Posts Tagged ‘TCA’
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).
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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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.
VIVITÉ® Glycolic Chemical Facial Peel is a buffered 70% glycolic compound. This is a very superficial peel, with little to no visible peeling. Its advanced formulation helps improve overall skin clarity and smoothness and helps reduce the appearance of fine lines and wrinkles. This peel is also ideal for
mild – moderate acne.
MICRO PEEL/AHA
The mildest of peels that corrects minor problems such as rough or dry skin and sun damage. A gentle, three step exfoliation rehy- drates below the skin’s surface to stimulate collagen production. This treatment begins with (dermaplaneing) gently scraping the skin with a surgical blade to exfoliate skin and remove hair. After dermaplaning the skin, a light AHA peel is applied. This is a very superficial peel with little to no peeling. Ideal for most skin types, not recommended for skin with active acne.
Sensi Peel® Exfoliating Treatment
This gentle TCA solution is formulated primarily for ethnic skin, and other extremely sensitive skin types. Sensi Peel® will strengthen and brighten the skin while helping to treat sun damage and other forms of hyperpigmentation (skin discoloration). This multi-faceted treatment also provides anti-inflammatory, anti-acne and antibacterial action, making it an excellent choice for helping calm rosacea, as redness and inflammation can subside substantially after treatment. This peel creates very mild peeling.
Key Ingredients
Lactic Acid
Trichloroacetic Acid (TCA)
Azelaic
Kojic Acid
Arbutin
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
Patients achieve enhancement of skin appearance with minimal downtime and discomfort
Appropriate for first-time chemical peel patients or patients looking for a gentle, very superficial peel
May be performed on Skin types I- VI
Little or no visible peeling
Paradise Valley Skin Klinic offers a wide variety of peels at all depths.
Call to schedule a treatment or consultation. 480 421-1701
www.shapiroplastic surgery.com
You can follow Paradise Valley Skin Klinic on facebook.
Thank you for visiting Best of Both Worlds Az.
You can follow us on facebook, twitter and on our blog site.
www.bestofbothworldsaz.com
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
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
You can follow Paradise Valley Skin Klinic on facebook
Thank you for visiting Best of Both Worlds Az.
You can follow us on facebook, twitter and on our blog site.
www.bestofbothworldsaz.com
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