Posts Tagged ‘complications’
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 ]
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.
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.
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.
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.
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
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.
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.
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Cosmetic Laser Warning!
What you need to know before choosing to do a cosmetic procedure.
On one complaint website, there were 1,437 complaints regarding laser treatments and over 600 for one specific laser center. If you decide to go to a laser center based on their social media following or because you are looking for a low cost, you are taking a gamble. Some clinics hire inexperienced, even unqualified technicians to do treatment and rarely have a Doctor on site. A clinic may have a “medical director” on staff whom acts as a medical director for several locations. A med spa with a medical director on staff does not mean it is the medical practice of that person, in fact the medical director may never actually be in the clinic. I have even heard of cases where the “medical directer” was in another state. Med Spas often set sales quota’s for employees, so technicians are pressured to rush treatments. I call this type of practice ” turn em’ & burn em’ “. I don’t blame the technicians, it’s just a poor way to do business. These types of laser centers usually have a very high employee turn over rate and many unhappy customers.
Increasing popularity for Laser, IPL and RF treatments has lead to an increase of treatment complications. A poorly done laser treatment can lead to burns, hyperpigmentation, hypopigmentation, ocular injury, scars and a simple lack of results. Most complications are preventable and all are manageable. The increase in complications is primarily due to lack of training, experience, and medical supervision. It is important to know that it is not just the technology, it is also the technique that determines the result of a treatment. Cosmetic and laser treatments can be complicated and are best done by an experienced technician. Laser and IPL treatments all come with some inherent risk, which you should understand and except before you consent to treatment. Burns and other side effects can result even when treatment is performed by the best and most experienced laser technicians.
With all the new products and technology available today it is easy to be confused, when choosing a treatment. Laser, IPL, LED, Infrared, Radiofrequency and fractional resurfacing are all energy based technologies and each have different indications. A knowledgeable esthetician / laser technician can educate you on energy based treatments in addition to other treatment options. In some cases a chemical peel, Botox, or a cosmetic filler may be a better option than laser. A consultation with an experienced esthetician can help you to make an educated decision on treatment.
It’s easier to stay out of trouble than to get out of trouble.
Patients play an active role in their treatment.
Tanning is a contraindication to most laser and IPL treatments, it is the patients responsibility to use proper protection from UV rays and inform technician of any possible sun exposure. Follow all pre and post treatment instructions, including keeping skin cool. Patients that are noncompliant may be responsible for treatment complications. Anyone with dark skin is at increased risk for complications, and should look for an experienced technician that specialize in treating dark skin.
When choosing to do a cosmetic procedure always look for someone who is experienced with proper training and a successful reputation. Do not base decisions regarding laser treatments, solely on price. A poorly done treatment will cost you more in the long run. Laser clinics should not operate the same as a tanning salon or health club. Laser treatments are serious and should be treated as such.
Are they telling you what you want to hear?
Regardless of the technology, laser hair removal usually requires a minimum of 12 treatments on the face and 8 treatments on non-facial areas. In most cases periodic treatments are needed to maintain results. Laser technicians that tell you that you will only need 5 treatments are not necessarily lying to you intentionally, this is often what they are told by the companies that manufacture lasers. Same applies to claims of safely treating tan skin or effectively treating light hair, although it may be possible don’t count on it.
Questions to ask:
Are you a licensed esthetician and certified laser technician in this state?
Is there a Doctor on location?
How long have you been doing laser treatments?
How long have you worked with this laser or device?
How long have you been in this clinic?
Have you treated my skin type before?
If you have been burned
Most complications are manageable, and can often be completely resolved. Treatment protocol will depend on severity of burn. In some cases the “burns” are not as severe as they look. If it is just superficial redness with speckles of dark, you may even get a nice result. Unfortunately some burns may need medical attention and can lead to scarring. If you have been burned, return to the laser clinic immediately for follow up care. Proper treatment of the skin post treatment can make all the difference.