Q&A:The latest tool in skin rejuvenation : chemical peels

*Dr. Alka Dogra

Q. What is chemical peel?

A Chemical peel is the application of one or more chemical agents to the skin, so as to cause controlled chemical burns resulting in destruction of a portion of epidermis and / or dermis followed by resurfacing of the epidermis along with remodelling of collagen leading to rejuvenation of skin.

Q. What is the classification of chemical peels?

A. The classification  is done depending upon the level/depth  the  peeling agent achieves.According to Mark Rubin’s Classification, peels are broadly divided into:

 Very superficial

Superficial

Medium

Deep

Q. What are the indications for chemical peel?

A  a. Post acne hyperpigmentation

     b. Acne scars

     c. Post chicken pox scars

     d. Post trauma scars

     e. Melasma

     f. Post inflammatory hyperpigmentation

     g. Other pigmentary conditions like Lichen planus pigmentosus, Macular amyloidosis

     h. Photo ageing

     i. Aesthetic- Dilated pores, fine wrinkles

Q, What  are the advantages of chemical peels?

A. 1) Safe,  quick and inexpensive office procedure for re-juvenation of skin and  photoageing

2) Wide patient acceptance due to simple technique

3) Less time consuming OPD procedure                                                                

Q. What are spot chemical peels?

A. It is the wounding of skin surface carried out only to a limited, affected area; small or large but well localized ( not full face or region).

Q. What are the indications for spot peels?

A. When lesions  are well-localised – postinflammatory hyperpigmentation , peri-orbital hyperpigmentation

Q, What  are the precautions for the patients who are undergoing chemical peel treatment?

A. 1) Adequate sun protection post- procedure

      2) Use of sunscreen with SPF 15 or more post- procedure. Sunscreen  has to be applied half an hour before going outside and repeated 2 hourly

      3) Adequate pre-peel priming with either Tretinoin 0.025% - 0.05%  or Glycolic acid 6-12% or Hydroquinone 2% at night time for 2 weeks

Q. What are the side-effects of chemical peels?

A. 1) Mild pruritus and burning sensation during procedure

     2)Postinflammatory hypo or hyperpigmentation if adequate sun protection is not taken post-peel

Q. What is the schedule for chemical peel?

A. There is no fixed schedule . It can be done every 15-20 days till the desired effects are achieved. Maintenance peels as and when required can be given.

Q. What  are the types of chemical peels available ?

A. 1) Glycolic  Acid  peels (GA peel ) – 35%, 50%, 70%

     2)Trichloroacetic acid peels ( TCA peel ) – 20% ,30%

     3) Salicylic  acid  peels ( Sali peel ) – 20%, 30%

(*The author is Professor & Head, Dept of Skin & V.D, DMC&H , Ludhiana)