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Posts Tagged ‘chemical peel’

refresh peel
Chemical peels can be performed at various depths to achive a variety of desired results. Typically a deeper peel involves more peeling, for a longer period of time and result in more correction. Although deeper peels may be needed to address specific concerns, light peels have their place too. Extremely superficial peels, do not require any down time, and there is generally not any actual peeling skin. Light peels work by excelerating skin cell turn over in the upper most layer of the skin and are typically well tolerated, even by those with very sensitive skin. Superficial peels smooth skin texture, reduce congested pores to clarify skin and brighten dull sallow skin.

The Epionce “Lite Peel:Refresh”, designed by the well respected dermatologist, Carl R. Thornfeldt, M.D., is gentle enough for almost all skin types, including those with rosacea, acne, hyper pigmentation, sensitive skin even peri-oral dermatitis. The Epionce Refresh peel is unique with its key ingredient being Malic Acid, an AHA that not only increases skin cell turnover, it enhances hydration and reduces surface bacteria. Willow bark is a key botanical in the Refresh peel, that is anti-bacterial, reduces inflammation and improves skin clarity. This lunch time peel is also formulated with a little Salicylic acid to boost penetration and further enhance results. Onion bulb extract has anti-inflammatory properties and is added to sooth and calm skin. The Refresh peel may be repeated as often as every 2 weeks in a series of 3-6 peels, or it may be combined with other in-office treatments to enhance results.

Read MoreApril 4, 2017 1:43 pm - Posted by Kristy


The eyes are the focal pointe of the face and one of the first places we start to age. A professional chemical peel to treat the skin around the eyes, may be just what the doctor ordered.
A Medium Depth Peel will..
– Treat skin laxity, fine lines, “stretchable” wrinkles and scars.
– Improve skin texture, reducing roughness
– Treat hyper-pigmentation Brown spots and Melasma
– Tighten large pores
– Increase collagen and skin density

The skin around the eyes is thin and with age begins to show fine lines and take on a crepey texture. Treating the delicate skin around the eye can be tricky. Lasers can damage the eye, so this limits how we treat this area. Laser resurfacing can be done, if special laser eye shields are placed inside the eye. Chemical peels are another option for treating the skin around the eye, and when done by a skilled professional can be done up to the lash line.

Chemical peels that penetrate to the appropriate depth in the skin, can improve texture and tighten skin. A TCA peel that penetrates beyond the papillary dermis, just to the Immediate Reticular Dermis (IRD) will provide skin tightening effect, this is called a Medium Depth Peel. I am choosing not to mention the strength of TCA used, because I read too many horror stories online about people who attempted to do a professional peel at home. Skin care professionals are trained on how to determine where we are working in the skin, this is a medical grade peel and should be done by an experienced professional.

Aging Skin and Chemical Peel Intervention

Skin care professionals often talk about “skin cell turn over”. Skin cell turnover is the process of a new skin cell being produced, working it’s way up to the surface and replacing old skin cells which have been sloughed away. In young healthy skin this process takes about 6 weeks, however aging and sun damage slow this process. Chemical peels increase skin cell turnover, which in turn improves skin texture.

The production of growth factors, collagen, elastin and hylaraunic acid all slow with age, so the goal in anti-aging is to preserve and increase the production all of these things. Collagen is a protein that gives skin it’s volume strength and structure, while elastin is what gives skin it’s elasticity or ability to snap back. Hyaluronic acid is a key molecule involved in skin moisture, as it binds and retains water. Hyaluronic acid is also needed to bind collagen to elastin. When we do chemical peels and laser treatments that penetrate beyond the skins epidermis, we are benefitting from the skins own wound healing ability to up regulate growth factors and stimulate the production of collagen, elastin and hyluranic acid. The result is a thicker dermis, smoother surface and skin tightening.

What to expect

The day of the peel is considered day 1. On days 1 and 2 your skin looks okay, but it may look dry and slightly older. By day 3 skin begins to look dark or bronze, this will vary depending on your natural skin color, skin discolorations and depth of peel. Skin usually begins to peel on day 4 and is usually done by day 5. After the skin has peeled of it may be pink for a couple days. The healing process does vary for each person. Healthy skin will always recover more quickly with less inflammation.

During the peeling process you will need to follow the post peel instructions given to you by your skin care professional. This usually includes using a gentle cleanser, a hydrocortisone cream and mild moisturizer. An occlusive ointment such as Vasoline or Aquaphor may be recommended. It is VERY important to not pick or pull off the skin, let it peel in its own time! (seriously… don’t do it) You should also avoid sweating during the pealing phase, because it will create sweat beads under the skin that will cause it to peel of prematurely and thats bad. The skin should be protected with a totally physical sunscreen, I like Physical Eye UV Defense SPF 50 by Skin Ceuticals.

After the old skin has peeled off, it instantly looks and feels smother. The collagen production will continue to increase and the skin will continue to feel tighter. To keep the skin renewal process un regulated and functioning more similar to young skin, I usually recommend having around 4 TCA chemical peels around the eye area per year. Treatments should be scheduled over 6 weeks apart.

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Read MoreJune 5, 2014 9:35 pm - Posted by Kristy

We are excited about the newest chemical peel to hit the scene and the name “Perfect Peel”says it all.

The Perfect Peel works from the inside out to repair and nourish skin by giving it a radiant glow, refining pores, improving skin hyperpigmentations, lifting melasma, diminishing fine lines and wrinkles, eliminating acne and preventing acne marks. Most importantly the Glutathione element defies the aging process. The Perfect Peel is the only peel on the market with Glutathione, a powerful antioxidant and anti-aging ingredient. In addition to Glutothione, the perfect peel is formulated with an impressive list of active ingredients including: TCA, Retinoic Acid, Salicylic Acid, Phenol, Vitamin C and Kojic Acid.

I recently had this peel myself and I was pleased with the level of correction I saw, it did a wonderful job of lightening the melasma and skin discolorations on my skin as well as smoothing out the fine lines. The peel it-self was quick and surprisingly comfortable with virtually no stinging or burning. The treatment includes a post treatment moisturizer and two treatment towelettes that are infused with retinoic acid and Vitamin C which are designed to enhance the effects of the peel. I simply swiped the moist treatment towel over my face the night of my peel and again the following night. The Vitamin C does make your skin itch slightly, after you use the towelettes. To sooth the itching I just mixed a topical hydrocortisone cream in with the moisturizer and applied it to the treated areas. The peeling was easy to tolerate, with one major day of peeling on day three. I personally only “peeled” for about 2 days with a little sloughing after that. I would say most people can expect about 3 days of social down-time, which just means you will comfortable with routine activities but, this is not a good time for a social event like a party or wedding.

The Perfect Peel will:

- Rejuvenate and produce younger healthier looking skin.
– Reverse signs of aging and sun damage.
– Even out your overall skin tone.
– Lighten and brighten your skin.
– Slow down the skin aging process.
– Reduce pore size and soften lines and wrinkles.
– Stimulate collagen production resulting in firmer skin.
– Improve the overall tone and texture of your skin.
– Prevent Wrinkles and Age Spots.
– Improve skin conditions such as acne, melasma, and hyper pigmentation.

What is Glutathione?

Glutathione is the ultimate antioxidant known to prevent damage to important cellular components caused by free radicals and peroxides. As we age, our Glutathione levels are depleted due to sun exposure, air pollutants and environmental stress.

Glutathione penetrates deep into the cellular level of the skin to fight oxidant damage and is the anti-aging answer to premature wrinkling. Glutathione is proven to reverse the melanin’s metabolism turning dark pigmentations (eumelanin) into light pigmentation (phaeomelanin)

How long will I peel?
The day of the treatment is considered day 1. Peeling usually begins on day 3 and is generally completed by day 5 or 6. Most of the peeling happens on days 3 and 4.

If you want to peel over the weekend schedule your treatment on a Thursday. You will look fine on Friday, with most of the peeling on Saturday and Sunday, by Monday and Tuesday you usually will have some mild sloughing with little to no peeling.

The content provide in this post is intended to be informative and does not replace medical or professional treatment.

Thank you for visiting Best of Both Worlds Az
You can follow us on Facebook, Twitter and on our blog site
www.bestofbothworldsaz.com

®© All Rights Reserved.

Read MoreNovember 2, 2011 6:37 pm - Posted by Kristy

The Illuminize Peel is a very superficial treatment that gently exfoliates and brightens skin with out any peeling or down time. Mild exfoliating treatments like the Illuminize peel work well to enhance the benefits of skin care products and freshen up skin in between more aggressive skin treatments.

At Paradise Valley Skin Klinic, we include dermaplaning with the Illuminize Peel!

This non-invasive very superficial chemical peel utilizes a novel approach to chemical peeling with a newer generation of alpha-hydroxy acids (mandelic acid and malic acid) in combination with phytic acid and commonly used peeling agents (salicylic acid and resorcinol) to maximize skin rejuvenating effects with low irritation.

– Increase skin glow and radiance
– Tightens the skin and restores a more youthful appearance
– Improves clarity, color and skin texture
– Achieve enhancement of skin appearance with minimal downtime and discomfort
– Appropriate for a first-time chemical peel or for those looking for a gentle, very superficial peel
– May be performed on dark skin
– Little or no visible peeling

The content provide in this post is intended to be informative and does not replace medical or professional treatment.

Thank you for visiting Best of Both Worlds Az
You can follow us on Facebook, Twitter and on our blog site
www.bestofbothworldsaz.com

®© All Rights Reserved.

Read MoreOctober 27, 2011 11:59 pm - Posted by Kristy

The Obagi Blue Peel improves hyper pigmentation, fine lines, wrinkles, large pores, laxity, skin texture and acne scars.

The Obagi Blue Peel is a unique procedure designed to precisely control the depth of a TCA chemical peel. The Blue Peel uses Trichloroacetic acid (TCA) as the active ingredient and a patented Blue Base with built in safeguards. The TCA and blue peel solution is prepared at a fixed concentration and applied in a “coating system”. The Blue base gives the skin professional more control over the peel by slowing the penatratation of the TCA solution and making it easier to recognize desired endpoints. The coating system helps monitor and control the depth of the peel.

The Obagi Nu Derm system and Obagi Blue Peel are designed to work together. The Obagi Nu-Derm system is used before the peel to precondition skin and as a post treatment protocol. Pre-conditioning prepares skin by correcting and stimulating normal skin function to speed healing. The amount of time for preconditioning is determined by the skin type and condition, usually a minimum of 6 weeks. Post-treatment promotes shorter recovery time, aids in resolution of erythema (redness) and post- inflammatory hyperpigmentation. I will not do a Blue Peel on anyone who has not preconditioned, post treatment care is also not optional.

The Obagi Blue Peel is not something you just schedule and show up for, it requires a little planning and preparation. A consultation is required before scheduling a Blue Peel to determine the depth of the peel needed to achieve desired results. In some cases a Blue Peel may not be your best option or additional treatments may be needed, so other treatment possibilities may be discussed. You will also need to begin a skin care regimen with the Obagi Nu-Derm system, a minimum of 6 weeks prior to your peel. During the consultation you will discuss the length and amount of peeling to expect with your peel , so that you can plan your schedule accordingly. The price of the Blue Peel varies depending on the depth of the peel, however even in the deepest Blue Peel is only a fraction of the cost of many laser treatments. ( The Blue Peel is amazing when combined with fillers and Botox. Think Chemical Facelift!)

Depth of Obagi Blue Peel

The Obagi Blue Peel can be performed at different levels or depths, depending on the desired results. The Obagi Blue peel uses a coating system as a way of preparing and controlling the depth of the peel. People often get confused by the term “coat”. When we say coats we are not referring to how many times the peel is painted on the face, a coat refers to a specific volume of a prepared solution. The blue peel uses a 30% TCA and a patented blue base that is prepared in either a 15% or 20% solution. It is important to understand that 2 coats of a 15% solution is not the equivalent of 2 coats of a 20% solution. A Blue peel solution of 20% is also not the equivalent of a plain 20% TCA. When considering a Blue Peel try not to confuse your self with the coat system and the concentration of the prepared solution, instead focus on the depth of the peel needed to achieve specific results.

[ Chemical Peels 101: skin anatomy, chemical peels, and peeling agents ]

Light Exfoliation: Peeling is complete in 2-3 days.
This is commonly referred to as a 1 coat peel
– Penetrates the stratum corneum layer of the skin.
– Provide light exfoliation to freshen the skin
– Unclogs pores and reduces comedones

Deep Exfoliation: Peeling is complete in 4-7 days.
This is commonly referred to as a 2 coat peel.
– Penetrates to the basal layer of the skin.
– Temporary improvement of superficial hyper-pigmentation
– Enhances results of the Nu-derm system

Standard Blue Peel: Peeling is complete in 7-9 days.
This is commonly referred to as a three coat peel.
– Penetrates the papillary dermis layer of the skin.
– Treats hyper-pigmentation Brown spots and Melasma
– Improves skin texture, reducing roughness
– Tightens large pores

Designed Blue Peel: Peeling is complete in 9-14 days.
This is commonly referred to as a 4 coat peel.
– Penetrates to the reticular dermis layer of the skin.
– Treats hyper-pigmentation Brown spots and Melasma
– Improves skin texture, reducing roughness
– Tightens large pores
– Skin laxity, fine lines, “stretchable” wrinkles and scars.
*Immediate reticular dermis (IRD) is the area where the papillary dermis meets the upper reticular dermis.

Pre-conditioning before the Obagi Blue Peel

Skin should be conditioned before a Blue Peel, this is done by using the full Obagi Nu Derm system along with a topical tretinoin (Retin-A). Conditioning the skin prior to the peel will enhance results and reduce complications. Pre-conditioning prepares skin by correcting and stimulating normal skin function to speed healing. The Obagi Nu Derm is a complete system and should be used as such. It is not recommended to eliminate or substitute the skin products in the Obagi System. Your skin health professional will give you a specific protocol that is appropriate for your skin. You will be instructed when and how to use each product as well as how to measure the recommended amount of each product. You will also be shown how manage reactions and how to modify your protocol to fit your lifestyle.

Obagi Medical skin care products are prescription strength, and available only through a physician’s office.The products in this system should be used with the same respect and diligence as any prescribed drug. You should only use Obagi products that you have received directly from your skin care professional, under a doctors supervision. Products sold by unauthorized distributers or online may be counterfeit, expired or degraded in quality. This can lead to reduced results and complications. When you purchase Nu-derm products from anyone other than your personal skin care professional, they are unable to calculate if you are using your creams correctly or guarantee efficacy of the products, consequently the results of your treatment can not be assured.

[ Obagi Nu-Derm: Restore Skin Health ]

Post- treatment after the Obagi Blue Peel

The Peel Stage
The peeling stage is 3-14 days depending on depth of peel.
The amount of peeling will depend on the level of peel. Skin will generally begin to darken on the 3rd day and peeling will begin on day 3 or 4, depending on depth of peel. Peeling begins around eyes, nose and mouth. With a standard or designed blue peel, days 4-6 will appear the worst. The peeling stage is not painful, but the skin will feel tight and dry. Follow all post treatment instructions. NO PICKING! It is extremely important that you do not assist the peel, treat the skin like you are trying to keep it on. Do not pick, pull or remove skin. Complications can occur if skin is peeled off prematurely.

During the peeling stage you will be instructed to follow specific post treatment instructions. This will include using a gentle cleanser and mild topical creams designed by Dr Obagi to be used after a Blue peel. If you have had a deeper peel you may be instructed to use an astringent solution compress. Sun exposure should be avoided after the peel. Chemical sunblocks and makeup can not be used, however you may be able to use an “approved” mineral makeup which will provide a little sun protection. I usually recommend Jane Iredale mineral makeup.

[ Chemical Peels: Post Treatment Care and Instructions ]

Recovery Stage
The recovery stage begins when peeling is complete and lasts 1-6 weeks, depending on depth of peel. When the peeling is complete, skin will look good and will continue to improve as it heels. Skin may look a little pink or red and it is not un usual to see an acne flare-up. After peeling is complete it is important to resume Obagi Nu-derm system as instructed to enhance results and reduce the probability of post inflammatory pigmentation.

Return to Normal
Skin will return to normal when the recovery stage is complete. Results of the procedure can be evaluated at this point and you will resume Obagi Nu-Derm system under the normal protocol. It is important to not discontinue Nu-Derm system prematurely. You will continue on a normal Obagi Nu Derm protocol until advised to begin a maintenance protocol, usually 6-12 weeks. This will depend on how aggressive your nu-derm protocol is, the condition of your skin and desired results.

Maintenance
When skin has been corrected and has returned to a normal healthy state a maintenance protocol will be designed to help you maintain your results. Your skin health professional will instruct you when to begin a maintenance protocol, this is usually.

The content provide in this post is intended to be informative and does not replace medical or professional treatment.

Thank you for visiting Best of Both Worlds Az
You can follow us on Facebook, Twitter, Tumblr and on our blog site
www.bestofbothworldsaz.com

®© All Rights Reserved.

Read MoreOctober 18, 2011 1:18 pm - Posted by Kristy

Whats Trending Now?

Plastic surgery and cosmetic procedures have been a hot topic lately. Why? Because the cosmetic industry is boosting and is predicted to continue to growing as the economy improves. It is expected that Plastic Surgery and non-surgical cosmetic procedures will soon exceed pre-recession levels. The industry peaked in 2004 and saw a big decline in 2009. According to the ASAPS, Plastic Surgery procedures grew by almost 9% in 2010.

I am not sure if the increase in plastic surgery is a sign of an improved economy or not. I will say that I have seen more clients coming in because they want to stay competitive in the work force, especially in industries such as technology, that attract a younger generation of workers. People that are in sales or work with the public feel that their appearance has an impact on their income or ability to obtain a job. I have also seen an increase new clients, that want to improve their appearance before starting a new job. They are taking advantage of the time away from work to recover from surgery.

Top Procedures in 2010

2010-Top Surgical Procedures
#1 Breast augmentation (38.0% saline implants & 62.0% silicone implants)
#2 Liposuction
#3 Eyelid surgery
#4 Abdominoplasty (Tummy Tuck)
#5 Breast reduction
#6 Rhinoplasty (nose reshaping)
#7 Facelift
#8 Breast Lift
#9 Autologous fat ( Fat transfer)
#10 Forehead lift
There were 1,622,290 total surgical procedures done in 2010.

2010-Top Non-surgical Procedures
#1 Botulinum toxin type a ( Botox & Dysport)
#2 Hyaluronic acid (including Hylaform, Juvederm, Perlane/Restylane)
#3 Laser hair removal
#4 Laser skin resurfacing (36.0% ablative & 64.0%nonablative)
#5 Chemical peel .
#6 Microdermabrasion
#7 Sclerotherapy
#8 IPL treatments ( aka..photofacial, fotofacial, photorejuvenation,)
#9 Non-invasive skin tightening
#10 Calcium hydroxylapatite (Radiesse)
There were 9,336,814 total non-surgical procedures done in 2010.

Men vs Women: Top Surgical Procedures

Woman
#1 Breast augmentation
#2 Liposuction
#3 Breast reduction
#4 Abdominoplasty
#5 Eyelid surgery

Men
#1 Liposuction
#2 Rhinoplasty
#3 Eyelid surgery
#4 Breast reduction to treat enlarged male breast
#5 Cosmetic ear surgery.

The ASAPS survey is based on procedures performed by the surgeon, and may not include all of the nonsurgical procedures performed in the office by other staff such as physician assistants, nurses, laser technicians and estheticians .

Thank you for visiting Best of Both Worlds Az
You can follow us on Facebook, Twitter, Tumblr and on our blog site
www.bestofbothworldsaz.com

Read MoreApril 4, 2011 10:19 pm - Posted by Kristy


Chemical Peel’s can very in depth from very superficial to very deep. Post treatment care for chemical peels is dependent on the type of peel, and condition of the skin. Your skin health professional should give you post treatment instructions that are specific for the type of peel you have had. Some peels are so superficial that they cause little to no peeling, and may not require a big change in your skin care regimen. Having a deeper level chemical peel provides a greater level of correction, however it also can create a greater risk for complications. Most complications can be avoided by strict patient compliance, meaning you should follow your post treatment care instructions exactly as instructed. Deeper peels may also require preconditioning, this especially important for darker skin types. The Obagi Nu-Derm system is ideal for preconditioning skin for resurfacing procedures and chemical peels. Be sure that you have all of the appropriate products needed and do not use any skin care products that have not been approved by your skin health professional.

Keep Your Skin on

One of the most important things to remember after a chemical peel is to avoid picking, scrubbing or assisting the peel in any way. Treat the skin like you are trying to keep it on. The old dead skin that is about to peel off acts as a protective barrier. If you have caused the skin to peel off prematurely you are at increased risk for complications, including hyper-pigmentation. If you have assisted or accidentally removed the peeling skin prematurely, contact your skin health professional immediately. You may be instructed to apply an occlusive such as Aquaphore to the area’s that have peeled off. You may also need to use hydroquinone and/or tretinoin after the peeling process is complete to prevent or correct complications.

[ Chemical Peel: Do’s and Don’ts ]

Gentle Cleanser

Beginning the day of the peel until peeling is complete you will need to use a gentle cleanser. Avoid scrubs, exfoliants and any acne cleansers unless otherwise instructed. This is also not the time to use cleansing brushes such as the Clarisonic, you should cleanse the skin gently.


I prefer Obagi Gentle Cleanser after most chemical and laser peels.


Cetaphil gentle cleanser is another option, and you can buy this product at most drug stores.

Moisturizer and Topical Hydrocortisone Cream

Use a gentle moisturizer 2 – 4 times a day.
Be careful that you do not use a moisturizer that contains exfoliants or irritating ingreadiants after your peel. If you have had a medium to deep peel, you may also be instructed to use a topical Hydrocortisone cream. It is important that you do not over use Hydrocortisone creams, as extended use can inhibit healing. Check with your Esthetician or Doctor before using any products after a peel.

post peel instructions
Obagi’s Tolereen has a 0.5% Hydrocortisone cream, and can be applied before moisturizer or mixed with in with the moisturiser.


Obagi Action is appropriate after most peels and is generaly my first choice.


Skin Medica’s Ceratopic Replenishing cream is ultra hydrating and can be used after most peels.

Sun Protection


After a chemical peel your skin is more vulnerable to Ultra Violet Rays. You should avoid sun exposure as much as you can, hats and sunglasses are helpful. Depending on the depth of the peel, you may be instructed to avoid sunscreen until the skin has completed the peeling phase. You will find that your skin is sensitive to chemical sunscreens, so look for a physical sunblock that contains zinc oxide. A pure mineral makeup such as Jane Iredale, contains a Titanium Dioxide 14% and Zinc Oxide 3% and can be used immediately after chemical peels, when other sunscreens may not be appropriate. Keep in mind that the depth of your peel will determine when you can start to use sunblock.

Anti viral

post peel
Herpes simplex infection can occur on the face after skin resurfacing procedures, including chemical peels. A viral outbreak is more common with deeper procedures. You may be prescribed an antiviral medication such as Zovirax to help prevent breakouts. If you do have a history of cold sores or any herpes breakout be sure to mention this to your Esthetician or Doctor before your peel. Many skin professionals prefer to treat all patients with antiviral agents regardless of a positive history. Don’t be insulted or embarrassed if you are prescribed an antiviral medication, it is often standard protocol. It is important to understand that some people may carry the virus, even if they have never had an outbreak.

Antibiotics

antibiotics, post peel procedures
It is not unusual to see milia or small acne breakouts after deep resurfacing procedures, including deep chemical peels. There are chemical peels, such as Skin Medica’s Vitalize peel that are appropriate for treating skin with active acne. Deep chemical peels should be put off until acne is under control, without any active breakouts. Topical antibiotics can not be used immediately after a chemical peel, so if you have a recent history, you may be prescribed an oral antibiotic.

Domeboro Astringent Soaks

post peel, domeboro
Domeboro Astringent solution is an over the counter product that can be found at most drug store. Domeboro Astringent Solution, when applied as a wet dressing or compress, cools and cleanses irritated skin and soothes inflammation. Domeboro contains Aluminum acetate which helps to reduce itching, stinging, and inflammation. Domeboro powder can be mixed with water, the solution is then applied topically as cold compresses to the treated area. I usually recommend using sterile gauze dipped in the solution and gently press onto the treated area for about 5-10 minuets, twice a day. The skin should first be cleansed with a gentle cleanser, after treating skin with the compress solution you can apply an appropriate moisturizer and Hydrocortisone.

Cosmetics

Generally, cosmetics such as foundation, concealer and powder are not recommended after resurfacing procedures and chemical peels. There are some mineral cosmetics that can be used immediately post procedure. It is important to know that not all mineral makeup is created equal, many are simply mineral based. Jane Iredale is an excellent mineral makeup, that is safe to use after cosmetic procedures and provides SPF protection. Jane Iredale is also antimicrobial and anti inflammatory, offering several benefits after a chemical peel.

[ Chemical Peels 101: A lesson in skin anatomy, chemical peel levels, and peeling agents ]

Deep Chemical Peels

If you have a deep chemical peel, such as a 30% – 35% TCA peel, Standard or Designed Obagi Blue Peel, you will be instructed to follow additional instructions. Avoid “cracking” by keeping the skin moist and minimizing facial expressions. You can use Aquaphor in the corners of the mouth. Aquaphor can be used if the skin becomes tight or over areas that cracking may have occurred. When you shower, do not let the water strike you in the face. You will also need to sleep on your back with your head slightly elevated. If you have a deep chemical peel, it is important to make follow up appointments with your skin care professional and address any concerns immediately.

After the peeling phase

The first stage of a peel is the peeling stage, this is complete when the skin is no longer peeling and reepithelialization has occurred. After the skin has completed peeling, you may begin a skin care regimen. Again, if you have had a superficial peel you will most likely continue with your normal skin care regimen. If you have had a deeper peel, the next stage is when dermal changes begin. You may be instructed to use products like Hydroquinone, tretinoin and a good sunblock. You should avoid exfoiliating treatments and products for about 6 weeks, depending on the depth of the peel.

Thank you for visiting Best of Both Worlds Az
You can follow us on Facebook, Twitter, Tumblr and on our blog site
www.bestofbothworldsaz.com

Read MoreMarch 28, 2011 8:49 pm - Posted by Kristy

The delicate thin skin around the eyes is the first place that skin starts to age. Even the hair on our eyebrows and eyelashes reduce and become lighter over time, and if that isn’t enough many women find it difficult to apply eye makeup because vision can become worse with age.

Crows Feet and Lines Between Eyebrows

BOTOX® Cosmetic is a prescription medicine that is injected into muscles and used to improve the look of moderate to severe frown lines between the eyebrows (glabellar lines).
Botox will temporarily relax the muscles that create the lines around eyes known as crow’s feet. Botox is also used to treat the lines between the eyebrows, often refereed to as the elevens (11).

Eyes, Botox

Fine lines and Crepey Skin

Laser and chemical peels can be done to resurface the skin around the eyes and stimulate the fibroblast to produce collagen. Some laser treatments can be done around the eyes, as long as ocular shields are used to protect the eyes, however some patients are not comfortable with having the metal ocular shield placed inside their eyes. I personally prefer to do a chemical peel using a 30% – 35% TCA. I prefer the TCA because I am able to peel all the way to the lash line, I also feel that I am able to produce a better result with the TCA peel.

If you are considering a TCA peel, be sure to go to someone with a lot of experience, especially if you have dark skin. It may be recommended that you precondition the skin with Tretinoin ( Retin-A) and Hydroquinone, before the peel. It takes about 7 – 9 days for the skin to complete the peeling phase, however this is dependent on the depth of the peel. In general you can expect the skin to start to darken up on the third day, you may see some peeling as soon as the fourth or fifth day. It is extremely important that you don’t “assist” the peel, treat the skin almost like you are trying to keep it on. Picking and peeling the skin off prematurely can lead to complication. Follow all post treatment instructions, which usually includes using a moisturizing product like Obagi’s Action.

Bags under the eyes

A plastic surgeon can easily remove fat pads from under the eyes. A Blephaplasty removes excess skin and fat. A transconjunctival blepharoplasty, is a procedure where the fat is removed from the lower eyelid, by making the incisions from the inside of the eyelid. The advantage is that there isn’t any visible scars, however it doesn’t remove excess skin from the lower lid. A plastic surgeon can also reposition fat, and reinforce muscles and tendons around the eyes. The surgeon may recommend a canthoplasty to reinforce lower eyelid support. In some cases a blephaplasty can be performed in the office with little to no down time. You should schedule a consultation with a plastic surgeon to see what procedure is best for you.

Hollow under the eyes, or sunken in look

You can have filler injected under the eyes to fill on the hollow area under the eyes. This is an advanced technique and should be performed be an injector that is very experienced at injecting fillers around the eyes.

Photograph from Shapiro Plastic Surgery


This patient has been bothered by the hollowing beneath her eyes that make her appear fatigued. The photograph shows the patient after injection of Restylane® to the right lower eyelid region, and before injection to the left side to simulate a before and after view. She was delighted with her immediate improvement at the end of the injection session. Photo courtesy of Shapiro Plastic Surgery.

[ Arizona’s Master Injecter: Botox, Juvederm, Restylane and more ]

Droopy Brow

The browlift is a procedure designed to elevate the brow to a more youthful position relative to the eyelids.
The endoscopic browlift is a minimally invasive procedure, which means there is very little bruising or swelling from the procedure. The procedure involves inconspicuous incisions made throughout the scalp, hidden in the hair meaning that the thin, few scars that are left behind, are hardly noticeable by even the patient themselves. The recovery time is very quick; surgical sutures are removed within ten days, after which most patients can comfortably socialize without pain. This is a very common procedure performed by, Paradise Valley Plastic Surgeon, Dr Daniel Shapiro. An open (coronal) browlift is a specialized procedure for patients with deep wrinkles or heavier skin. Deep wrinkles in the mid-forehead and between the eyebrows can be lifted out by using an open browlift technique. Both techniques are common procedures performed by, Paradise Valley Plastic Surgeon, Dr Daniel Shapiro.

Skin Tightening

ReFirm and Thermage are skin tightening treatments that use Radio Frequency (RF) technology to gently tighten the skin. These treatments do not require any down time, however you may need a series of treatments for best results. I find that these treatments work best when combined with other treatments.

[ Radio frequency (RF) 101: Understanding (RF) Skin Treatments ]

Permanent Makeup

Permanent cosmetic makeup is cosmetic tattooing elevated to the highest artistic level. Permanent make up can help give you back what time has taken away, and help to enhance your natural look. Permanent make up is not necessarily intended to replace cosmetics completely, because the color is placed “in” the skin and not on the skin, so a more natural, softer look results after the skin has healed. Permanent make up makes it possible to look better round the clock and be less self conscious. When you look better you feel better! It is a great time saver, perfect for active outdoor lifestyles, sensitive skin, and clients with contacts, glasses or difficulty applying make up.

Latisse

You may notice that your lashes and brows are not as full as they were when you were younger.Latisse is the first and only FDA approved prescription treatment for eyelash growth. It is an easy to use topical solution that you apply once a day at the base of your eyelashes. Lashes gradually start to get longer, thicker and darker. You will notice results in as little as 8 weeks, and full results in as little as 16 weeks. Keep in mind that hair growth can develop in other areas that the solution is applied to. I personally have used Latisse on my eyebrows and have seen an improvement.

Eyelash and Brow Tinting

To enhance the look of your eyes, you can have your eyelashes and eyebrows tinted. The treatment is quick, painless and inexpensive. The results are temporary, and last about 4 weeks. Eyelash and eyebrow tinting is also great for men, because they generally don’t wear makeup.

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Read MoreMarch 22, 2011 2:22 am - Posted by Kristy

pregnancy mask

Melasma (chloasma) is hyperpigmentation or dark, irregular patches commonly found on the upper cheeks, nose, upper lip, and forehead. The patches can develop gradually over time or during pregnancy. Melasma can also develop when taking oral contraceptives or hormone replacement therapy medications. Melasma is thought to be stimulated by hormones, however exactly which hormones are involved has yet to be determined. The most important factor in the development of melasma is sun exposure,and without the strict avoidance of sun exposure, treatments for melasma are likely to be unsuccessful. Melasma can be permanent or disappear and reappear with each pregnancy.

Hyperpigmentation is the term used to describe any type of abnormal dark area of the skin, this includes melasma, freckles and sun spots. When we treat hyperpigmentation in the skin, it is important to understand that the melanocyte is not functioning properly, so it overproduces melanosomes and the excess melanin can not be evenly distributed among the keratinocytys. As the cells rise to the surface of the skin they cause over pigmented or dark spots. When the skin is exfoliated with AHA’s, chemical peels or microdermabrasion, the hyperpigmentation will appear lighter because some of the top layers of skin have been removed and the pigment is less dense (temporarily). The pigment is still there, it is just appears lighter and the melanocyte is still not functioning properlly, so in a few weeks as the top skin layers are replaced the pigment will appear dark again. Tanning will also further stimulate the melanocyte causing darker pigmentation to develop and Melasma will become worse. Hydroquinone works to suppress the melanocyte and is an excellent way to treat the pregnancy mask. For best results Hydroquinone can be used in conjunction with exfoliating treatments. I understand this description may be a little difficult to understand, so if I have lost you, you can come in for a consultation and I will use visual aids to better explain the cause and treatment for hyperpigmentation.

melasma, pregnancy mask

Melasma: My Personal Story

I have Melasma myself, on my upper cheeks and forehead. I first developed Melasma patches on my upper cheeks in my late twenties and later after giving birth to my second child I developed another large patch in the center of my forehead. I have successfully treated my Melasma, but I need to continue to maintain my skin so that it doesn’t come back. As a Medical Esthetician, I obviously have access to the best skin care products and treatments available. I can share both my professional and personal experience with treating Melasma. Using hydroquinone, and broad spectrum sunblock is absolutely necessary for treating and controlling Melasma. Even after successful correction of Melasma, the hyperpigmentation can reappear especially after sun exposure.

My Personal Skin Regimen

Topical Products
My personal skin regimen includes using the Obagi Nu-Derm system, with a 1/2 gram of Clear (4% hydroquinone) AM and PM. Initially I used a 1/2 gram of a .1% tretinoin ( Retin-A) every night, however I am now on a maintenance protocol and only use tretinoin occasionally. I also use a topical vitamin C and a broad spectrum sunblock containing Zinc oxide. I top it off with Jane Iredale mineral makeup SPF 20.

Professional Skin Treatments
I have had an Obagi Blue Peel, and Fraxel treatments. I personally felt I had better results with the Blue Peel. Fractional laser resurfacing and Blue Peels are ideal when treating deep or resistant Melasma.

Although I have corrected my Melasma, I still need to continue to maintain my skin to keep the Melasma under control. In addition to the topical products I previously mentioned, I try to have a light chemical peel every 4-6 weeks. The chemical peel I have found that gives me the best results treating pigmentation, is a custom chemical peel.

Obagi Nu-Derm System

This is correction after using the Obagi Nu-Derm System. This is a prescription strength skin system and is only available at medical skin clinics. Treatment protocols vary depending on skin type and condition.

Obagi Blue Peel

This is an example of deeply pigmented Melasma.
After treatment with Obagi Nu- Derm & Obagi Blue Peel

It is important to precondition with the Obagi Nu-Derm System and Retin-A before having a Blue Peel. I recommend preconditioning for a minimum of 6 weeks or longer depending on how aggressively Tretinoin is used. Patients that are better preconditioned get a better result. It is also necessary to continue to use the creams after peel to prevent Hyperpigmentation & to maintain healthy skin.

Custom Chemical Peel for Melasma
The Custom Chemical Peel I use is a light peel that can be repeated as often as every 4-6 weeks, compared to the Obagi Blue Peel which is a deeper peel necessary for treating deeper pigmentation. I have decided to not include details of my protocol for this custom peel. It is proprietary information that I don’t wish to share with others in the industry. If you would like to learn more, you can schedule a private consultation. I can tell you that with this peel, I will usually get light peeling for 2-3 days. The peeling is minimal and I would not consider there to be any “down-time”, you can still go about your regular routine. You just don’t want to schedule a peel less than a week before any major event like a wedding. I make it a point to work with my clients and their social calendar, so that they look their best for any events.

Get Professional Treatment For Melasma

If you have Melasma call to schedule a free consultation at
Paradise Valley Skin Klinic.
480 421-1701

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Read MoreMarch 9, 2011 1:36 pm - Posted by Kristy

Chemical Peel, Sex in the City
Kim Cattrall’s character Samantha, has a chemical peel in a memorable episode of Sex in The City. Unfortunate timing left her with a dark and peeling face the day of Carries Launch Party. It looks as if she had a medium – deep peel. If she were better informed she could have timed her peel so that she looked as gorgeous as usual for her event or just opted for a more superficial peel. Now in her mid-fifty’s, Kim Cattrall looks amazing, I would not be surprised if she has chemical peels to maintain her skin.

Action and Benefits of Chemical Peels

Chemical peeling is used to improve the skin’s appearance by applying a chemical solution to the skin, causing the top layers of skin to separate and peel off. The new skin is smoother, less wrinkled, more even in color, peels can also be used to improve acne. Chemical peels can be performed at different depths, depending on the layer of correction desired. Deeper peels will cause the skin to peel for a longer period of time and provide more improvements in the skin. There are also a variety of acids and peeling agents that can be used alone or together, depending on skin conditions to be treated.

Chemical exfoliation and peels involve using destructive chemical agents to create a controlled wound.
All peels (whether they are chemical or laser) create a mild burn. They improve skin by the wound healing process, new tissue is created and damaged tissue is quickly replaced. Chemical peels stimulate the fibroblasts wound healing activity, the proliferation of fibroblast activity increases collagen and elastin. The depth of the wound determines the amount and intensity of healing. The body’s response to the burn is what yields the results, a deeper peel will result in more correction.

The terms exfoliation and chemical peel are often used interchangeably, however superficial peels are technically exfoliation not a true peel. True chemical peels are generally performed under medical supervision, and penetrate into the papillary dermis.

Chemical exfoliation and peels are a way to speed up the natural migration process of skin cells. When the bonds between cells are dissolved and epidermal cells begin to shed more rapidly. The shedding skin cells send signals for more cell division, which in turn forces keratinocytes to the top of the stratum corneum. This process helps treat acne, fade skin discoloration and leave the skin with a fresh new layer of skin on the surface.

*Dark skin types are more prone to complications such as hyperpigmentation and should go to a professional that is experienced in treating dark skin.

[ Read: Chemical Peel Do’s and Don’ts ]

Skin Layers

layers of the skin

Layers of skin, chemical peel

Epidermis (Epidermal layers)
Stratum corneum horny layer
Stratum lucidum horny layer – only present on palms of hands, soles of feet
Stratum granulosum horny layer
Stratum spinosum basal layer
Stratum mucosum basal layer
Stratum germinativum / basal layer
Dermis ( Dermal layers)
Papillary dermis
Immediate reticular dermis
upper reticular dermis
mid dermis
lower reticular dermis
Hypodermis/Subcutaneous Tissue
Adipose Tissue ( fatty tissue)

Epidermis
The epidermis is completely cellular, meaning it is in a constant cycle of producing new cells while older dead skin cells are pushed to the surface to exfoliate or slough off. The epidermis is made up of keratinocytes, lymphocytes, melanocytes, Langerhans cells and Merkel cells. Approximately 80% -90% of the cells in the epidermis are keratinocytes, with all others interspersed among them.

Dermis
The dermis is a layer of connective tissue, composed mainly of collagen fibers as well as about 5% elastin. The Dermis is subdivided into the superficial papillary dermis and the reticular dermis. The papillary dermis is a thin layer of connective tissue fibers, the reticular dermis is thicker and contains collagen and elastin fibers.

Collagen constitutes 75% of dry skin weight, giving the skin volume. Fibroblast cells lie among collagen fibers and are known to synthesize (produce) collagen. Fully mature collagen fibers have a low turnover rate. Elastin fibers maintain tension in the skin and provide elasticity ( snap back after being stretched). Metabolic turnover for elastin fibers are very slow and only make up about 2% – 4% of dermal volume. Damage or alterations to the elastin fibers network cause skin to become loose, saggy and wrinkled. Fibroblasts are responsible for producing collagen, elastic fibers, and the ground substance of the dermis. Fibroblasts also control the turnover of connective tissue, unfortunately with age they become smaller and less active.

Understanding the depth of a chemical peel

With chemical peels, the depth is determined by the agent used, concentration of agent, and time applied. {click to view photo’s of peeling}

Very Superficial
Penetrates to Stratum Corneum, Peeling is complete in 0-3 days. Very superficial peels can usually be done as often as once a week. This type of “peel”, generally produces little to no peeling and is ideal for anyone that can’t afford any downtime.

[ Chemical Peels: Superficial Peels Create Little To No Peeling ]

Superficial
Penetrates between the stratum granulsome and stratum germinativum basal layer of epidermis. Peeling is complete in 3-7 days, superficial peels can usually be repeated in 4 weeks. Ideal for most skin types including acne prone skin. This is the most common form of chemical peel performed by estheticians. There isn’t any true “down time” with superficial peels, only what is referred to as “social down time”. You can generally continue normal activities including work, however superficial peels should be done a week before any special events. You can expect to be slightly red or bronzed and have a few days of superficial peeling. On day 1 and 2 skin is slightly red or bronzed, skin starts to peel around day 3 and continues to peel for 2-3 days, may have minimal areas of superficial peeling on day 7. You may be red or pink first few days after peel.

Medium
Penetrates papillary dermis, performed under medical supervision. Peeling is completed in 7-8 days, medium depth peels can be repeated as soon as 6-8 weeks, however it isn’t usually necessary. Peeling skin will be darker and thicker with medium peels vs. superficial peels. Skin will start to darken on day 2 or 3, slight peeling around mouth on day 3, skin will continue to peel until day 7 or 8, starting around mucus membrane ( eyes, nose , mouth) and the forehead usually peels last. Toward end of peel you may just have slight peeling in the hairline. Often times you look okay the first 2 days and last 2 days, it is day 3- 6 that look bad. Exfoliating products and treatment need to be avoided for at least six weeks after a medium depth peel. You can start to see complications at this level, skin should be precondition before peel, especially for darker skin types. Should not be performed on skin with active acne. Follow post treatment instructions to avoid complications. Treats: skin discolorations, epidermal melasma, skin roughness, large pores, fine lines. If peel is medium – deep you may see improvement in stretchable scars and wrinkles. The “Standard Obgai Blue Peel” is a medium depth peel.

Deep
Penatrates to Intermediate Reticular Dermis (IRD). Peeling is completed in 8-10 days. Must be performed under medical supervision. Skin should be preconditioned in advance, and skin should not have any active acne. Following proper post treatment care is important, to prevent complications. This level of peel can be done with phenol, however TCA and lasers have largely replaced phenol peels. This treats: lines, wrinkles, deep melasma, and some scars, The” Designed Blue Peel” is a deep peel. With deep peels the skin will start to darken very quickly and may not start peeling until day 4 or 5, peeling skin will look very dark and thick almost like a thin scab. It is important that you do not assist the peel by picking or pulling skin off, loose peeling skin should be cut of with small sterile scissors to prevent inadvertently removing skin prematurely.

Very Deep
Penetrates upper to mid reticular dermis. Peeling takes up to 3 weeks.
Special training is required, done by a physician. Lasers have largely replaced very deep peels.

Acids and Chemical Peeling Agents

Chemical peels use several types of acid solutions to improve and smooth the texture of skin. Acids come in different strengths and can be used individually, combined or layered. A variety of acid compounds can be used. There are many branded peels, however an experienced esthetician can also create custom peels.

CO2 (cryogen therapy)
Cryotherapy, also called Co2 slush or acne slush, has been used in dermatology for over a quarter of a century. Co2 slush is created at the time of treatment, liquid Co2 is made into a “snow” ball and wrapped in gauze or cheese cloth and then dipped into acetone. The “slush” is the lightly swiped over the treated areas. Cryogenic “slush” can cause mild exfoliation and has antibacterial and anti-inflammatory abilities. Cryogen therapy is added to some superficial peels at the end of treatment
Also known as: Dry ice treatment, acetone slush and slush peel

Glycolic acid
AHA (alpha hydroxy acid), AHA’s are water soluable. Glycolic acid is formulated from sugar cane, and has the smallest AHA molecule, giving it great penetration ability and softening ability. Glycolic acid works by loosening up the horny layer and exfoliating the superficial top layer, also stimulates collagen growth. Needs to be neutralized to stop action, and can cause irritation.

Lactic Acid
AHA, derived from sour milk and bilberries, mild action, often used in conjunction with other acids.

Malic Acid
AHA, derived from apples, mildly invasive peel It can open up the pores, allow the pores to expel their sebum and reduce acne.

Tartaric Acid
AHA, derived from grapes, mildly invasive, similar benefits to other AHA’s

Salicylic acid
BHA (beta hydroxy acid), derived from wintergreen and birch bark. Differs from AHA’s, because it is oil soluble and penetrates the lipid plug in a congested follicle. Salicylic acid is also less irritating than glycolic acid and doesn’t alter skin barrier properties. Has antimicrobial properties.

Retinoic Acid
derived from retinoids; which is denatured vitamin A. It is chemically similar to Retin-A. It is a deeper peel than the Beta Acid peel and is used to remove scars as well as wrinkles and pigmentation problems. It is usually performed in conjunction with other acids to a cause peeling at a deeper level.

Resorcinol
A dihydroxy phenol produced from resins. Used externally resorcinol is an antiseptic and disinfectant, and is used in ointments in the treatment of chronic skin diseases such as psoriasis, and eczema. Resorcinol has been used as a peeling agent as far back as 1800 in strengths up to 30%, the problem with high concentrations of resorcinol is it’s corrosive ability and tenancy to depigment. Currently it is used at low concentrations in chemical peel compounds such as Jessner’s Peels.

TCA (Trichloroacetic acid)
TCA is a chemical cauterant, an agent that coagulates skin proteins. TCA can be used in different strengths and has the ability to penetrate past the papillary dermis and should be used with caution. TCA in concentrations less than 25% can be used in superficial peels. Medium depth peels are achieved with 30-40% TCA, and 50% TCA should only be used by a physician to achieve a deep peel and has greater chance for complication. TCA is used in the Obagi Blu Peels.

Phenol
Phenol is a very strong and toxic chemical, phenol peels require general anesthetic and heart monitoring. Lasers and TCA have largely replaced deep phenol peels, however low concentrations are often added to superficial and medium depth peels.

The Medical Estheticians at Shapiro Plastic Surgery, Paradise Valley Skin Klinic are experienced with chemical peels at all levels.
Call to schedule a treatment or consultation.
480 421-1701
www.shapiroplasticsurgery.com
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Read MoreSeptember 20, 2010 2:15 am - Posted by Kristy