Posts Tagged ‘peeling’
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.
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.
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.
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.
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.
Tretinoin ( retinoic acid) is the acid form of vitamin A and is available as a cream or gel (brand names Retin-A, Renova, Aberela, Airol, Atralin, Avita, or Stieva-A). Tretinoin was FDA approved as a topical medication in 1971. Tretinoin treats acne, minimizes pores and reduces oiliness. The anti-aging benefits of tretinoin include, reducing appearance of fine lines and skin discoloration.
Tretinoin promotes detachment of cornified cells and the enhanced shedding of corneocytes from the follicle. Tretinoin also increases the turnover rate of thin, loosely-adherent corneocytes. By making keratin softer and more gelatinous, the stratum corneum becomes soft and compact. Tretinoin suppresses the melanocytes, this is why it is often used when treating skin discoloration.
Tretinoin stimulating fibroblast.
It is believed that tretinoin stimulates the fibroblast. Some studies suggest that tretinoin can help firm the skin by stimulating fibroblast activity. Fibroblasts produce collagen, elastic fibers, and the ground substance of the dermis. With age fibroblasts become smaller and less active.
Tretinoin enhances the skin healing process.
Studies show that topical use of tretinoin before chemical peels, enhanced healing. There is more epidermal regeneration and collagen regeneration appears to be faster when skin was pre treated with tretinoin.
Tretinoin makes my skin peel and it feels tight and dry.
Initially, tretinoin dehydrates the skin the outer surface of the skin ( stratum corneum ), causing a rapid exfoliation. The good news is, tretinoin repairs the damaged keratinocytes, increases mitosis, and restores proper hydration. With time your skin builds up tolerance and reactions subside.
Does tretinoin thin the skin?
I have heard people say, “don’t use tretinoin it thins the skin”. I think there is some confusion, about what part of the skin is thinning and if that is a good or bad thing.
Tretinoin works by thinning the outermost layer of the skin (stratum corneum), while cells in the epidermis are stimulated to produce a thicker epidermis layer. Collagen production and cellular growth in the dermis layer also increases. Although it is true that tretinoin does thin the stratum corneum, it actually makes other layers of the skin thicker. Thinning the stratum corneum isn’t exactly a bad thing. With age the statum corneum can become thick and dehydrated causing the appearance of fine lines and rough, sallow skin.
Epidermis Stratum corneum, outermost layer with dead keratinocytes being exfoliated off.
Is retinol the same as Retin-A ( tretinoin)?
Many people confuse retinol with Retin-A (tretinoin). Retinol and retinoic acid (tretinoin) are related but distinctly different. Retinol, retinal and retinyl palmitate, do not have the same effect on the skin as tretinoin/ retinoic acid. They first need to be converted by special enzymes into the active metabolite, retinoic acid. Unfortunately , the conversion rate is low and varies among individuals. The other problem is that when retinols are exposed to air, they can become oxidized and degraded. There are some companies that have produced retinol formulas that are more stabilized.
Tretinoin vs AHA’s
Tretinoin causes a rapid coarse exfoliation, which is the shedding of attached group of cells. AHA’s cause shedding of individual cells. The action of AHA’s is extracellular, compared to the intracellular action of tretinoin. The intracellular action of tretinoin works goes into the dermis and stimulates the fibroblast. The effects of tretinoin can last up to four months even after product has been discontinued, in contrast to the short lasting smoothing effects of AHAs.
Tretinoin is a drug.
Tretinoin is a drug and should be used only as prescribed. There are certain contraindications for using Tretinoin, including pregnancy and nursing. You should not wax skin that has been treated with tretinoin and some skin treatments are not recommended while using tretinoin. Be sure to discuss possible contraindications with your skin professional.
*You should never purchase Tretinoin or any other prescribed drug on line.