Articles on peel

Chemical Peel

Dr. Anil Trimbake, Dermatologist
WHAT IS CHEMICAL PEEL?Chemical peel is a common office procedure where in with the help of chemical we invoke controlled skin injury. This helps to remove the outer damaged layer, thus accelerating the normal process of exfoliation. The underlying new regenerated skin is smoother, shinier, even toned and less wrinkly.HOW DOES IT WORK?The chemical applied to the skin penetrates in the layers of skin and stimulates the deeper layers of skin to produce new cells and provokes collagen remodelling.TYPES OF PEELS1. Very superficial peel(limited to stratum corneum only)2. Superficial peel(limited to whole epidermis)3. Medium depth peel(limited to papillary dermis)4. Deep peel(limited to reticular dermis)WHAT ARE PEELING AGENTS USED?Salicylic acid 20-30%Retinoic acid/ Tretinoin/ Yellow peel 1-5%TCA 10-20%Glycolic acid 30-50%Jessner’s solutionMandelic acidAzelic acidLactic acidMalic acidCitric acidLactic acidKojic acidFerrulic acidTCA 30-50%Glycolic acid peel 50-70%TCA 50-100%Phenol 88%WHAT ARE THE INDICATIONS?Pigmentary disordersMelasmaPost inflammatory hyperpigmentationTanningRiehl’s melanosis (post cosmetic use skin darkening)Acne / Acne scarsSkin rejuvenationAged skinSun damaged skinWrinkles/ dull patchy skinWHO CAN UNDERGO PEEL PROCEDURE?Fair skinned with light haired patient are the best candidate for the chemical peel. In Darker patients careful selection of peel as well proper pre peel preparation and post peel care is necessaryIf tretinoin acid or any other exfoliating cream is being used, should be discontinued 3 to 4 days prior to the application of chemical peelPatch test of peel is to be done behind the ear or on fore arm to see if any allergy to the product or untoward side effect develops in patient, 1 week before peel procedureHOW IS CHEMICAL PEEL DONE?Treatment part (face, back, chest, hands, legs) is degreased with acetone (soap & water if acetone not available)Pat drying of the degreased area with a napkin/cotton is doneWith help of a cotton ear bud Vaseline jelly to the corners of eyes, corners of nose in nasolabial fold & corners of mouth is appliedWith the help of brush the chemical peel is applied to the face and other treatment area in a systematic patternTime for which the chemical peel has to be applied is carefully calculated and depends on what is the condition for which peel is used, patients tolerability and type of peel used.As soon as the required time for the peel to work is finished treatment area is cleansed.With help of ice cubes or ice packs treated area is massaged for a minute to decrease if any burning or stinging sensation presentAny redness, scaling, crusting and swelling is observed.Immediate application of the sunscreen on the treated area is doneIf tretinoin acid or any other exfoliating cream is being used patient is asked to discontinue for 3 to 4 days post application of chemical peelSmoking and direct sun exposure without sunscreen should be avoidedWHAT ARE AFTER EFFECTS OF PEEL?Mild redness, mild burning for few minutes to hoursMild scaling, temporary change in colour or mild darkening of skin for few daysNew rejuvenated skin starts appearing.IT IS A SAFE OFFICE PROCEDURE WHICH CAN BE DONE AT REGULAR INTERVALS TO KEEP SKIN YOUNG AND RADIANT! 

Chemical Peel Facts That You Should Know

Dr. Harikiran Chekuri
Chemical Peel is a process to get rid of scars and reduce the visibility of wrinkles on your face, neck and hands. However, this method is often defamed in the aesthetic industry due to the involvement of an acidic substance. It is important to understand that a proven methodology performed by experienced and expert doctors has a very minimum chance of negative results.Chemical Peel doesn’t harm your skin If you are thinking to try out Chemical peel, it is important to have your misconceptions cleared about it. We are often made to think that chemicals and bad for our skin. But not all chemicals are harmful. The process of chemical peel involves the use of some of the safest chemicals like Glycolic acid, lactic acid and salicylic acid. The term ‘acid’ may seem dreadful, but relax; Glycolic acid is extracted from sugarcane, lactic acid from sour milk and salicylic acid from wintergreen. These ingredients will not burn or irritate your skin rather will help in skin rejuvenation.Chemical Peel Doesn’t Have A Prolonged Recovery Time A laser chemical peel done by an expert does not have any side effect. The recovery time is only 7 to 10 days. The stronger, non-laser chemical peels that could have resulted in scarring and required longer recovery time are no longer in use. The laser chemical peels that are used lately are safe even if you go for a deeper peel.Do not try this at home Chemical peel isn’t a Do-It-Yourself procedure that can be done at home. You need to have a thorough examination of your skin before you know whether you are eligible for the procedure. Creams and solutions available on store, which claim to do the same, do not yield desirable results. Use of these without proper medical solicitation might leads to irritated facial skin and even scarring.Chemical Peel Isn’t a One-Time Procedure Though chemical peel reduces fine lines, acne, sun damages, wrinkles to a great extent, but it is certainly not a one-stop solution. People who are more exposed to sun might develop wrinkles, lines and acne more often and thus might feel the requirement for repetition of the procedure. Also, as you age wrinkles on your face starts to show again and hence you might require a second peel.Chemical Peel Is For All Skin Type Chemical peel works well for all skin types and is not limited to problem skin only. On the contrary, it can act as prevention against skin problems if used wisely. The normal duration of skin cell turnover is 21 to 28 days which starts to increase with age. A mild peel at regular interval may stimulate the cell turnover time leading to the formation of new cells faster and exfoliation of dead cells. This will ensure that your skin remains soft, supple and healthy for years.However, if you decide on taking up the procedure, it is important to get in touch with an expert to know about your chances with chemical peel.

Do You Peel the Apple Skin?

Ms. Swati Kapoor, Dietitian/Nutritionist
“An apple a day keeps the doctor away” is a saying that we have heard multiple times to ingrain into our minds the benefits of an apple. But do you peel the skin of the apple when you eat it? If you do, then you might be depriving yourself of the apple’s most essential nutrients. Here are some very powerful reasons to never remove the skin again.1. High in fiberApple is a rich source of dietary fiber. A medium apple contains approximately 4.4 gram of fiber and out of which 47% of the fiber is present in the skin. Which means without the skin you are only getting 2.1 grams of fiber OR almost half of the actual content.2. Source of vitamin and mineralsApple is a good source of Vitamin C and Vitamin A, but most of this content lies in the skin. A medium apple with skin packs 8.4 mg of vitamin C and 98 international units (IU) of vitamin A. Without the skin, this amount reduces to 6.4 milligrams of vitamin C and 61 IU of vitamin A.3. Eases breathing problemsThe skin of an apple contains quercetin, which is a kind of flavonoid and helps in proper functioning of the lungs, which in turn eases different breathing problems. It also helps in reducing the release of histamine and other allergic or inflammatory chemicals in the body.4. Control your weightA major chunk of the fiber is present in the skin, so if you eat an apple with the skin, it will keep you fuller for longer and helps you in maintaining your weight. The peel also contains ursolic acid, which is an important compound that fights obesity by increasing muscle mass and good fat in the body. This pushes up calorie burn, thereby lowering obesity risk. It did so at least in mice, according to a 2012 study.5. Keeps cancer at bayAccording to a study at the Cornell University in 2007, the apple skin contains compounds called triterpenoids that either inhibit or kill cancer cells in laboratory cultures. One of the study authors said that these compounds targeted human liver, colon and breast cancer cells.But remember to clean the apple properly before eating. Rub it properly with a soft scrub under running water to remove the coating of wax which may be present on it to act as a preservative. Also, you can use warm water to clean your fruits but be careful about the temperature of the water. Always consume the apple with the skin to derive maximum benefits.

The 5 What's of Chemical Peels

Dr. Pradnya Shastri, Dermatologist
Have too many acne marks?Did someone comment on how 'old' you looked?Have to go to party?Or are you getting married?Is a chemical peel the only solution to all of the above?Unfortunately, the answer is no. Of late, I have seen a lot of people resorting to peels because it's apparently the latest trend. The market has painted this  as a anytime, anywhere, done by anybody type of procedure... and the market doesn't stop there. They claim that it a quick fix solution to any skin problem. So, here is what you need to know about peels:What is it? A Chemical Peel is a medical procedure Not a ‘cosmetic procedure’. What’s the difference? Have you heard of a beautician performing face lift ‘surgery’? Similarly, if you hear a beautician performing a chemical peel you know in which direction you need to run... the opposite!What are the types? Chemical peels can be of 3 types:Superficial:  Where only the Epidermis is targetedMedium Depth: The Epidermis + Papillary Dermis is targetedDeep: Where the peel reaches the Reticular DermisYou didn’t know it was this complicated? So, do you think that a non-medical personnel would know? Stick to getting your done from a dermatologist only!What are the indications for a peel?Post Acne PigmentationAcne ScarsMelasma (Mask of Pregnancy)Crinkles and Fine WrinklesDull and Sallow SkinSun damaged SkinWhat are the precautions that you need to take?Protect yourself from the sunEspecially the first 7 days, where new skin is forming, are crucial for the peel to give you good results. Sunscreens or better yet thick scarves or umbrellas work well.  And please don’t be fooled by the rains. A peel in this season also warrants the use of a sunscreen. Even though we don’t see the sun, the ultraviolet rays pass through the clouds and this can cause post inflammatory hyperpigmentation (PIH). Limit washing of your face to the minimum The skin, after a peel, tends to get dry. Even though you might not ‘see’ the skin peeling with your naked eye, it is ‘microscopically’ peeling. Washing your face with (even with plain water) can ruin this healing process and not give you the outcome that you desired.Do not bleach We have a ‘No Bleach Rule’ 7 days before and 7 days after a peel. Why? Because a bleach also acts like a very superficial peel and after a bleach the skin is raw (you can’t see the rawness) and is injured. If you top such a skin off with a peel, then you are bound to get a rash! Plus, informing your dermatologist that you have done a bleach or a facial before you get a peel done is important. That gives the dermatologist a perspective on what peel needs to be done.Going for a facial  I have so many patients asking me whether they could do a facial post a peel. NO! You shouldn’t. A peel is like a facial minus the massaging! You want a massage... get yourself a back or neck rub. Do not let anyone touch your face. And honestly, a peel gives you a far better outcome than a facial massage could ever give.What are the results expected post a peelA peel isn’t magic! So don’t expect a drastic change in the nature of your skin in just a single session. Multiple sessions are needed depending on the skin type and the skin problem. So if anyone is claiming ‘magical results in  1 session’ be aware.Even though we use the word peel, the skin doesn’t literally peel off. What we try and induce is peeling at a microscopic level. But there are exceptions. The deep peels and at times the medium depth peels produce ‘visible peeling’. So ask your dermatologist what peel is going to be used so that you are aware of what is to come in the 7 days post the peel.A very important thing that you also need to remember is that, although chemical peels if done by the right person using the right products can give great results, they are only adjutant treatments. They work the best with creams and lotions prescribed by the dermatologist. So don't go hopping into a 'salon' or a 'beauty parlour' for a peel no matter what they claim! Remember, it's your skin that is going to be at risk!

Understanding Chemical Peels

Dr. Jolly Shah Kapadia, Dermatologist
Every day thousands of our skin cells die, flake off and are replaced by fresh new cells.As we age, our skin may become dull and lifeless. The skin colour may become darker, it may become patchy, and signs of ageing begin to appear.Chemical Peels can provide a fresher, younger-looking skin.Chemical Peel :A chemical peel uses a solution which is applied to the skin to remove the dead skin cells and stimulate the production of new skin cells allowing a glowing, smoother, evenly coloured new skin.Chemical Peels can dramatically change the look and feel of your skin face in a safe, natural and a positive way.It is a treatment available to people of all ages; suitable for all skin types (light to dark skin) and can be performed on any part of the body,but is especially used for face, neck and hands. Benefits of Chemical peels : Chemical peels in Pimples (Acne): Chemical peels can reduce the formation of new pimples, remove stubborn blackheads and whiteheads, remove pimple marks, regularize the oiliness, Chemical peels in Pigmentation: Chemical peels can reduce freckles, sun spots, age spots, liver spots, blemishes, brown blotches, melasma (dark patches due to pregnancy); lighten dark underarms, under-eye circles.Chemical peels as Anti-Ageing agents:You can take a few years of your face; with the reduction of fine lines, sun damage, and dull, weathered skin. It can truly re-texturize the skin and restore the radiance and youthful appearance. Types of Chemical peel : Chemical peels are mainly of 2 types:a. Mild or Superficial peels: done with Glycolic acid b. Strong or Deep peel : TCA peel Number of Chemical peel sessions required : 6 – 12 sittings are required for best results, The benefits will be seen after one treatment, but continued commitment will generally yield greater benefit.Interval between 2 sessions : 1 - 3 weeks.Side Effects : As the solution is non toxic it will not cause any harm to the skin and hence the procedure of chemical peeling is absolutely safe with no side effects. Peels do not thin the skin. Repeated peels will generate more collagen and elastin ensuring that the skin will remain rejuvenated and in optimal condition. Steps in Chemical peel procedure : 1. Cleansing the skin to remove dirt and sebum2. Application of peel solution (one might experience little warm to hot or tingling or stinging sensation) 3. Neutralization of the solution & removing excess solution4. Applying products containing sun screen and skin lightening, skin repair properties5. Chemical peel treatment (on face) sessions usually last about 25 – 45 minutes. A mild peel only tingles on application, or may be a little irritating, whereas a medium / deep peel burns for a few minutes on application. If you have the following you may not be a suitable candidate for a peel:1. Pregnant or lactating women (a microdermabrasion or lactic acid peel may be possible) 2. History of sun allergies 3. Keloid or hypertrophic scars / Facial warts / Cold sores or fever blisters / Hepatitis / HIV4. Prior bad reaction to a peel 5. Radiation treatment for cancer / Surgery or cryosurgery, a month prior, to the area that is to be treated. Important : Chemical peel will not cause skin sensitivity, however, since the dead cells on the surface of the skin are removed, the underlying exposed skin is tender. It is crucial to take precautions to avoid sun exposure to protect your skin as well as to achieve the desired effect of the peel. A stringent use of sunscreen before going out in the sun is advisable.Remember, there is no such thing as a quick fix. Continued treatment is normal in order to achieve the results you desire.

Frequently Asked Questions About Chemical Peels

Dr. Nithya Raghunath, Dermatologist
What are chemical peels?Chemical peels involve the use of an exfoliating chemical mixture that removes damaged or older layers of skin. The chemical mixture often includes one of three chemicals: alpha hydroxyl acid, trichloroacetic acid or phenol or a combination.How are they performed?Doctors use one of three strengths to achieve the desired results. Mild peels, also called superficial peels, are safe for all skin types. Medium strength peels usually include trichloroacetic acid and create deeper exfoliation on the skin. Deep phenol peels are commonly not used on people with darker skin because they can end up bleaching the skin. The chemical peel is applied to the face in layers and left on the skin for the appropriate amount of time. After the peel is removed, the skin is cleansed and an antibacterial cream is applied.How should I prepare my skin for the procedure?Prior to your appointment with the dermatologist, you will wash your face, apply sunscreen, and apply moisturizer at least once a day. This helps to ensure that the chemical peel works evenly on all areas of your skin. The doctor goes over the daily routine with you beforehand.What are the risks?Risks during a chemical peel are rare. Deep chemical peels have more risks than a mild peel. The risks include allergic reaction to the ingredients, crusting of the skin, increased risk of sunburn, infection, organ failure, redness, scarring, skin discoloration, and swelling.What should I expect following a chemical peel?Following a chemical peel, your skin may feel tight. You may look like you’ve had a bad sunburn. Try to avoid making facial expressions for a few days to prevent tearing or bleeding. Continue following the skincare regimen given to you by your dermatologist. Do not go out in the sun for a few days or peel off the loose skin. Let the skin fall off naturally or scarring may occur.How noticeable are the results?The results depend on the level of chemical peel performed. Mild peels remove the superficial layers of skin, so minor changes are seen. Medium peels reduce fine lines and damage from the sun. Deep peels tighten the skin and eliminate deep wrinkles.

Salicylic Acid Peel for Acnes

Dr. Parthasarathi Dutta Roy, Dermatologist
 Salicylic acid peels are a type of beta hydroxyl peel and the name salicylic acid is a common ingredient used to treat acne. There is no surprise that these peels are treated as perfect for treating the acne and he clogged pores. They can be quite penetrating and stronger than an AHA peel. As this acid is more suitable for every skin type, individuals with oily and acne prone skin prefer this treatment to get the best outcome.What are the functions of salicylic acid peel?A salicylic acid peel for acne is a superficial and light chemical peel which affects the outermost layers of the skin and is limited to the epidermis and does not damage the deeper layers. Mainly, it helps to treat and improve:Oily and congested skinClogged poresBlackheads and acnebest and effective and if you are trying to reduce pigmentation, then the peels prove to be perfect to treat and have problem free skin.How does it work?Initially, as the first step, the face is cleansed and prepared for the treatment. The peel is applied to the skin. After that you will feel a warm and itching sensation and may even make your skin turn red. Usually, this peel is left on the skin for nearly 10 to 25 minutes and the concentration will differ based on the situation which you are treating. Generally, a characteristic salicylic peel will have 30% concentration due to its limited side effects and quick treatment, which is known as the lunchtime peel to many.You can apply it for every two weeks till you get the desired results and are recommended to wait for about two weeks after a single treatment for better results.                                                                                                                                   

6 Tips to 'Not' Treat Pimples

Dr. Pradnya Shastri, Dermatologist
It was fine day at my clinic and in came a patient, depressed and almost on the brink of tears.Me: So, what's the problem?Patient: Can't you see?I could see! But 'assuming' or even 'guessing' the patients problem has put me in such embarrassing positions (I guess acne and the patients says, no! Itching in the groin!) that I ask the patient to spell out the problem for me at the expense of getting a ' how dumb are you!' look.Me: Okay... so it's your face...Patients: I hate these pimples! I have tried everything and they just don't go away!Now, whenever a patient says, 'I have tried everything', they literally have tried everything! It's alarm bells ringing in my head and in my assistants head at the same time! Patients have gone to the extent of getting a TCA peel from a beautician! FYI, even  dermatologists think twice before using a TCA peel. So you could imagine the damage (permanent at times) that I have seen in patients who have 'been there and done that'.This case wasn't as bad. But it wasn't good either.Me: So what have you done?Patient: I have used Multani Mitti, Besan ka Atta, Garlic and yesterday I used Toothpaste (I cannot disclose the brand!) and now look... it’s all burnt.Me: Yes, I can see that. But tell me (and this is my favourite question of them all), did you go see a dermatologist?Patient: (deafening silence)... no... umm, but I did go to a beauty parlour ...Me: (And when I hear the word beauty parlour I stop listening and start writing the prescription).So far, it had been a fine day for me. Then, it turned into a routine day at my clinic. Different patient, but the same conversation. There are so many ‘expert websites’, which give so many ‘home remedies’ and so many ‘quick fix solutions’, not to forget all those celebrities endorsing ‘skin care in a jiffy creams’,  to treat acne that it is turning into quite a serious affair for us dermatologists to handle. So here is what you should not do if you have pimples:1. Use Home RemediesUsing of Besan Atta scrubs, Multani Mitti packs, Milk mixed with Turmeric powder packs, Sandalwood packs etc won’t be a very smart move on your part. All these make the skin temporarily dry but in the long run they end up irritating your skin and thence causing further damage, even scars (which are permanent).2. Using Fresh fruit extractsPapaya or tomatoes used raw on the face can cause the pH balance of the skin to go awry and cause irritation.3. Using Toothpaste Using toothpaste (any brand for Pete’s sake) is not a quick fix solution no matter what any expert website says! If it were so simple, wouldn’t we just tell people to use their toothpaste (not only to brush their teeth) but as a skin care product! Complete paisa vasool na? But unfortunately, it doesn’t work that way. And fortunately you have a dermatologist that you can go to for pimple treatment advise.4. Visit a beauty parlourBlack head removal is not a ‘simple routine’ procedure. Only an expert eye can know which black heads to pop and which not to! Yes, there are instances where you should just leave them alone and the let the dermatologist prescribed creams clean ‘em out! Unnecessary popping can actually aggravate acne and cause scarring too.  Also, getting chemical peels done at a parlour is a big no – no! Only a trained dermatologist knows what peels are safe and what peels will be effective. Remember, there is a big difference between a beautician and a dermatologist!5. Using creams suggested by your ‘expert’ friendPlease understand that no matter how much you love and believe your friend, they aren’t skin care experts! They might have the best skin in the world but that is because it probably runs in their genes or they might be also visiting a dermatologist for all you know! The creams they use need not necessarily suit your skin type. Every skin is unique. So is yours. Do not share creams at all. Especially  fairness creams and steroid creams (Betamethasone/Mometasone/Fluticasone/Hydrocortisone based creams). I have seen so many patients come to me stating that the pimples started after they had started using these creams! So if you are currently using any such creams  (you can check the ingredients section) please latch them on to a rocket and send them off to Mars.6. Assume all 'Skin Care Clinics' are certified dermatologist run clinicsJust because a clinic or even a person claims to be a dermtologist doesn't make it authentic. Verify the places or the persons credentials. To know more you could check here.Pimples or Acne vulgaris, as we call it in medical terms, is a ‘disease’ of the sebaceous glands of the skin. So what do we do when we hear the word disease? Yes, we go to a doctor. And since we have specialists from every field of science, so do we have Skin Specialists. So don’t waste time doing what you shouldn’t do... use it wisely and do what you should do! Hand over your pimples and worries to your dermatologist!