Chemical peeling: types, features, indications and contraindications. Stages of chemical peeling

Every day we wash dust from furniture. The same must be done with the skin. Only the “dust” from it needs to be “washed off” correctly.

Concept of method

The term “peeling” means to scrape hard. It helps remove dead cells and restores the skin to a different level. Chemical peels can be used on any part of the body.

Peeling is a cleansing procedure. New cells can grow unhindered and the skin begins to live again. This is not only rejuvenation, but also health. It is used in dermatology when skin problems are “obvious”: scars, stretch marks, cicatrices, etc.

The top layer of skin is removed using different methods: mechanical, chemical, laser.

Chemical peeling of the face (before and after photos)

Types of chemical peeling

There are three types of chemical peels: superficial, medium and deep. Each of these types has several private subspecies, which depends on the composition of the chemical exfoliant (solvent).

Surface

The safest type of peeling. It helps remove fine wrinkles, consequences and... It is used to treat. This peeling is carried out using fruit acids.

Glycolic, malic, citric, and tartaric acids are also called AHA acids. AHA peeling is a subtype of superficial peeling. The name of the ingredient gives the name to the procedure itself. Each has its own peculiarity.

The video below will tell you what you need to know about chemical peeling:

Almond

It is carried out using mandelic acid, which is obtained from almond seeds. This is a gentle peeling that slowly penetrates the skin cells. Its use is permissible even during periods of solar activity.

The results of such peeling are in no way inferior to the results achieved with the use of glycolic acid. The advantage is the absence of contraindications.

Glycolic

The glycolic acid molecule easily penetrates the skin, which contributes to a lasting effect. Peeling is suitable for any skin, but not at any age. There are contraindications:

Seasonal restrictions
Pregnancy,
Presence of warts
Infectious skin diseases in the acute stage,
Skin damage
Very dark skin
Recent course of hormone therapy or chemotherapy.

Salicylic

One of the most popular peelings. In addition to cleansing properties, salicylic acid also has anti-inflammatory properties, which helps smooth out the skin and improve the structure of the epidermis. She fights wonderfully.

Salicylic acid quickly penetrates deep and prevents the formation. This method can be combined with other cleansing methods. It is only incompatible with resorcinol and zinc oxide. The procedure is more suitable for oily skin.

Skin before and after peeling for freckles

Retinoic

Very gentle peeling. To carry it out, they use (artificial vitamin “A”), which corrects processes in skin cells and promotes its self-healing. The rehabilitation period after such peeling is very short, the damage is minimal, and complications are almost impossible.

Lactic

This is an extremely gentle peeling that will help refresh the skin and moisturize it. But he is unable to deal with serious problems.

Fruit or AHA peeling

Most often, such peeling is superficial, but in some cases it can be medium. It is used at the first signs, with a tendency to acne, with.

Peeling makes the skin more elastic, brightening and smoothing it. When carrying out this procedure, it is permissible to mix different acids. Not only acceptable, but also desirable.

Elena Malisheva in this video will tell you more about chemical peeling:

Median

Peeling is used to penetrate deeply into the skin. It creates a wound, which provokes cells to renew themselves more quickly.

To carry it out, high concentration trichloroacetic and glycolic acids are used. They are often used in combination. It is recommended that the procedure be performed by a specialist. Recovery time is longer than with superficial peeling.

Deep

This is already a very complex procedure that can only be performed by a professional. It is carried out using carbolic acid (phenol). There are a number of contraindications and risks. If the result is positive, the effect is amazing: the flaws “go away” completely. The method is rarely used, replacing it with laser procedures that have fewer risks.

Jessner Peel

It is a surface type, but can also be used as a middle type if the concentration of acids is higher and the number of layers applied is greater. During this procedure, several acids are used: salicylic, lactic and resorcinol. The peeling effect is soft.

The result is due to the properties of its constituent components:

Anti-inflammatory,
Exophilating,
Moisturizing,
Brightening,
Disinfectant,
Tanning, which is important for dermatological diseases.

Photo of a patient before and after Jessner peel

Bleaching

Any type of peeling has whitening properties. The whitening effect is stronger when several procedures are used in combination. The type of peeling is selected strictly individually.

Rejuvenating

For these purposes, deep peeling is often used, for example, superficial peeling in combination with deep peeling. The program is selected individually, based on the condition of the skin. The procedure does not take one day, and several procedures must be completed.

Advantages and disadvantages

Every coin has two sides. Peeling is no exception to the rule. It has both pros and cons.

Pros: the result of the procedure. If you follow all the recommendations, the result can be preserved for many years.

There are a number of contraindications,
Preparation is required to carry out
It takes time to recover.
Complications are possible.

Which is better - laser, chemical or mechanical peeling?

You can only make a choice purely individually, weighing all the pros and cons, analyzing the indications and contraindications. Everything has its own characteristics and advantages. All types of peeling are good. It is also important to consider what result you need:

Maintain balance
Get rid of a flaw or solve a global problem.

Chemical peeling gives amazing results, but sometimes has significant contraindications. If you are resorting to the procedure for rejuvenation purposes, then it is better to use the laser method, as it is less dangerous. The cost of the procedure also matters: chemical peeling is much more expensive than mechanical peeling, laser peeling is more expensive than chemical peeling.

Indications for testing

Chemical peeling can be used at any age and in any condition. What does it give:

stretch marks,
Acne elimination,
Consequences ,
Scars,
Ingrown hair.

In dermatology, the method is sometimes irreplaceable. It is also used for dry and oily skin problems to establish the right balance.

When chemical peeling is used to eliminate problems in children, the acid concentration is selected individually. It should be minimal.

Photos before and after retinoic peeling

Contraindications

Contraindications can be absolute and relative. Absolute contraindications include:

Cardiovascular diseases,
Viral skin diseases
Infectious diseases in their acute stage.

Relative contraindications include pregnancy, lactation and childhood. In such conditions, the procedure is possible, but there are several “buts”. It all depends on the composition of the mixture: some can be used without hindrance, others cannot be used. A doctor's consultation is required.

Preparation for the procedure

Chemical peeling is best done in winter and during the off-season, while the sun is not yet very active. Some types of peeling can be carried out in the summer, but you should consult a specialist about this. These include gentle superficial types of chemical peeling. No special preparation is required for this peeling. It is only necessary for medium and deep peeling. It lasts from 2 to 8 weeks.

A week before the procedure, you should avoid using products that contain vitamin A,
The use of products containing Roaccutin should be stopped within 6 months.
Antioxidants are prescribed
Peeling is allowed only a week after depilation.

Chemical peeling is not permitted before a planned spa vacation. The procedure should be carried out 6 weeks in advance.

How does the session work?

In a special institution

First, degrease and thoroughly clean the skin with soap, then with a degreasing agent containing alcohol or acetone. This allows the active components to penetrate evenly.
Vaseline or gauze wipes soaked in a protective agent are applied to those areas of the skin that should be protected from acid contact.
Apply the required mixture to the skin. The duration of exposure is from 30 seconds to 5 minutes. It depends on the goal and the individual. If the burning sensation is severe, it can be reduced or blown with air.
Apply an alkaline solution to neutralize the effect of the acid.
Wash off with water, dry and be sure to cool. Cold eliminates pain and burning.
Apply cream or anti-inflammatory ointment.

Peeling techniques may differ slightly, this is just a general scheme. When carrying out a Jessner peel, an alkaline solution is not used for neutralization. The duration of the procedure is from 20 to 40 minutes.

Before and after gas-liquid peeling

At home

More often, the chemical peeling procedure is carried out in special institutions. Although you can use the method at home. It is important to carefully follow all points! At home, it is permissible to carry out only superficial peeling using Alpha and Beta hydroxides of acids: fruit acids, salicylic acid, glycolic acid. It’s easier to choose a ready-made product for home use: “Dermaceutic”, “Jan Marini”, “LA Peel”, etc.

How to carry out the procedure at home:

We choose a peeling product, check for allergies by applying it to a small area of skin,
Cleanse the skin with a scrub the day before the procedure,
Immediately before the procedure, cleanse the skin with a mild cleanser,
Apply Vaseline to areas not intended for peeling.
Apply the composition to the skin, leaving it for the required time,
Wash off
Apply cream.

For home peeling, a fruit peeling recipe with glycolic acid is ideal. Its composition: honey, gelatin, pineapple, papaya. Mix the fruits in a blender, add gelatin and honey. The mixture is first heated, then put in the refrigerator. And they use it, it’s simple. After 10 - 15 minutes, the mixture is washed off.

Consequences and possible complications

After the procedure, even bronze, this is normal. It may also occur. But complications are also possible.

Chemical peeling is the removal of the upper layers of the dermis.

And thanks to this procedure, you can achieve a lifting effect, restore the protective properties of the skin and solve many aesthetic problems.

Chemical peels can be divided into three categories. Read on about this and much more.

Every woman wants to be well-groomed and beautiful and pays special attention to the condition of her face. To cleanse and rejuvenate the skin, remove age spots, various defects and irregularities, women have used various masks, decoctions and herbal tinctures since ancient times.

But all these means were ineffective. Modern cosmetology has made great strides forward and chemical peeling is now successfully used to restore and rejuvenate the skin.

What is it and types of cleaning

Facial peeling using chemicals is an active process of exfoliating the top layer of dead epidermal cells, stimulating the natural process of skin renewal. With the help of an individually selected chemical composition, various stains, defects and irregularities are removed and smoothed.

The natural protective functions of the body are activated, active production of hyaluronic acid begins, cells begin to produce large amounts of collagen and elastin, the surface becomes more elastic and taut.

Using chemical action, you can effectively cleanse your face of pigmentation and freckles (read about laser), remove spider veins (find out how this is done) and small expression wrinkles. This procedure effectively combats unevenness caused by various skin diseases.

With its help, you can smooth out scars, remove excessive redness and normalize the function of the skin glands.

Depending on the method, such cleaning is carried out using various acids: fruit, glycolic, salicylic, trichloroacetic and phenolic. Based on the strength and depth of penetration, they are distinguished between medium and light superficial. Most often, this peeling is used exclusively for the face, but it can also be used on other areas, such as the neck and décolleté.

Deep

This type is the most radical in its effect on the body and is carried out with the help of phenol. It is a very aggressive substance and penetrates very deeply into the lowest layers of the epidermis. Phenol is highly toxic and essentially destroys the upper layers of the skin, but this allows you to solve a number of serious problems that other methods cannot do.

This procedure is very painful and is performed only under general anesthesia in an outpatient setting at a cosmetology clinic.

During this procedure, the patient is sedated using painkillers. Duration from 20 to 60 minutes, depending on the size of the surface being treated and the number of defects.

After the procedure, the surface is covered with a protective crust, and severe redness and peeling may be observed. The recovery period lasts 3-4 weeks. Bed rest is recommended for the first week; the doctor may also prescribe a number of medications that will speed up healing and prevent the inflammatory process.

After exposure to the drugs, the surface becomes significantly lighter, so it is not recommended for patients with very dark skin color.

With the help of deep effects, you can remove strong pigmentation, remove scars and unevenness, even out deep wrinkles and remove vascular inflammation and other age-related changes.

Like any method, it has its pros and cons.

the method allows you to cope with deep wrinkles;
removes deep unevenness and strong pigmentation;
eliminates sagging and sagging;
It is more effective than dermabrasion;
One session is enough;
the effect lasts for several years.

very painful procedure;
long recovery period;
possible complications in the form of redness and hard crust;
not suitable for too dark skin;
high price.

See the results of a deep chemical peel:

Median

For this procedure, trichloroacetic, glycolic or salicylic acid is used. This method is less aggressive and does not act as actively and deeply as cleaning with phenol. But medium-impact peeling, as well as deep peeling, can remove deep wrinkles and reduce small pigmentary manifestations.

With it you can refresh and rejuvenate your face, remove small spider veins and smooth out scars and unevenness. This method is softer and is carried out in 3-4 sessions. The result of the median effect lasts about six months and, if necessary, it must be repeated.

The session is carried out in an outpatient setting and lasts from 20 to 60 minutes. The method does not require general anesthesia. To enhance the effect, special products are first applied to the surface. They soften the skin and prepare it for the main composition.

Chemical acids are then applied to penetrate the middle layers. During the session, the patient may experience a slight burning and tingling sensation.

After the procedure, the composition is removed with dry ice. There is slight redness and swelling that goes away within 24 hours.

Sometimes peeling and a feeling of tightness may appear. After this procedure, the complexion brightens a little or remains the same. The recovery period lasts 1-2 days, the face becomes smooth and radiant.

For a speedy recovery after chemical peeling for the face, a cosmetologist can select an individual skin care set: moisturizing or nourishing cream, special serum, vitamin mask and cleansing tonic.

You should also refrain from wearing decorative cosmetics; for the first 2-3 weeks you will need to apply sunscreen. Medium peeling is performed for patients of any age.

there is practically no pain;
allows you to remove small wrinkles and irregularities;
removes acne and inflammation;
removes puffiness and dark circles under the eyes;
evens out tone and adds shine;
eliminates slight flabbiness and sagging (RF-lifting can solve these problems);
improves complexion.

preliminary preparation is required;
the result is visible after 3-4 sessions;
unable to remove deep wrinkles and skin defects;
the effect lasts less than from phenol peeling;
quite high price.

Surface

This is the mildest type of chemical treatment; lactic and fruit acids (enzyme peeling) and a weak solution of trichloroacetic acid are used for it. Cosmetologists recommend superficial cleansing for young patients under the age of 40, when the first age-related changes and small wrinkles appear on the skin.

This method only affects the top layer and is not able to cope with wrinkles, large pigment spots and unevenness.

But it copes well with acne, seborrheic manifestations, improves the surface of the skin, and promotes active rejuvenation.

With this procedure you can get rid of small freckles, remove local redness and peeling. After superficial exposure, blood circulation improves, cells are actively saturated with oxygen, the face looks radiant and toned.

This procedure does not require preliminary preparation. It can be done in a salon or at home. Using a cotton pad, apply the active substance to the cleaned surface. Exposure time is 15-20 minutes.

The session is completely painless and does not require a recovery period. Superficial cleansing does not cause burning or redness, and the tone of the face does not change. After such cleansing, it is recommended to apply sunscreen.

absolutely painless method;
does not require preliminary preparation;
does not injure the skin and does not cause side effects;
does not change skin tone;
improves blood circulation;
actively rejuvenates and improves the structure of the dermis;
effective against acne;
inexpensive and accessible method.

unable to cope with wrinkles and age spots;
does not remove lumpiness and deep unevenness;
the result is visible after 5-6 procedures;
the effect lasts 1-2 months, then repeat is required.

We invite you to watch a video about the procedure for medium and deep chemical peeling for the face:

Indications, photos before and after the procedure

Indications for this procedure are:

any types of pigmentation;
various skin defects, the presence of scars and cicatrices (it copes well with such defects);
uneven skin surface as a result of various diseases;
wrinkles and dry skin;
dark circles under the eyes;
severe redness;
presence of spider veins;
improper functioning of the sebaceous glands;
clogging of pores and the appearance of “blackheads”;
sagging skin.

These are the results of a medium facial peel:

Contraindications

Like any cosmetic procedure, peeling has contraindications:

skin diseases such as dermatitis, neurodermatitis and psoriasis;
oncological diseases;
keloid scars;
period of pregnancy and lactation;
fresh wounds and cuts;
purulent inflammation;
allergic reactions;
individual intolerance to a chemical substance.

How often can you do it

Deep chemical peeling can be done no more often than once every two to three years.

You can find out why diamond peeling is a type of microdermabrasion.

Customers' opinions

Margarita, 31 years old, housewife:
“I did a shallow exfoliation to cleanse. The result was very good, I really liked everything. Fine wrinkles have disappeared, the skin has become more even.”
Svetlana, 37 years old, director:
“I had my face cleaned at the salon - after giving birth my complexion changed a lot. I was pleased with the result, but the cost of such cleaning was quite high, and you often can’t afford this.”
Vera Ivanovna, 67 years old, pensioner:
“I always try to take care of my appearance, a friend advised me to cleanse with fruit acids. I liked it very much! My face became fresher and younger, even small wrinkles disappeared.”
Karina, 45 years old, salesperson:
“I decided to have a deep cleaning at a beauty salon. They did it under general anesthesia, I was warned about the consequences, I had to stay at home for two weeks, my face was covered with a red crust and was very swollen. But the pigment spots have practically disappeared. I won’t do it a second time, it’s too painful.”

Chemical peeling is an effective salon procedure that can help eliminate serious defects and make the face and body more youthful and beautiful. This method has no analogues; it can be used at any age.

A dermatocosmetologist will tell you more about chemical peeling:

Chemical peeling - cosmetic facial procedure, which promotes rejuvenation and elimination of various skin imperfections.

It's essentially a controlled acid burn., the degree of which depends on the acid concentration.

The procedure is effective and popular, but to obtain the desired result, to avoid complications Proper facial care is necessary after chemical peeling.

The skin is treated with a special acid, which helps eliminate wrinkles, acne, remove dead cells, and normalize the functioning of the sebaceous glands.

Chemical peeling can be deep, medium, or superficial.

Deep- the most effective, but most traumatic peeling. The top layer of the epidermis and the dermis layer are removed. The procedure is comparable to a third degree burn.

Superficial peeling- the safest, in which only the top layer of dead cells is removed. You can do it yourself at home. Designed to get rid of minor flaws.

Consequences

After deep peeling (phenol) the following manifestations are observed:

severe facial swelling;
severe redness and irritation of the skin;
peeling that does not go away for several days;
severe unbearable itching.

How to care for your face after a chemical peel?

For superficial peeling the effect on the skin is the least traumatic. It may affect only the stratum corneum of the skin or several layers of the epidermis, which consist of living cells.

After this procedure, the skin becomes fresh and the grayish tint disappears. The process of their renewal is stimulated. The skin is brightened, the pores are cleaned and narrowed.

Superficial peeling carried out using alpha hydroxy acids:

glycolic;
almond;
apple;
dairy;
lemon and others.

The procedure does not cause pain, and there is no need for long-term rehabilitation. Can be done at any time of the year. This is the safest type of peeling, but requires repeated use to enhance the effect.

Medium peeling involves almost complete removal of the epidermis. This triggers skin regenerative reactions. The procedure successfully combats the manifestations of skin aging, fine wrinkles, and post-acne.

The surface of scars is smoothed, superficial keratomas, pigment spots, and freckles are removed.

During peeling, living skin cells are destroyed and the formation of new cells is accelerated. The process of growth of new capillaries in the skin, the synthesis of collagen and elastin, which are responsible for elasticity, are activated.

More than one person takes part in the procedure concentrated acid, trichloroacetic (TCA). The effect is pronounced and noticeable within a week. Provides a rejuvenating effect from one to two years.

But this type of peeling causes a burning sensation. A rehabilitation period of about a week is also required. All this time the skin is peeling off.

Medium peeling does not cope with facial and vertical wrinkles, nasolabial folds. Not suitable for dark-skinned people - may disturb skin pigmentation.

Deep peeling destroys all layers of the epidermis. Removes wrinkles and scars that affect the deep layers of the skin.

This is a very painful and traumatic type of peeling. There is a high risk of toxic effects of phenol on internal organs. Performed under general anesthesia.

Repeated use may cause the skin to become yellowish-white and waxy. There is a high risk of infection during the postoperative period.

Before and after peeling You must take antibiotics for two weeks.

Healing can take up to six months. The procedure is usually performed once in a lifetime.

To care for your skin after a chemical facial peel, you need to:

What else should you not do after peeling? After peeling Do not touch the skin in the first hours. You can get an infection.

On the second day or later, the film formed after the procedure will begin to crack and come off. It is prohibited to touch or rip it off. Peeling will go away in two weeks or less.

During the rehabilitation period Do not use regular foundation or powder, only mineral cosmetics or Korean BB creams, with the permission of a doctor.

? Alcohol can dilate blood vessels and increases the risk of hematomas and bruises. Some acids are quite toxic, just like alcohol.

The interaction of two toxic substances will lead to unpredictable consequences.

What should I put on my face after a chemical peel?

Post-peeling care products

Creams

Tinted protective cream after chemical peeling. Provides maximum protection against ultraviolet radiation due to the content of sun filters.

The main properties of the product: antibacterial and antifungal. Shea butter ensures easy application, red clay helps to mask skin imperfections well.

Compound: Shea butter, zinc oxide, red clay from the mountains of Israel, triclosan, common larch extract and other components. Apply an even layer to the skin.

Price: 2800 rubles.

Provides:

increasing skin elasticity;
protection and restoration;
the effect of antioxidants on capillaries and skin cells;
improvement of skin color;
reducing the number of wrinkles.

Compound: aloe vera extract, mimosa, hydrolyzed soy protein, soluble collagen, apricot kernel oil and other beneficial ingredients. Apply the cream to cleansed skin twice a day and distribute evenly until absorbed.

Price: 3300 rubles.

Regenerating protective post-peeling cream. Actions of the product:

intensively moisturizes;
calms and tones;
relieves inflammation, relieves irritation and swelling;
suitable for preventing dryness and flaking;
restores the protective functions of skin cells;
accelerates the regeneration process;
enriches skin cells with oxygen, nourishes with active ingredients;
improves local blood circulation;
regulates cell metabolic processes;
softens the skin, improves its elastic properties;
provides protection from UV radiation and other aggressive environmental factors;
restores after chemical peeling.

Compound: collagen, vitamin E, avocado oil, panthenol, lecithin and other components.

Application:

Apply a few drops to cleansed skin and distribute evenly.
Rub in with gentle massaging movements until absorbed.
The cream is applied in the cold season 15 minutes before going outside.
Use of the product after medium and deep peeling strictly during the rehabilitation period.

Price: 820 rubles per tube of 30 ml.

Serums

Action post-peeling serum B1 from Sismetica aimed at restoring the epidermal barrier, nourishing, moisturizing, getting rid of the feeling of tightness, burning and itching.

The serum helps speed up the tissue healing process, provides protection from aggressive environmental influences, and evens out skin tone. Thanks to the product, the stratum corneum is healed and the skin's immunity is increased. Do not apply to the eyelid area.

Compound: kukui oil, jojoba, amaranth, squalane, vitamin E, silicon biocomplex and other components. Can be purchased in self-breaking ampoules of two milliliters.

Serum Laser Repair Serum from a South Korean brand Storyderm has the following actions:

skin regeneration;
moisturizing, protection;
nourishing the skin, giving it elasticity and health;
restoration of the skin's protective barrier;
filling the space between collagen fibers of cells, smoothing wrinkles;
improvement of cell metabolism;
antioxidant effect.

The product was created for skin care after peeling, laser procedures, scrubs, and plastic surgeries. Ingredients: purslane extract, panthenol and other components.

The serum should be used after toner, evenly applied to the skin twice a day. Use two days before the procedure and immediately after.

Other serum Christina Rose de Mer Calm & Hydrate soothes and moisturizes the skin, suitable for all skin types. The product is designed to saturate the skin with moisture, increase its elasticity, and relieve irritation after peeling.

Able to imitate natural moisturizing factor, and hyaluronic acid retains moisture in deep layers. Extracts and soothing composition (arnica, chamomile, sweet licorice) provide skin care and even out texture.

Other components: butylene glycol, sodium lactate, fructose, glycine, urea, cellulose resin.

Masks

Deeply moisturizes and cares. Properties:

neutralization of free radicals;
restoration of the capillary wall, improvement of microcirculation;
increasing the thickness and density of the epidermis;
increasing skin elasticity;
restoration of barrier functions;
relieving inflammation and irritation.

Compound: hyaluronic acid, amino acids, glycerin, panthenol, oat, dandelion extracts, kaolin and others.

Apply the product to clean skin, leave for 20 minutes, rinse with warm water. You can apply a moisturizing serum under the mask to improve the effect.

Price: 860 rubles.

Thanks to the active ingredients, it has a therapeutic, antimicrobial, anti-inflammatory effect. Lavender oil can relieve hyperemia, irritation, swelling, regenerate, and relieve pain.

Kaolin and zinc oxide dissolve sebum, cleansing, brightening the skin and tightening pores. Allantoin and chamomile extract help the skin get rid of redness, amino acids and oligosaccharides fill with moisture. Suitable for darsonvalization.

First you need to treat the skin with lotion, then apply a mask. Leave for 20 minutes, rinse with cool water. Afterwards apply moisturizer.

Price: 1900 rubles.

Mask Christina Rose de Mer Peel & Renew exfoliates and renews. Provides removal of remaining scales, hydration, renewal, stimulation of cellular metabolism.

Compound: peanut and mineral oil, Shea butter, microcrystalline and beeswax, isopropyl, cetyl alcohol, methylparaben, allantoin and others.

There are a lot of products for restoring skin after chemical peeling. But a cosmetologist will help you choose the most effective and most suitable one.

Women are wondering what skin care should be used after a chemical facial peel? What is peeling? This is a facial rejuvenation procedure by removing the top layer of the epidermis with dead cells - it can be mechanical or chemical. The second type is very popular, since it can be used on thin epidermis, unlike mechanical, it rejuvenates much more effectively.

To get a good anti-aging effect, it is not enough to prepare, carry out the procedure correctly, and the main emphasis is on post-peeling care.

All peels have the same effect on the epidermis:

remove dead skin;
release a layer of new cells.

The environment aggressively affects young cells for the first 3 days, during which time the face is protected as much as possible from negative influences:

direct ultraviolet rays;
UV rays of artificial origin;
aggressive and anti-aging cosmetic creams;
temperature changes; precipitation, wind.

Experts advise cleaning before the weekend to prevent going outside, at least for the first two days. If this is not possible, then you need to stock up on hypoallergenic sunscreens. Do not visit the solarium, bathhouse, sauna. Care after chemical peeling for the face is a mandatory procedure.

Types of chemical exposure

If we consider peelings as such, then chemical peeling is gentle, since exfoliation occurs with the help of acids, mechanical damage to the epidermis is excluded in this case.

Skin after exposure to acids needs care, and the degree of exposure to the products must be taken into account. There are three types of chemical influences:

surface;
yellow middle;
deep.

Considering these types, it is worth noting that the third option is carried out only in a hospital, since it is equivalent to surgical intervention. When applying this rejuvenating procedure, a long, step-by-step course of recovery is required, which takes place under the supervision of specialists.

Superficial chemical exfoliation is carried out using fruit acids:

glycolic;
almond in liquid concentration;
ferulic;
pyruvic.

Medium - produced with high concentration acids - this can be glycolic or retinoic acids. For each type of acid, facial skin care will be different.

Visual video about chemical peeling

Features of care for surface peeling

The cosmetologist should tell you in detail how to care for your face after this procedure. But there are several recommendations that you should definitely know before you go for this procedure.

After using fruit acids, frequent touching of the treated skin should be avoided, and the use of tonics and lotions should be avoided. The cosmetologist will advise which moisturizing gels and serums should be applied to the face of your skin type.

Cosmetics used after this procedure should be of an airy structure - light foams or gels. You should not use scrubs for five days; they can damage delicate skin after superficial exfoliation. Let's look at what to put on your face after a chemical peel.

If the epidermis on the face is sensitive, then you need to stop using day and night creams, and care products around the eyes. This rule is optional, but it is worth listening to. If the peeling was carried out with ferulic acid, then you can use your usual care products the very next day, since it is the most gentle.

Glycolic peeling is more aggressive, so after the procedure it is strictly forbidden to use cosmetics for the next three days.

Exfoliating with mandelic acid is very drying for the skin, and it needs to be actively moisturized. In this case, products containing collagen, hyaluronic acid, aloe juice, seaweed, and shea butter are suitable. As soon as you have completed the exfoliation procedure, you need to take a course of vitamin A and E, this will increase the resistance of young skin to external influences.

Pyruvic chemical - does not dry out the skin too much, but it needs to be protected from the sun for a week. When purchasing sunscreen, make sure that it contains a filter - SPF 30. Before applying this cream, the skin should be moisturized with a gel containing a high content of geoluronic acid.

After glycolic exfoliation, eliminate the usual cosmetics and protect the skin from sun radiation for three days using high-strength creams. Skin care is carried out with special moisturizing and restoring mousses, which are recommended by a cosmetologist.

Features of recovery after medium peeling

This rejuvenation method works with the deeper layers of the skin, which will take a long time to restore.

The most common is yellow medium peeling, after application of which the face becomes yellow in color. After using this product, you should not use scrubs to speed up the exfoliation process. The only thing you can do to help your face is constant, abundant hydration.

A mid-peel is a serious procedure and some swelling may occur. In order to remove it, use melt water prepared at home, or with special products that contain deuterium water. The face needs to be irrigated frequently. Antibacterial masks help a lot. You cannot use cosmetics for two weeks. It is also not recommended to dye your hair or do a perm. This is a complex procedure and you should not neglect the advice of cosmetologists.

When leaving after yellow peeling you need to use:

masks with lactic acid;
balms with Shea butter;
cranberry enzyme;
ointments with panthenol;
fireweed extract;
anti-inflammatory ointments.

Croton chemical peel

Very aggressive effect on the middle layers of the skin. In addition to products that will intensively moisturize, soothe and restore the skin, you need to use a course of vitamins: C, A, E, as well as natural antioxidants. If you experience severe pain, it is not uncommon to take painkillers and antibiotics.

ABR peeling

After this procedure, you need to focus your care on quick recovery and consolidation of the effect. Apply:

antioxidants;
photoprotectors;
generating drugs;
moisturizers.

After this peeling, it is important to protect the skin from mechanical stress, as there is a risk of scarring and scabs. Cosmetologists have a special procedure that is aimed at enhancing the lifting effect, while at the same time well restoring and rejuvenating the face. It is carried out three days after the procedure.

TCA peeling

The procedure is carried out using trichloroacetic acid - the most difficult. And the epidermis will have to be restored within 2 weeks. This is a whole range of care measures: the use of protective, moisturizing and restorative agents. Moreover, after the procedure there are a number of serious restrictions that must be followed, otherwise complications cannot be avoided.

Prevention of complications

There are typical complications that will not affect the condition of the face and health - just a reaction to the use of chemicals. But there are also atypical complications, ignoring which can lead to negative results.

You need to see a doctor urgently if:

herpes rashes appear - herpes after peeling is normal, but it is worth noting that this may be the first sign of infection of the epidermis, so it is better to play it safe and go to a specialist;
severe redness, with burning and pain; allergies are rare, but the body’s predisposition to allergic manifestations can play a role. So before the procedure it is better to undergo a drug tolerance test.

Chemical peeling is widely used to combat aging facial skin. The risk of complications when this procedure is performed by a professional is minimal. Peeling is effective not only in improving skin texture, reducing the severity of hyperpigmentation and minor wrinkling, but also in treating acne, rosacea and melasma. In 1999, peeling was so popular that it was the most commonly performed cosmetic procedure in the United States. In 2006, chemical peels were among the top five most commonly performed minimally invasive cosmetic procedures, performed 1.1 million times, according to ASPS Certified Peelers. In terms of frequency of use, peeling was in second place, and botulinum toxin therapy was in first place. The emergence of laser therapy as a new method of skin rejuvenation may have had some impact on the frequency of peeling. Although there have been many previous claims that the effectiveness of peeling has been exaggerated, there is a lot of data confirming the benefits of the substances used during this procedure in beauty salons and at the doctor's office.

Depending on the depth of exposure to the substance, there are several types of chemical peeling:

surface;

deep.

Superficial peeling causes necrosis of all layers of the epidermis from the granular layer to the basal layer. Medium-depth peeling causes necrosis of the epidermis and part of the papillary dermis. With deep peeling, necrosis involves the reticular layer of the dermis. Currently, superficial peeling is most often used. This is due to the fact that instead of medium and deep peeling, procedures such as laser therapy based on the action of high-intensity pulsed light (IPL), laser resurfacing and dermabrasion have appeared. Superficial medium peeling does not significantly reduce the severity of deep wrinkles and does not improve skin tone. However, it can be used to improve the color and texture of the skin, making it look younger. This article will provide information regarding the types of superficial and medium peeling most commonly used in beauty salons. In this case, the main attention will be paid to the features of each type of peeling, mechanism of action, side effects and treatment results, obtained when using various acids.

Types of superficial peeling

The mechanism of action of these substances is that they cause desquamation, thereby accelerating the cell cycle. These solutions cause the surface layer of the stratum corneum to slough off, revealing smoother, more evenly pigmented layers of skin. Below information will be presented separately about each of the substances, however, it should be noted that when carrying out peeling, combinations of substances are usually used. Many of these substances can be found at home.

α-hydroxy acids and β-hydroxy acid (salicylic acid) are natural acids that cause cell sloughing and accelerate the cell cycle. In cosmetic dermatology, these acids are used for different purposes. The effectiveness of a-hydroxy acids and salicylic acid in the fight against photoaging is ensured by reducing the severity of spotty pigmentation, fine wrinkles, rough skin, freckles and lentigo. α-hydroxy acids and salicylic acid have also been shown to be effective in the treatment of actinic and seborrheic keratoses.

In a study conducted in 1970, it was found that topical preparations containing a-hydroxy acids have a pronounced effect on the keratinization of the epidermis. By changing the pH, a-hydroxy acids and salicylic acid affect the strength of adhesion of corneocytes to each other in the deep areas of the stratum corneum. Thanks to this mechanism, these substances are able to influence the properties of the skin. When concentrated solutions containing a-hydroxy acids and salicylic acid are applied to the skin, contacts between keratinocytes are broken and epidermolysis occurs. Applications of substances in lower concentrations cause rupture of contacts between corneocytes located above the granular layer. As a result, desquamation of the cells of the stratum corneum occurs and its thinning. Through this mechanism of action, these substances have two main effects: they accelerate the cell cycle (slow in older people) and increase desquamation, resulting in a decrease in the severity of hyperpigmentation and roughness of the skin.

a-hydroxy acids.

α-hydroxy acids refer to natural acids containing a hydroxy group at the α-position. This broad group of acids includes glycolic acid, found in cane sugar, lactic acid, found in fermented milk products, citric acid, found in citrus fruits, and phytic acid, found in rice. Hydroxy acids began to be used in Ancient Egypt during the reign of Cleopatra, who applied fermented milk products to her face in order to preserve youth.

Tretinoin peeling

For several years, various topical preparations containing tretinoin have been used successfully in the treatment of melasma, acne, and photoaging of the skin. It is known that when tretinoin is applied topically, collagen deposition in the skin increases and the activity of metalloproteinases, which cause collagen degradation, decreases. Tretinoin peels are not performed in the United States, but are used in many other countries, such as Brazil, without approved indications for the treatment of photoaging, melasma, acne, and keratosis pilaris. The peeling solution is an orange liquid stored in brown containers. When applied to the desired area, it stains the skin. It is recommended to wash off the solution 4-6 hours after application. The effect of peeling usually becomes noticeable after 2 days. D.E. Kligman studied the effectiveness of a solution containing 50% ethyl alcohol and 50% polyethylene glycol 400 in the treatment of 50 women aged 30 to 60 years with signs of photoaging, rosacea and acne. Patients applied the solution to their face once every 2 days at night for 2 weeks or more. After treatment, an improvement in skin condition was noted, manifested in the form of smoothing of the epidermis, a decrease in the number and depth of fine wrinkles and a decrease in the severity of hyperpigmentation. Histological examination revealed thickening of the basal layer and papillary fibroblasts, a decrease in the number of melanosomes, thinning of the stratum corneum, and improved organization of the epidermal ridges. D.E. Kligman suggested that the effect arising from the use of low-active tritinoin for 6-12 months can be achieved in 4-6 weeks when using tretinoin in high concentrations.

L.C. Cuce conducted a study in which 15 women aged 23-40 years with Fitzpatrick skin types I-IV took part. The purpose of the study was to evaluate the effectiveness of using a 1% tretinoin solution when performing peeling. Efficacy was assessed using histological and clinical features. A skin biopsy was performed before treatment. Chemical peeling lasting 6-8 hours was carried out at intervals of 2-3 days. 15 days after the last procedure, the subjects underwent a repeat biopsy, which revealed thickening of the epidermis and thinning of the stratum corneum. These signs correlated with improvements in skin appearance. During histological and clinical assessment of the skin condition of patients, it was found that the effect that occurs 2.5 weeks after peeling with tretinoin can also be achieved by topical application of tretinoin for 4-6 months. Another study of 10 patients with Fitzpatrick skin types III-V who had moderate to severe melasma compared the effectiveness of a peel using 1% tretinoin with the effectiveness of a peel using 70% glycolic acid. The duration of one tretinoin peeling session was 4 hours, while the duration of a glycolic peeling session was no more than 3 minutes. After 3 months After treatment, the effectiveness of both types of peeling was the same. However, when carrying out tretinoin peeling, erythema occurred less frequently and less pronounced desquamation was noted, due to which it was better tolerated by patients.

Side effects of all types of superficial peels

Although all types of superficial peels are safe when performed correctly, they can cause erythema, itching, peeling, skin sensitivity and even epidermolysis. Cases of allergic contact dermatitis have been reported with the use of resorcinol, salicylic acid, kojic acid, lactic acid and hydroquinone. Irritant contact dermatitis has been reported with the use of glycolic acid. Any substance used in a peel, when used in high concentrations, when peeled frequently, or when combined with highly active products containing acetone or other degreasing agents, can cause irritant dermatitis. In some cases, during peeling, deeper layers of skin may be exposed to the active substance than intended. This occurs if the patient has recent damage to the stratum corneum caused by using triinoin, shaving the face, using exfoliating scrubs and Buff-Puffs, or kissing for a long time with a man with a thick beard. Therefore, before performing a peel, it is necessary to carefully assess the patient's skin condition and obtain a detailed medical history.

Post-inflammatory hyperpigmentation is a rare complication of superficial chemical peeling, which is performed starting with substances with low activity, gradually increasing their concentration. R.E. Grimes monitored the condition of 25 patients with Fitzpatrick skin types V and VI, who were prescribed peeling preparations containing 20% and 30% salicylic acid as treatment. Before peeling, these patients were pretreated with 4% hydroquinone for 2 weeks. Only 3 patients developed temporary post-inflammatory hyperpigmentation. Several studies have found that superficial peels are also safe for use in Asians. However, most dermatologists believe that these patients should be pretreated with depigmenting agents and tretinoin. In addition, they should be recommended effective sunscreens that protect against exposure to UVA and UVB rays.

Medium depth peeling

10-40% trichloroacetic acid.

Trichloroacetic acid came into widespread use in the 1960s thanks to the work of S. III. Ayres. Weakly concentrated trichloroacetic acid (10-15%) is used to eliminate fine wrinkles and dyschromia, as well as to improve the condition of the skin, giving it a smooth and healthy appearance. At this concentration, trichloroacetic acid does not affect deep wrinkles or scars41-42. Trichloroacetic acid in higher concentrations (35-40%) causes necrosis of the epidermis and dermis, with no serious systemic toxic effects observed. However, it should be used with extreme caution at this concentration as hyperpigmentation or scarring may occur. Clinicians should carefully select patients for treatment: patients with dark skin types should not be treated with trichloroacetic acid, as they have an increased risk of developing post-inflammatory hyperpigmentation.

A 40% trichloroacetic acid solution is most often used for medium-depth peeling of the face and hands. The strength of the peeling effect carried out with trichloroacetic acid is determined through the ratio of mass to volume. Unfortunately, not all authors use these units of measurement, so when reading the literature on peeling, you need to pay attention to the method for calculating the strength of the peeling effect. This will avoid incorrect, underestimation of the impact force. This precaution helps reduce the risk of scarring after the procedure. For example, a 25% trichloroacetic acid solution cannot be prepared by diluting a 50% trichloroacetic acid solution with an equal volume of water. This is because in this case volume is diluted by volume, resulting in a solution with a concentration of trichloroacetic acid exceeding 25% when measured in mass-volume units. As recommended in the literature, the clinician should calculate the percentage of trichloroacetic acid using a mass/volume measurement system. This will avoid mistakes. Solutions of trichloroacetic acid of the required concentration, prepared using a mass/volume measurement system, are commercially available.

After the application of trichloroacetic acid, denaturation of proteins occurs, as a result of which frost forms on the skin. Frost is a sign of the end of peeling. The time elapsed from the moment of application of the acid to the appearance of frost depends on the concentration of the acid. When applying a 40% solution of trichloroacetic acid, the procedure lasts 5-7 seconds. However, when using weaker solutions, this time can increase to 15-20 minutes. Doctor 3 There are several chemical peeling products available for sale, produced by various companies. When comparing the activity and effectiveness of drugs containing α-hydroxy acids, it is necessary to know the pH and concentration of free acids. To prevent the development of hyperpigmentation, the physician must be extremely careful when choosing a chemical peel product when treating patients with dark skin color. In this case, treatment should begin with drugs containing free acids in the lowest concentrations, and then gradually increase the content of free acids.

At the first appointment, the patient's skin should be examined using UV rays or a Wood's lamp. This will help identify pigmentation disorders, assess the extent of their spread, and also convince the patient of the need to use sunscreen. If possible, skin images should be taken regularly, and the use of a UV camera is recommended. It is also necessary to determine the patient's skin type according to the Baumann system. You should then discuss skin care practices, the need for sunscreen, and the importance of using topical retinoids with the patient. The doctor should recommend the drug to the patient taking into account the patient's skin type. In addition, in this situation, it is necessary to advise patients not to use topical preparations at home containing a-hydroxy acids and salicylic acid, as well as other irritating agents, such as vitamin C. This will avoid excessive skin irritation. The physician should also ensure that the patient is not using other products to increase desquamation, such as facial scrubs or Buff-Puffs. At the first appointment, the doctor should use a peeling drug with minimal activity during treatment, or a substance with a minimum duration of action when peeling the face (even if the patient has skin type I).

This will determine the degree of sensitivity of the patient. It is necessary to explain to patients that after the first procedure they will not notice any differences in the condition of their skin, since for the first time a low-active solution is used to assess the tolerance of the peeling. At each visit, but especially during the first visit, one should inquire about social aspects that would make the patient undesirable to experience erythema or noticeable peeling of the skin. Hypersensitivity reactions are rare (most often after peeling with Jessner's solution). According to Murphy's Law, they most often occur in those patients who have an important appointment or lecture scheduled. 10-14 days after the first procedure, patients should come to see a doctor to assess the condition of the skin and conduct a second peeling session.

If the patient had minimal or no peeling of the skin after the first peeling session, at the second appointment the doctor may use a more active peeling drug. Most patients use topical retinoids before their first doctor's visit, so care should be taken to avoid the flaking of the skin that is retinoid dermatitis. In this case, the doctor should not perform a chemical peel until the retinoid dermatitis disappears. At the appointment, it is also necessary to assess the patient’s psychological state associated with the occurrence of side effects during peeling. If the patient complains of skin peeling or erythema, the concentration of the active substance should be increased more slowly. If the patient believes that severe erythema and/or peeling are criteria for an adequate peel, you can start using more active agents earlier than usual.

Third and subsequent visits. Manufacturers of most surface peeling preparations recommend repeating procedures every 10-14 days. The patient can continue to perform peeling until the primary symptoms disappear, and then to maintain the effect, the procedure is prescribed once every 4 weeks. The doctor should know whether the patient is using retinoids and sunscreens. Thanks to this, it will be possible to achieve compliance. After the third peeling session, if there is no skin irritation, patients should be advised to continuously use retinoids. If there is no irritation, it is time to prescribe medications containing α-hydroxy acids and salicylic acid to patients for home use. There are many drugs produced by different companies. All of them are described in the text, and this should help in choosing a remedy.

Trichloroacetic acid can be used as monotherapy, or after using Jessner's solution or glycolic acid, which will allow for a deeper peel. When using only trichloroacetic acid, procedures are usually carried out once every 5-7 days, and when prescribing trichloroacetic acid in combination with Jessner's solution or glycolic acid - once every 7-10 days.

Pyruvic acid.

Pyruvic acid is an α-keto acid that can be converted into lactic acid in the body. Thus, it can be used as a peeling agent while hydrating the skin. Pyruvic acid is able to penetrate the papillary layer of the dermis, enhancing the synthesis of collagen and elastin. It should be noted that pyruvic acid should not be used in high or very high concentrations as this may cause scarring. Pyruvic acid has been successfully used in the treatment of moderate acne, photoaging and melasma. Given that pyruvic acid breaks down into CO2 and acetaldehyde, the accumulation of CO2 in a vial that is not used for some time can lead to an explosion.

When performing chemical peeling of the face, pyruvic acid is usually used in a concentration of 40-60%, and before the procedure, the skin is treated with topical retinoids. These concentrations are considered to produce a medium-depth peel, so caution must be exercised when treating dark-skinned patients or those with sensitive or irritated skin. 2 minutes after the start of the procedure or within 5 minutes (as well as when frost is clearly formed), the face is thoroughly washed with water. This is done primarily to make the patient feel comfortable rather than to neutralize the acid. Some authors recommend neutralizing the pyruvic acid used for peeling with 10% sodium bicarbonate and water. Substances used in chemical peeling can actively evaporate and cause irritation of the upper respiratory tract, so it is recommended to perform the procedure in a well-ventilated area with an electric fan. Re-epithelialization is observed 1-2 weeks after peeling, while erythema can persist for 2 months. Pyruvic acid in combination with 5-fluorouracil has also been successfully used to treat actinic keratoses and warts.

Side effects and warnings

Patients should be advised that they will not look well for at least 10 days following a medium depth peel. During the first 2 days after the procedure, the skin acquires a barely noticeable pink color. On the 3rd and 4th days the skin darkens. By the 5th day, layer-by-layer peeling of the skin begins. Peeling of the skin usually ends by day 10, but erythema may persist until day 14. It is recommended that patients be shown illustrations of what they will look like after the peel. This will stabilize the psychological state of patients (changes in appearance will not be unexpected). Many authors recommend avoiding the use of trichloroacetic acid in concentrations exceeding 50%. Contraindications for medium-depth peels include dark skin types and recent treatment with isotretinoin or local radiation therapy. Because re-epithelialization begins in the adnexal structures of the skin, some authors have suggested that patients who have recently undergone laser hair removal may experience problems with healing of the treated skin after undergoing a medium-depth or deep peel. However, there have been no reports of this complication. You should also take extra precautions when performing medium-depth peels on the jaw, neck, and chest, as these areas are more likely to cause scarring.

Patients should be warned that after undergoing a chemical peel, skin lesions such as solar lentigo may initially disappear and then reappear. This phenomenon is noted due to the fact that melanocytes, responsible for skin pigmentation, are located deeper than those layers that are affected by substances during chemical peeling. If patients use retinoids, sunscreens, hydroquinone, or other bleaching agents, better results may be achieved.

After a medium-depth peel, as well as after a superficial peel, it is important that patients use sunscreen and avoid exposing the skin to sunlight. Patients with dark skin types should use hydroquinone after peeling, as this will reduce the incidence of hyperpigmentation. Doctors should prescribe antiviral drugs to patients who have previously had a herpes simplex virus infection. Also, the doctor should not overuse trichloroacetic acid, which can cause scarring. Patients who have recently undergone treatment with isotretinoin are also at increased risk of scarring after undergoing a medium-depth peel.

Combination of superficial peeling and medium depth peeling

Many doctors perform superficial peels to reduce the thickness of the stratum corneum or even remove the stratum corneum. For this purpose, they prescribe applications of trichloroacetic acid. When performing peeling, various combinations of drugs are used, including the use of glycolic acid after the application of trichloroacetic acid (“Coleman peel”) or Jessner’s solution after the application of trichloroacetic acid (“Monheit peel”). The use of Jessner's solution initially leads to a decrease in adhesion between epidermal cells, due to which the 35% trichloroacetic acid solution then penetrates more deeply into the skin. This combination of drugs is effective in the treatment of mild to moderate photoaging, including lentiginosis, pigmentary changes in the skin and wrinkles. In some cases, it is necessary to prescribe mild sedatives and anti-inflammatory drugs before the procedure. Dr. Harold Brody advocated the use of solid CO2 (dry ice) before using a 35% trichloroacetic acid solution. Application of solid CO2 also leads to ruptures of epidermal structures and deep penetration of trichloroacetic acid. There are publications that describe in detail the combination of different types of peeling.

Deep peeling

Laser surgery and dermabrasion, which can achieve good results with rare complications, have replaced deep peeling. Modified phenol peels are currently available, such as the Stone Venner-Kellson peel (a product containing phenol, croton oil, water, olive oil, and septisol), but are rarely used by US physicians. The doctor can order the Stone Venner-Kellson peeling drug from Delasco, but he must specify the composition of the drug.