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FROM LUNCH TIME FACIALS TO LOCKDOWN RECOVERY

Facial peels are a hot topic in beauty these days. From micro-dermabrasion to glycolic acid facials, extreme exfoliation has arrived, and it looks like it is here to stay.

There are different methods to achieve exfoliation of the skin and there are varying degrees of intensity of exfoliation from mild to extreme. But firstly, what is exfoliation? Well, basically exfoliation, in cosmetology, is the process of removing dead skin cells from the surface of the skin to improve the skins appearance. Exfoliation can be done mechanically (by hand) or chemically (with chemicals).

EXFOLIATION
Often referred to as a facial 'scrub' or 'exfoliator'. These are skin care products which contain small rounded granules in a gel or cream base and are generally used once a week at home in your cleansing routine. They are applied to a cleansed skin with gentle circular movements. The granules and circular friction help remove dead or loose skin cells from the surface of the skin leaving behind a fresher more radiant skin. These products, considering the granules are rounded, are safe to use on a weekly basis but i personally don't recommend everyday use. I feel too much exfoliation can scourer the skin and can lead to skin dehydration so i'm a once a week lady. This is the perfect time to apply a serum or ampoule as well as a hydrating or anti-ageing mask as the horny layer of dead cells, that were previously hampering product penetration, have been removed. Remember never exfoliate the eye area. See Skincare

MICRODERMABRASION
Microdermabrasion is a mini procedure that involves the skin being "sandblasted" by jets of zinc oxide or aluminum oxide crystals, fine organic particles, or a roughened surface to remove the surface layer of the skin.
All of the action in microdermabrasion takes place at the level of the stratum corneum - the topmost layer of the skin. Since it only really targets the epidermis (and not the dermis), it is more accurate to call it micro-epi-dermabrasion. And it is because of this fact that although many will tell you that microdermabrasion stimulates collagen formation, there is very little, if any, evidence that microdermabrasion stimulates collagen formation. See Fact or Fallacy

This procedure may not give everyone the same results but requires no medical oversight and is commonly used in conjunction with facial treatments. As microdermabrasion temporarily removes some moisture from the skin, it is always followed by the application of moisturizing creams.
NOTE: The term dermabrasion itself refers to the more severe medical procedure carried out under general or light anesthesia.

The procedure
Whether done with a product at home or in a professional setting with a specialized tool, the principle of microdermabrasion is the same. The idea is that if you remove or break up the stratum corneum, the body interprets that as a mild injury and rushes to replace the lost skin cells with new and healthy ones. In the first hour after treatment, this causes mild edema (swelling) and erythema (redness). Depending on the individual, these side effects can last anywhere from an hour to two days.

Microdermabrasion uses a specialized tool for the procedure. The tool shoots a stream of tiny crystals, like aluminum oxide, sodium chloride or sodium bicarbonate, and collects the leftover dead skin cells and used crystals.
The vacuum action of the machine has four main functions:
It pulls and raises a small section of skin to work on.
It creates mild swelling and brings some of the impurities to the surface.
It shoots a stream of crystals across the targeted skin patch.
It collects the used crystals and dead skin for disposal.

Complications, Contra-indications and Recommendations
Before you commit to any skin care procedure, remember knowledge is power. Though microdermabrasion is generally recommended for all skin types, there are concerns you should be aware of. And always consult with a medical professional before any procedure.

First, it’s important to stop using glycolic acids, Retin-A and alpha-hydroxy acids a few days before the treatment. Microdermabrasion should not be used on patients who have taken the medication Accutane/ Reacutane (Isotretinion) in the previous twelve months.

Microdermabrasion shouldn’t be done on sun burned skin. Also, the procedure shouldn’t be performed around the eye lids as the skin is very thin and may scar.

Dangers
Professional microdermabrasion can bruise or discolor the skin if done incorrectly. The vacuum action tends to cause blemishes if the skin tension is let up or uneven. The lip area is particularly susceptible to bruising, and the eyelids should never be treated with microdermabrasion. Treatment that is too deep or intense can cause permanent discoloration to the skin.

CHEMICAL PEELS
First, you need to understand exactly what a facial peel is, the difference between them and how they work before you race off to your cosmetic surgeon for a little 'rejuvenation'.

In short, a chemical solution, typically composed of either an organic substance such as sodium chloride, or a chemical like glycolic acid, TCA or phenol is applied to the skin to remove outer layers of the skin. This allows fresh skin cells to surface. Much like chemical paint strippers, chemical peels strip off the top layers of skin.

A chemical peel can help rejuvenate skin that has lost vitality due to overexposure to the sun, pollution or even just normal intrinsic aging and is most often used for wrinkles around the eyes and mouth, skin discoloration, age spots, dull skin texture or mild acne scars.

To see the best results, you need to figure out how much environmental damage your skin has, and pick a peel accordingly. Skin damage from prolonged exposure to the sun or elements will require a more aggressive peel in order to see results.

Types of peels
Light Peels - commonly use Alpha and Beta Hydroxy Acids.
Medium Peels - commonly use chemicals such as trichloroacetic acid (TCA).
Deep Peels - commonly use chemicals such as phenol.

MICRO OR LIGHT PEEL
Light peels are typically used to treat less severe skin problems, such as sun spots, dry skin, fine lines and wrinkles, or acne scarring. These can usually be done more frequently because they are less harsh on your skin, and the effects are usually mild. And although you may experience redness that lasts a day or two, the ultimate result should be glowing, clear skin, with a reduction in blemishes, fine lines or redness.

Typically, these peels involve the application of a chemical irritant such as glycolic acid solution, usually between 20% and 50%. During this phase you may experience mild, temporary burning and itching.

Light peels use fruit acids or alpha-hydroxy acids which are naturally occurring organic carboxylic acids such as glycolic acid, a natural constituent of sugar cane juice and lactic acid, found in sour milk and tomato juice. This is the mildest of the peel formulas and may take multiple treatments for desired results.

NOTE: It is becoming common for the use of Beta Hydroxy Acid (BHA) peels to be used instead of the stronger Alpha Hyroxy (AHA) peels due to BHA's albility to get deeper into the pore than AHA. Studies show that BHA peels control oil and acne, as well as remove dead skin cells to a certain extent better than AHA's, due to AHA's only working on the surface of the skin.

Post Procedure
Following each peel, your dead superficial skin cells will invisibly shed. You will see the maximal effect two weeks after each peel. Six peels are usually required at two-week intervals to achieve optimal results. It is recommended that to maintain your results you should receive a light peel every one to three months after the initial six peels. Light peels are used in conjunction with a skin care program for best results. SUNSCREEN (SPF 30+) IS A MUST!!!

Advantages
Micro peels offer significant advantage over skin care products alone, because the products are more potent, yet recovery is immediate. A micro peel will improve your skin texture, color, and overall appearance as well as decrease the apparent size of your pores. Many patients experience improvement in superficial crepe paper wrinkles.

Disadvantages
As long as your expectations are realistic, there are few disadvantages. Most notably, a micro peel will not improve dynamic wrinkles, skin fold wrinkles, or skin tone. If you have thin, sensitive skin, you may have redness for one to two days following your micro peel. If this occurs speak with your doctor so that a lower concentration of solution can be used for subsequent peels.

MEDIUM PEELS
Medium peels have a higher percentage of active ingredients, so the after-effects tend to be more visible. Redness, not unlike severe sunburn, may last a week or more and the skin can also peel or flake during recovery. Medium depth peels can be achieved with a variety of chemicals but *trichloroacetic acid (TCA) is probably the most common used.
Medium chemical peels are effective in promoting skin smoothness and vitality. They also improve superficial discoloration and eliminate fine wrinkles, however, they do little or nothing for severe acne scarring or dynamic wrinkles. Medium peels are preferred for darker-skinned patients rather than a deep peel using Phenol due to the 'bleaching' effect of Phenol.
Typically, a peel of this intensity is performed every two years or so, with results lasting anywhere from 6 months to a year.

*Trichloroacetic acid (TCA) is used as an intermediate to deep peeling agent in concentrations ranging from 20-50%. Depth of penetration is increased as concentration increases, with 50% TCA penetrating into the reticular dermis. Concentrations higher than 35% are not recommended because of the high risk of scarring.

Preparation for Medium Chemical Peel
Preparing your skin prior to a medium depth chemical peel will result in deeper penetration, faster recovery, lower risk of discoloration, and a better results. Applying Retin-A, Vitamin enriched creams and AHA's daily to the treatment area for four to six weeks will help to prepare the skin for treatment. This will also help remove dead skin cells and allow the chemical peel agent to penetrate more deeply.

Women with dark skin are at increased risk for developing blotchy skin after a medium chemical peel. Bleaching agents used before and after your peel will minimize this problem.
Some physicians may perform medium peels in patients that do not prepare their skin beforehand. These patients must understand that the results may not be optimal, recovery may be longer, and risk of discoloration is greater than if the skin were properly prepared.

The Procedure
Medium peels like TCA do not require anesthesia and are performed in the doctor’s office or in a clinic as an outpatient procedure. They are a bit painful and your surgeon may offer you pain pills or sedatives to help you tolerate the intense burning during the peeling agent application. A Medium peel takes anywhere from 15-60 minutes.

Your surgeon will apply the chemical solution, usually TCA, to your skin, one area at a time. When the desired depth has been achieved, your physician will neutralize the peel by applying iced saline. After ice is applied, you will have no further discomfort. Burning lasts about two to ten minutes. Once all areas have been neutralized, your skin will return to its normal color in 15 to 45 minutes. Your face will be covered with an oil-based ointment, steroid ointment, or vegetable shortening to keep your skin moist and promote healing. You will then be allowed to go home. Post operative pain medication is not required.

Post Procedure
There should be little or no discomfort following the procedure. Your face will initially appear red. Within a few days, your superficial layers of skin will turn dark, become stiff, and resemble leather. They will then crack, flake, and peel. Flaking is usually complete in four to seven days. There will be no open wounds and no scabs. Once your old skin has sloughed, your new skin will be bright and flushed. When your skin has finished peeling, you may begin wearing makeup. You will physically be able to return to work immediately, but your appearance may preclude this. Most patients are able to comfortably return to public within seven days. You should resume your skin care program within two weeks of your procedure. Your flushed appearance will fade slowly over several weeks.

Advantages
A medium chemical peel can improve the colour, freshness and texture of your face. It helps to improve skin tone and reduce the visibility of fine wrinkles and superficial discoloration, such as age spots. It may improve blotches and can sometimes improve dark circles under your eyes. Medium peels may be repeated every three to six months for optimal results. Unlike deep peels, medium peels may be performed safely on people with olive and light brown skin. They may also be used in some people with dark brown skin, although the risk of discoloration is higher.

Disadvantages
Although you will see an improvement in the visibility of fine wrinkles, medium chemical peels offer no improvement for dynamic wrinkles. To achieve the best results, you should use skin care products before your peel and anticipate that two or more peels may be needed at three-month intervals. The effects of a medium chemical peel may dissipate over six months to a year, but improvement will persist if you adhere to a skin care programme along with salon treatments.

DEEP PEELS
Deep peels are typically done using a chemical called phenol. Because of their strength, great care must be taken in evaluating the individual beforehand to ensure they are an appropriate candidate for this procedure.
The application is very painful and most practitioners will perform it under general anesthesia, administered by an MD-anesthesiologist or nurse anesthetist.
A peel of this intensity treats deep wrinkles, very dry or splotchy skin and even precancerous growths. Recovery time is much longer than with light or medium peels, and this type of peel can be problematic for darker skin tones as phenol can have a bleaching effect. However, for appropriate patients, the results can be significant and may even resemble a facelift.

Phenol peels may:
Pose a risk for patients with heart problems.
Permanently remove facial freckles which creates unnatural disharmony with a freckled neck, chest and body.
Cause permanent skin lightening by reducing the ability to produce pigment.
Take several months to heal.

Post Procedure
Discomfort: Mild to severe. Anticipate 1-5 days of prescription pain medication.
Swelling: Moderate to severe and may temporarily interfere with eye opening. This should improve in 7-10 days.
The peeling process: Your face will be swollen, red, oozing, and crusted. Over several days, your face will become stiff, dark, and begin to flake. Within seven to ten days peeling and flaking will be complete, and you will be left with healthy, smooth, bright red skin. This sunburned appearance will take two to three months to improve. Thereafter, your skin will appear extremely pale.
Presentable in public: You will be presentable in 2 weeks but with makeup.
Sun protection: SPF 30 or higher should be worn indefinitely.
Final result: Will be seen after your redness fades. Expect 2-3 months.
Because phenol peels are more aggressive peels, they offer some striking advantages, but also impose some striking disadvantages.

Advantages
A phenol chemical peel provides an overwhelming improvement in wrinkles. Results are unquestionably superior to those following other peels, laser, or dermabrasion. Just one treatment is required and results last decades. No special preparation is necessary prior to a deep chemical peel, and no special care is required to maintain your results afterward. Phenol peels may improve superficial acne scars and any dark discolorations.

Disadvantages
The main disadvantage of phenol is permanent skin pallor. After your redness has faded, your face will gradually turn ghostly white, which is irreversible, unnatural, and serves as a telltale sign that you have had this procedure performed. There is no way to smoothly transition from peeled to non-peeled skin, so a clear line of demarcation will exist. You may attempt to camouflage your appearance with make-up, but even heavy foundation may be inadequate. Because of the significant alteration in skin color, deep phenol peels are suited best to those with fair skin. Phenol peels are not appropriate for women with olive, brown, or black skin, as they will cause permanent disfigurement.
Other disadvantages include that your skin will never tan after a deep chemical peel. If you choose to tan the remainder of your body, an even greater discrepancy will exist between your previously peeled and non-peeled skin. If you are heavily freckled and have a full-face deep peel, all facial freckles will be removed, creating unnatural disharmony with your freckled neck and chest. Deep peels are therefore not recommended for those who are heavily freckled.

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