We offer a wide range of chemical peels which are done in-house by our highly trained cosmetic nurse in Liverpool. All treatments are overseen by Dr Jennifer Yip, the principle doctor of the practice. Conveniently located for residents of Bankstown, Narellan, Fairfield and surrounding suburbs.
These peels penetrate the epidermis.
These peels penetrate to the papillary or upper dermis.
These peels penetrate to the reticular dermis.
What is a chemical peel for?
The aim of a chemical peel is exfoliation and regeneration of the epidermis and regeneration of the dermis.
Epidermal regeneration occurs in superficial peels. The basal epidermal cells undergoes increase rate of cell division.
Medium and deep peels undergo dermal wound healing which can be divided in three phases
Phase 1 Inflammatory phase
This phase last less than 1 week. Inflammatory mediators (cytokines, prostaglandins) attract inflammatory cells to the area (white blood cells such as leukocytes and macrophages) as well as fibroblasts to the area. Blood vessels become dilated and nerve endings become sensitized leading to itch.
Phase 2 Repair phase
This phase can last from 1 week to several weeks. The macrophages in the dermis and metalloproteinases (enzymes that breakdown protein such as collagen and are involved in wound healing) increase in activity. Re-epithelization occurs simultaneously. This process starts from the hair follicle.
Phase 3 Remodelling phase
Fibroblasts start the production of new collagen which is then embedded into a new matrix of collagen and elastic fibres.
Dermal rejuvenation is only complete once the collagen neosynthesis (remodelling phase) is complete which can take several months. Epidermal rejuvenation is complete in a shorter time frame such as a few weeks.
What do chemical peels do?
Chemical peels damage the epidermis and or the dermis leading to stimulation of new tissue. The aim is to improve the aesthetic appearance of your skin. The ultimate cosmetic outcome of a chemical peel is determined by the depth of the penetration of the peel. This is turn is dependent on
chemical characteristics of the peel, the method of application of the peel and the patient’s skin type.
The two key aims of chemical peels are
- exfoliation and rejuvenation of the epidermis
- synthesis of new extracellular matrix (collagen and elastin) in the dermis
These include alpha-hydroxy acid AHA, pyruvic acid, salicylic acid and Jessner’s chemical peeling agents.
The acidic PH is less than 2 leading to decrease cell cohesion and therefore leads to exfoliation
These peels lead to reduction in abnormal epidermal cells and reduction in pigmentation. The epidermis becomes more smooth and compact.
These peels coagulate proteins both enzymes and structural proteins
No frost peels vs Frost peels
No frost peels (AHA, salicylic acid and pyruvic acid) are no frost peels. No frost peels reach only into the epidermis.
Peels that cause frosting (TCA, Jessner’s) can penetrate into the dermis due to their chemical properties. Peels that reach the papillary dermis are TCA 25% to 35%
Pre and post chemical peel treatment
The aim of treatment before and after chemical peel is to accelerate regeneration and prevent pigmentation.
Products that encourage exfoliation contain AHA and SA. Retinoids promoted epidermal turnover. Hydroquinone inhibit tyrosinase activity in melanocytes.
- Minor skin blemishes
- Shallow acne scars
Complications of superficial peels
The risk of complications with superficial peels is low. Potential complications are
- Erythema (redness)
Pigmentation and telangiectasia can be prevented with pretreatment of hydroquinone and high SPF sunscreen as well as sun protection. If the treated area is affected by herpes simplex (cold sores) there may be an increased risk of scarring. Oral antiviral prophylaxis are often given in patients with a history of cold sores to minimize this risk.
Complications of medium peels
- Wound infection and delayed healing
- Transient milia
- Pigmentation and transient hypopigmentation
- Persistent erythema
To minimize the risk of complications with medium peels, a careful history to evaluate any potential problems, possible use of oral antiviral prophylaxis in patients who have a history of cold sores, rule out acute skin infections and aggressive sun protection. Close followup at the clinic after the chemical peel.
Superficial AHA peels can be used for mild acne (comedones, pustules and superficial papules) and mild superficial pigmentation. Use long term with adjunctive therapy they can possibly smooth out very shallow acne scars. The usual procedures consist of 4 to 5 peels at 2 to 4 week intervals. Treatment can be continued at regular intervals up to 6 weeks or stopped.
Repeated applications of 10 to 30% salicylic acid peel can be used in comedonal acne or papulopustular acne particularly on the back.
Jessner’s peel plus 15% to 25% TCA is often called a ‘weekend peel’. It can be used to treat acne, early signs of ageing and pigmentation. These peels are suitable for neck and décolletage areas. When Jessner’s peel is combined with 35% TCA it can be used to treat shallow acne scars and moderate skin ageing with actinic keratoses (sunspots) and elastosis (ageing).
TCA can be used on the face, neck, décolletage and hands. TCA can be used in combination with Jessner’s formula.