Using Chemicals Peels to treat the skin can sound rather ominous… contrary to many beliefs, chemical peeling does not and will not thin out the skin...
What does a chemical peel do to the skin? To understand how chemical peels work, one needs to understand the anatomy and physiology of the skin.
The skin is made up of three integral layers; the Epidermis, our outermost keratinised layer. The Dermis – the ‘living layer’ where the structural components such as fibroblasts, collagen and elastin of the skin exist, and lastly, the hypodermis, the circulatory and fat layer of the skin. These layers all communicate with each other and work intrinsically to keep the skin as an organ, working to protect and keep the muscular and skeletal structure of the human body intact.
In Aesthetic Dermatology, the scope mostly pertains to the epidermis and dermis, although tissue fillers and botulinum toxin injections will work in the other arenas of the skin & muscle. Signs of Aging, both intrinsic and extrinsic are mostly seen on and within the dermis and epidermis. Due to the structural elements of the skin in these areas, it is easily treated.
On a cellular level, we understand that the skin has a natural turnover / renewal cycle which slows with age. This leads to the skin’s appearance looking lack lustre, collagen levels becomes depleted, and the epidermis will flatten and thin out making the dermis more susceptible to UV exposure, pigmentation & photodamage, deep lines and injury. The epidermis will additionally have textural changes, mutations such as pre-malignant and malignant lesions, there will be noticeable flaccidity, dryness and vascular changes.
To address the signs of skin aging, years of scientific studies and applied knowledge has shown that in treating the cell turnover, by using certain ingredients and treatments, professionals can stimulate the epidermis and the dermis to positive affect. There are many different treatments that can be done but the safest, and most widely used is chemical peels.
Chemical Peels use both natural and synthesised ingredients to bring about a chemical form of exfoliation. Meaning that the skin sloughs off naturally rather than having to use abrasive or mechanical techniques to remove it. All peels will differ in formulation and therefore their action on the skin may differ but it’s important to understand that the workings of a peel occur on a cellular level to stimulate certain functions and bring about certain results. All the acids and ingredients used within a chemical peel will bring about some form of chemical response on or within the skin.
A superficial peel, mostly made up of fruit acids, will resurface the epidermis. Depending on the concentration and formulation, this peel can stimulate collagen fibres and target grade I and grade II acne. Most superficial peels will have other ingredients in them to enhance certain results such as liquorice extract or mandelic acid to aid in the treatment of pigmentation or Salicylic Acid to assist in the treatment of oil / breakout / congested skin. Glycolic Acid is the most widely used acid amongst the AHA’s found in superficial peels due to the fact it has the smallest molecular size and hence penetrates effectively.
Okano Y et al, at the Kobe University in Japan, investigated the effect of Glycolic Acid on the dermal matrix metabolism of keratinocytes and fibroblasts using in vitro and ex vivo system study. The work showed that Glycolic Acid not only directly accelerates collagen synthesis of fibroblasts, but it also modulates matrix degradation and collagen synthesis through keratinocyte-released cytokines. They confirmed that interleukin-1 alpha (IL-1 alpha) is one of the primary mediators for matrix degradation released from keratinocytes after Glycolic Acid treatment.
These findings show that Glycolic Acid contributes to the recovery of photodamaged skin through various actions, depending on the skin cell type1.
In another study, Omi T et al, conducted chemical peeling on the skin with Glycolic Acid and Lactic Acid and observed it at the ultrastructural level. No changes in the horny layer or the upper epidermal layer were observed but there was dissociation and vacuolation between the basal cells and an increase in vimentin filaments within fibroblasts and endothelial cells were also observed.
These findings suggest that chemical peeling of the skin with these agents directly induces collagen formation within the dermis and thus directly stimulates remodelling of the dermis2.
Both these ingredients can be found in the Dermaceutic Milk Peel.
Medium depth peels such as the Dermaceutic Cosmo Peel 18% & 20% as well as the Mela Peel Forte, will result in the epidermis sloughing off. These chemical peels work within the papillary dermis where the dermis and the epidermis meet. This type of peel is known to bring about an abundance of actions such as; decreasing lines and wrinkles, retexturizing the epidermis, lifting off solar lentigo’s / pigmentary changes on the skin and targeting certain types of scars.
When selecting a medium peel, one needs to understand where the peel will be working and where the ‘problem’ areas are within the skin. It is also important to note that how or why the problems occurred. Pigment caused by sun damage is easily removed and improved with the Dermaceutic Cosmo Peel, however, melasma / post-inflammatory hyperpigmentation is targeted with the Dermaceutic Mela Forte Peel due to the nature of the problem within the skin: meaning that not all medium depth peels are appropriate for all medium depth concerns. Therefore, understanding how certain acids work within the skin is of paramount importance in scientifically formulating effective solutions.
TCA is an amazing ingredient, but it brings about an inflammatory response3, if the skin has an inflammatory concern – one should select a peel that doesn’t stimulate the inflammatory cycle such as a jessner peel (Mela Peel Forte).
Deep peels, such as the Dermaceutic Cosmo Peel Forte and TCA 30% work within the reticular dermis, the deepest layer within the dermis, to reform the structural components of the collagen and elastin but also remove anything and everything above it. These peels have far more downtime as it will take up to 60 days for the dermis and epidermis to reform / re-epithelialize.
The ingredients used in deep peels, such as phenol, have a necrotic effect on the upper layers, hence only professionals trained in its application should be performing these peels as they are extremely potent - but they too have the most amazing results and on a cellular level will reconstitute the dermis and epidermis as well as any proteins within the skin that may contain ‘faulty DNA’ caused by UV damage or excessive lifestyle, however these studies are still ongoing4.
Extra precaution needs to be taken post-peel. As there are so many cellular changes occurring in the recovery phase, clinicians need to advise key repairing and protective products such as Panthenol Ceutic & K Ceutic for a min of 60 days to ensure that all cellular activities are healed optimally. To learn more about Dermaceutic’s 21 Day Expert Care for Advanced Recovery post- Aesthetic Clinic treatment, simply click here.