Salicylic peels on the whole tend to be slightly stronger than glycolic acid peels. Glycolic acid peels tend to suit sensitive skin types better and helps to exfoliate the surface layers of skin away. Salicylic acid suits oily acne prone skin types better and also helps to remove dirt, debris and excess sebum from the pores.
Another type of chemical skin peel is a lactic acid skin peel, which suits all skin types and can be particularly effective at treating dark patches of pigmentation. Well, the answer is yes! If you have active acne, it's perfectly safe to have a chemical peel. Chemical peels effectively exfoliate away the top layer of dead, dull skin and help to treat acne scarring see below , but they also help to kill the skin bacteria, Propionibacterium acnes, that is a major cause of acne.
You will notice some peeling, which will disappear after a week or so. But sometimes, you may experience a darkening or lightening of the skin, which can be permanent. You may also experience some scarring, but this is very rare. But you must take precautions to protect your skin from direct sunlight afterwards. Repeated sunburn can lead to skin cancers developing in later life.
Since chemical peels are effective at removing the top layer of skin, they can also be effective at minimising the appearance of light acne scarring.
But can acne scars be treated by chemical peeling? A medium or deep chemical peel, which can only be carried out by a professional, may be more effective at treating deep or pitted acne scarring.
You could try laser resurfacing treatment, which again, is carried out only by professionals. Nanma Nikalji Dr. Kiran Godse Dr. Sharmila Patil Dr. Nitin Nadkarni Dr. Author information Copyright and License information Disclaimer. Address for correspondence: Dr. Patil Hospital, Nerul, Mumbai, India. E-mail: moc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.
This article has been cited by other articles in PMC. Abstract Superficial and medium depth peels are dynamic tools when used as part of office procedures for treatment of acne, pigmentation disorders, and photo-aging.
Immediate within minutes to hours after peeling :[ 5 ] Irritation, burning, pruritus, and pain Persistent erythema Edema Blistering Delayed within a few days to weeks : Infections bacterial, herpetic, and candidal Scarring, delayed healing, milia, and textural changes Hyperpigmentation, hypopigmentation, and lines of demarcation Loss of cutaneous barrier and tissue injury Acneiform eruptions Allergic reactions, toxicity, and ectropion Accidental Ocular complications.
Treatment Immediate ice application reduces the pain and burning sensation Topical calamine lotion soothes the skin Topical steroids such as hydrocortisone or fluticasone reduce the inflammation Emollients to moisturize the skin Sunscreens to prevent PIH.
Persistent erythema It is characterized by the skin remaining erythematous beyond what is normal for an individual peel. Treatment Topical, systemic, or intralesional steroids if thickening is occurring Pulsed dye laser to treat the vascular factors.
Pruritus It is more common after superficial and deep peels, although may occur following re-epithelialization. Edema It is more common with medium and deep peels occurring within h of chemical peeling.
Treatment Usually subsides spontaneously Application of ice Systemic steroids short courses. Blistering It is more common in younger patients with loose periorbital skin and around eyes. Open in a separate window. Figure 1. Prevention The nasolabial folds, inner canthus of the eye, and corners of the mouth should be protected with petroleum jelly. Ocular complications Accidental spillage of any chemical peel agents in the eyes can cause eye injuries in the form of corneal damage.
Treatment In cases of accidental spillage, the eyes should be flushed copiously with normal saline to prevent corneal damage. Prevention Extreme care should be taken while peeling the periorbital area Dry swab stick should be kept ready to absorb any tears Peeling agents should not be passed over the eyes.
Ectropion of the lower eyelid It is usually seen after a Baker Gordon phenol peel. Treatment Most of the time the process is self-limiting and corrects spontaneously or with conservative care. Inherent errors Incorrect peel pharmacology With resorcinol combinations, TCA, or phenol formulas, evaporation of the alcohol or water vehicle base can occur, inadvertently producing a stronger solution.
Accidental solution misplacement Avoid accidental spillage of the solution Never move the cotton-tipped applicators directly over the eye area. Impetigo and folliculitis streptococcal and staphylococcal Pseudomonas or Escherichia coli infections. Clinical features Delayed wound healing Folliculitis Ulceration, superficial erosions, crusting, and discharge.
Treatment of bacterial infections Swab for culture and sensitivity Appropriate antibiotics: Topical and oral Wound cleaning with potassium permanganate soaks or acetic acid soaks three to four times a day Topical mupirocin for gram-positive infections Light debridement. Candidal infections Recent intake of oral antibiotics is often a pre-disposing factor Superficial pustules can occur in candidal infections Immunocompromised patients Diabetics Oral thrush Prolonged topical steroid use.
Herpes simplex infection It is characterized by reactivation of herpes simplex on face and perioral area presenting as sudden appearance of grouped erosions associated with pain.
Treatment Active herpetic infections can easily be treated with anti-viral agents. Prevention Patients with a positive history of herpes simplex should be given mg of acyclovir three times a day beginning on the day of the peel and continuing for days, depending on whether it is a medium depth or deep chemical peel. Prevention of infections Frequent post-operative visits should be done so that it can be ensured that appropriate home wound care is being performed and to minimize the risk of infection.
Delayed healing Prolongation of granulation tissue beyond 1 week to 10 days signifies delayed healing. It could be due to the following: Infections Contact dermatitis Systemic factors Diminished or absent skin appendages may impair epidermal regeneration with delayed wound healing.
Treatment Treatment of infections already discussed Debridement if necessary Treatment of contact allergic or irritant dermatitis with steroids Change of contact agents or protection with a biosynthetic membrane. Prevention Strict sun avoidance and use of broad spectrum sunscreens before and after the peels indefinitely Hypopigmenting agents hydroquinone, kojic acid, and arbutin should be strictly enforced in the post-peel period too.
Treatment Triple combinations of hydroquinone, tretinoin, and steroids should be started once re-epithelialization is completed. Figure 2. Hyperpigmentation It can occur any time after a peel and can be persistent, if treated inadequately. Figure 3. High-risk groups Types III-VI skin Types I and II skin following intense sun exposure and tanning or use of photo-sensitizing agents Use of photosensitizing agents such as Non steroidal anti-inflammatory drugs, oral contraceptives, etc.
Early exposure to sunlight without adequate broad spectrum sunscreens Estrogen containing medication, e. Treatment Retinoic acid, 0. Prevention Good skin care regimens can sustain more long-lasting results though studies have shown that peeled skin returns to its baseline status within months without maintenance therapy.
Strict sun avoidance and use of broad spectrum ultraviolet A and B sunscreens before and after the peels indefinitely Pre-treatment with a depigmenting agent and tretinoin In case of superficial peels, start at low strengths and titrate up very slowly Cessation of use of birth pills during peripeel period because it may invoke pigmentary changes. Skin depigmentation Bleaching effect can be seen after phenol peels. Lines of demarcation These are seen in medium and deep depth peels in darker skin types.
Milia These are inclusion cysts which appear as a part of the healing process and are more common with dermabrasion than chemical peels. Treatment Milia often resolve spontaneously with normal cleansing of the face. Prevention Returning to gentle epidermabrasion after re-epithelialization or the use of tretinoin both before and after peeling may retard their appearance.
Texture changes Temporary appearance of enlarged pores post-peel can occur due to removal of stratum corneum. Atrophy It is characterized by the loss of normal skin markings in the absence of scarring. Figure 4. Predisposing factors History of smoking History of recent intake of 0. Overzealous application of TCA Medium depth peels on the areas like mandible, neck, and chest because these areas are more likely to scar Thin-skinned patients are more prone for scarring because the TCA is more likely to penetrate deep into the reticular dermis.
Systemic side-effects Phenol peels can cause cardiac, renal, and pulmonary toxicities. Cardiac arrhythmias In patients deliberately face peeled with phenol in min time, tachycardia was usually noted first followed by premature ventricular contractions, bigeminy, paroxysmal atrial tachycardia, and ventricular tachycardia.
Laryngeal edema Stridor, hoarseness, and tachypnea have been reported developing within 24 h of phenol peeling. Toxic shock syndrome Physician should be alerted if patients develop fever, syncopal hypotension, vomiting, or diarrhea days after a peel followed by scarlatiniform rash and desquamation. Prevention of complications Select only skin types I and II for deep peel Limit systemic levels of phenol due to absorption from skin Intravenous hydration with 0. Allergic reactions Allergic contact dermatitis is more common with resorcinol, salicylic acid, kojic acid, lactic acid, hydroquinone, etc.
Deeper penetration of peel Predisposing factors Beginning a regimen with tretinoin Facial shaving Use of exfoliating scrubs. Prevention Closely examine condition of skin Elicit a good history from the patient prior to peel Correct patient and peel selection Priming of skin Post-peel care and sun protection Beware of habitual skin pickers Beware of those who have a tendency for PIH The complications of superficial and medium deep peels are summarized below [ Table 1 ].
Table 1 Complications for peeling procedures[ 22 ]. Footnotes Source of Support: Nil. For patients who are receiving deeper chemical peels, mild sedative medication may be used on the day of the procedure. Before we begin the process, we cleanse and dry the skin thoroughly, and then use thick emollients, gauze, or other methods to protect your eyes, hair, nose, and mouth. The peel itself involves applying a chemical solution to the skin and allowing it to sit.
You may notice some stinging or discomfort as the solution sits on the skin. Then, depending on the type of chemical peel used, the dermatologist may apply a neutralizing agent to the treatment area. Most often the entire area is treated at once, but sometimes deeper chemical peels are performed in small sections which allows the dermatologist to carefully monitor your response and adjust treatment.
Some stinging or burning is normal during a chemical peel, but we never want anyone to be in excessive discomfort. That includes coming up with a good at-home care plan following the chemical peel to ensure you heal quickly and comfortably. Below are the top 10 things you should expect after your first chemical peel. Each person will react differently to skin treatments of all kinds, but for the most part, the side effects following chemical peels should be mild and healing should be completed within two weeks.
It is called a peel for a reason. The chemical is applied to peel away the existing layer of skin. This should be similar to how your skin flakes away after a sunburn. You should gently remove the flakes when cleaning your face, but avoid pulling or picking at the peeling skin as this can cause irritation and increase the risk for infection. It usually takes several treatment sessions to see the desired outcomes. Most people notice some improvement after their first chemical peel, but with multiple treatments over the span of several months, patients will be astonished by how much better their skin looks.
Because of the potential for rare but serious health risks, we like to schedule follow up visits with our patients after chemical peels. This also gives us a chance to check progress and adjust ongoing treatment plans. For the first weeks, you should not use any makeup. Each individual heals from a chemical peel at a different rate, given skin sensitivity, and also the different chemical peel medications that may be used as part of the treatment.
Exposing your bare skin to this bacteria can be an infection sure to happen. And makeup with minerals or metals in it also can do harm to healing skin. Bare skin is very vulnerable. Handle it with care. Your email address will not be published. Save my name, email, and website in this browser for the next time I comment.
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