A comprehensive skin care regimen encompasses multiple different products all designed to maintain or improve the appearance of the skin. There are products for cleansing, restoring, hydrating and repairing the skin. Essential to all of these regimens are the repairing agents - peels.
Photoaging results from repeated exposure to UV light. It is the same as normal aging but in an accelerated and more severe form. The visible changes, on the skin, are course and fine wrinkles, surface irregularities, spider veins and pigment changes.
On a cellular level the cells of the top layer of the skin, the epidermis, can become abnormal (dysplasia), eventually leading to skin cancer. The epidermis can also thicken abnormally, become thinner or poorly arranged. In the deeper skin layer, the dermis, there is loss of collagen and elastic fibers.
Chemical peels also called chemexfoliation or derma peeling are acids (mostly) that penetrate the skin to different depths creating a wound. The cells are injured and can no longer stick to each other thus the skin peels. This wound stimulates the growth of new skin cells and collagen leading to new, healthier skin.
Chemical agents are chosen based on their depth of skin penetration. Superficial peeling agents penetrate the skin thought the epidermal layer down to the junction with the dermal layer. These agents include Jessner’s solution, salicylic acid and alpha hydroxy acids. These agents are good for treating dysplasia and pigment changes of the epidermis. Peeling is minor. Because these agents don’t penetrate the dermis, treatments can be repeated weekly.
Medium-depth agents penetrate the dermal-epidermal junction. The Vi and Precision peels are representative of medium-depth agent. These peels not only improve the photo-damaged epidermis by treating dysplasia and pigment changes but also treat fine wrinkles.
In addition they improve skin health by stimulating the production of collagen. The period of peeling is 5-7 days and can be repeated in as little as four weeks in some patients.
Deep peeling agents penetrate well into the dermis. Phenol is the classic agent that has been used for this purpose. Because these agents penetrate so deeply they address all of the issues associated with photodamage. These agents can be painful when applied and therefore anesthesia is recommended.
In addition the deep wounding results in open wounds that ooze for 7-10 days. Finally, these deep peels carry an increased risk of complications such as infection, hypopigmentation and a prolonged period of skin redness.
At Hess Medical Spa we believe in customizing each patient’s facial treatment. Because of the more substantial risks associated with deep peels and the vast array of alternatives we find limited applications for them.
We have found that through a combination of medium-depth and superficial peels in combination with an appropriate skin care regimen the same results can be obtained. In addition we believe that the “down time” associated with deep peels is something most patients cannot make time for.