Aesthetics

To peel or not to peel… that is the question…..

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October is the hectic month of events and happenings. I just celebrated another birthday and blew my 8th cake (with more to come) and I am blessed to be where I am. Despite the hurdles and the constant stress of running the business and my two girls simultaneously, I think I’ve come far from where I was and I find myself more focused in the things I do. The clinic itself is evolving with newer adjuncts and direction which will soon be revealed.

So I made a promise to myself to update this segment of the clinic more frequent. I’m adjusting my writing habits to suit my activities and now with the girls settled in more into my life, I find that I can even write when they are around. It is a great change as to writing in complete privacy. I guess the kittens help to keep me home more. Although they envy my constant attention to my laptop that they make a point to sit on my keyboard and rename my files. Gees.

Recently, my daughter asked me the secret to flawless minimal pores skin. And so it got me thinking of all the different treatment modalities that I’ve come across. The most easiest and cheapest are actually chemical peels i.e. peeling off the superficial layer of the skin to make way for the newer one. But a lot of patients would tell me that they have sensitive skin and that they are not keen for peeling (but somehow rather okay with laser). Analyzing the responses, I think that there is a lot of misconception when it comes to peels and honestly, it is definitely one of the most favourite treatments I use on myself from the first year I started doing medical aesthetics and I still believe this is one of the most easiest and beneficial treatments you can do for yourself.

What determines flawless skin?

A few factors contribute to flawless skin. The in-built mechanism is your genes which plays about 10-20% role in determining the type of skin that you have. Certain ethnicity and skin tones have really smaller pores and finer skin textures. Therefore, people born with this trait are very lucky indeed thus does not require much intervention. However, the environment also plays an important role. Skin that is constantly exposed to the sun will have pigmentation issues and wrinkles. Skin in dryer climates tend to be dry and wrinkle easier. Teenagers or those people undergoing hormonal imbalance would have acne problems. In fact, certain foods tend to cause acne, where some people are sensitive to lactose or nuts or other foods. Lack of sleep, smoking, pollution exposure and lack of hygiene are also other reasons why the skin has bigger pores or acne. People with skin prone to post-inflammatory hyperpigmentation especially those with skin type 4, usually have residue pigmented scarring after acne or insult to the skin that can be unsightly and last for weeks to months to even years (yes, I am one of those). The worst part about this skin type is that any insult causes a pigmented scar, and we are too fair for the scar to go unnoticed. Other factors that increases skin congestion and enlarged pores is also the use of heavy make up especially concealers. Despite the flawless look of all these foundations, concealers, BB creams and others, some do block pores and thus causes skin to look rougher.

Why chemical peeling?

Like I mentioned earlier, it is an easy solution to remove the layers of the skin without much down time. Actually the down time really depends on the depth of peel being done. Beauticians are only allowed to use a 10% strength of any superficial peel (usually glycolic) and nothing more although some illegally uses peels of higher concentration. In Malaysia, we are only allowed superficial and medium peels which must be used in clinic to watch for complications. It maybe a simple procedure but bear in mind, that some of the complications of untrained use can be devastating.

Who should peel?

Personally, I think anyone who is more than 18 years old who either have acne issues or wears a lot of make up or just wants a quick rejuvenation should peel as long as you are not allergic to any of the ingredients of the peel. The single acid peels like glycolic or salicylic are easy since they are only one ingredient. However, if you are allergic to aspirin, you’d probably react more towards  the salicylic peels (so please inform your doctor of any prior drug allergies before the procedure is done). There are also some other combination peels that adds in other ingredients like retinol A, and ascorbic acid, or kojic acid or licorice in the solution that you may react to. Like myself, I am allergic to licorice extract thus any peels or skincare containing the ingredient will cause me to react and have wheals. I have come across retinol A sensitivity, synthetic glutathione allergy and other allergies which my patient never knew about prior. Hence why it is important to do these procedures with a trained doctor in a well equipped clinic. Some allergies or sensitivities may cause swelling of the face and in worst cases shortness of breath. These require administration of steroids and antihistamines (or adrenaline) to stop the anaphylaxis from advancing with monitoring and probably referral. So far, the worst I had to handle was swelling that responded to the initial treatment given in the clinic. In other cases, sometimes the peel maybe too strong or applied too long or not neutralised properly and thus leading to chemical burns that can lead to scarring.

Sounds scary, but in the wrong hands, even an easy procedure can cause harm.

What to expect when doing a peel?

Usually, the peel process is very short lasting between 2-8 minutes depending on type of peel use and area used. On the face usually the duration is shorter since the skin is thinner compared to the other parts of the body. The common superficial peels are the glycolic peels, the mandelic peels and the salicylic acid peel. These peels strip off only the horny layer of the skin or the keratin layer and usually has no down time. Glycolic and mandelic peels are usually neutralised and depth is time sensitive. Salicylic peels usually self neutralises and help to kill off bacteria and dries up sebum hence why it is usually used for acne prone skin.

Result wise, you can expect immediate brightening of the skin and smoother skin tone within a week. Some people experience dryness after peels which is usually due to underlying dryness of the skin and a simple moisturiser would easily fix that problem.

The medium peels would penetrate deeper and you would expect a more dramatic result with some downtime. The Jessner peel usually strips off a bit more than just the keratin layer but does not exceeds the basal membrane of the epidermis. Therefore, you may experience some whitish peeling of skin, but it is not as profound as the TCA peel. The TCA peels can peel until the basal membrane and in some concentrations a bit more, thus you get the whole layer peeling off slowly over a period of 1 week. I actually love this effect, although you have to be careful not to pull off the peeling skin by mistake since it may cause scarring or hyperpigmentation (I had this problem when I tried it the first time) Some modified TCA peels are less painful and less profound in effect, and thus you may not have the pieces of skin peeling like the more potent ones.

When using medium peels, the key is moisturisation. The more you moisturise the less dramatic the peeling appearance will be. It also helps to support the new skin growing below.

Results from peeling

The main result from peeling is smoother, softer and brighter skin. It is a complete must for people who are prone to acne or pigmentation issues and also for those people who use a lot of make up on a daily basis. Studies have shown that regular superficial peels can help to increase the skin thickness by approximately 1-2 mm in 12 months. It also help control sebum and reduce P acnes counts in the skin. It also helps to remove stuck make up inside the pores and allows better penetration of home care products.

How often to peel

Depending on type of peel, and what you want to achieve, I would recommend it to be a monthly ritual for people seeking flawless, smooth and brighter skin.

Precautions

The most precaution you will need is the post care of using sunblock since the outer skin layer has been stripped off. Using sunblock daily as a habit is actually one of the key to healthier and younger looking skin, but sometimes some patients are not too keen. If you have just peeled your skin, you should use sunblock at least daily for the first 2 weeks to avoid external sun damage to your skin. If you find that your skin is too dry after the peel, you will need to use more moisturisers on your skin. If you are allergic to any of the peels, you would usually react within the first few minutes the peel is applied on your skin, so if you have never tried peeling before, it is always safer to do a test patch. Delayed reaction may occur if wrong technique or not enough neutralisation is applied for peels requiring neutralisation. Regardless, you should always revert back to your physician if any problems. Immediate side effects could be but not limited to redness, itching, pain, burns, scabs etc which should be handles by your physician. Please tell your doctor if you are experiencing extremely painful burning sensation because although some peels hurt usually it would go off in a few minutes.

Post care

Immediately after the peel, you may apply a cooling mask or soothing mask to reduce any redness. If you have any vitamin C serums, this would be a good time to apply. However, some people become more sensitive after peels so if you have any burning sensation, stop and try reapplying after a week. You can use other serums and creams during this period and you will find that the absorption is much better. Sunblock is a complete must.

Since it is the end of the year we’ve decided to give a special promo for our patients who want to do peels. There is a special 70% off for all our peel treatments from now till year end. Contact us today for more info.

For more information or appointments feel free to email us at drmmclinic@gmail.com or send a text to +60129660852 and we will revert back to you.

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