Read on about chemical peels offered at Evolutions and a description of each. If you are unsure which chemical peel is right for you, we recommend requesting a complimentary consultation where our highly-trained clinical staff can assist you in making a choice that best suits your needs and your skin.

Pumpkin Antioxidant Facial
The Pumpkin Antioxidant Facial is a relaxing facial that incorporated a pumpkin enzyme peel supercharged with antioxidants that delivers a great exfoliation without major peeling involved. As it draws out impurities, it introduces vitamins, enzymes and nutrients into the skin. The pumpkin peel contains the highest concentration of salicyclic acid, vitamin A, vitamin C and beta-carotene.

AFA Peel
The AFA peel addresses aging, sun-damaged, uneven-textured and hyper-pigemented skin. It exfoliates with low irritation and is available in varying strengths to meet individual needs. Little to no peeling occurs and usually a series of five is recommended.

Clay Mask Peel (Advanced Acne Facial)
The Clay Mask Peel is excellent for oily and acne-prone skin. This treatment combines the AFA Peel with a clay mask to absorb oil and skin impurities.

Alpha Beta Peel
Evolutions most popular peel! The Alpha Beta peel is a medium peel that combines alpha hydroxy and beta hydroxy acids into one powerful peel. Strength can be varied (2 to 4 layers) and you will experience peeling for about 3 to 4 days. If you really want to peel and see results quickly, this is a great choice.

Obagi Blue Peel
The Obagi Blue Peel is the deepest, most aggressive peel. It is excellent for pigmentation issues and will significantly improve your complexion – resulting in tighter, firmer, smoother, more youthful-looking skin. For optimum results, a pre- and post home care kit is recommended. The Obagi Blue Peel is only available through physicians.

Evolutions recommends several ways to improve peel results such as doing a series of peels, doing light/laser-based treatments, prepping the skin with a Vibradermabrasion treatment and using physician-recommended products for home skin care.

Chemical peels are an important component in improving and maintaining the quality of your skin throughout your lifetime.

Call 805.687.0212 for an appointment today!
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