This sharing is for informational purposes, you should definitely consult your doctor for diagnosis and treatment.
Each treatment may offer different results and different duration of effectiveness for each person.
I wish you healthy and beautiful days...
The purpose of peeling applications; It is the "peeling" of the worn, damaged, upper part of the skin that has lost its freshness and brightness, and the restructuring of the skin support tissue (such as collagen, elastin) by increasing its quality. After the application, the skin surface acquires a fresh, clear, lively and bright expression, and it is purified from its problems and becomes almost rejuvenated. Peeling treatments are used for shrinking pores, treating acne and acne scars, treating sun and age spots, treating fine wrinkles, relieving deep wrinkles, and treating hormonal and pregnancy-related spots.
Since it is a medical intervention, it must be applied by a specialist doctor!!!
Methods used in peeling applications; (Fruit acid, chemical, laser, snow)
Chemical Peels; It is made by applying chemical substances to the skin.
Laser Peels; Erbium and CO2 (carbon dioxide) are made with laser.
Laser Carboxy Peeling; It is the application of a Q-swiched laser after the application of a carbon-containing gel to the skin.
Jetpeeling; They are peelings made with high pressure water.
Microdermabrasion; They are peelings made with mechanical special sanders.
Peeling; It is the process of peeling and repairing the skin at the desired depth with the right technique to be applied on the skin. With the appropriate peeling methods to be chosen individually, a controlled damage is created in the upper and deep layers of the skin at the desired depths, and a more lively, smooth and healthy appearance is provided to the skin by peeling. After the application, repair and restructuring of the skin begins, as a result of which the skin support tissues increase, making the skin look more tense, fuller and even younger.
Chemical Peeling Applications in History (fruit acid, chemical, snow);
Chemical peeling applications are encountered in ancient Egypt, India, Hungarian Gypsies and France in the form of milk, plant juice masks and red wine masks. Chemical peels for medical purposes were developed by P.G Unna in 1882. In 1941, Eller and Wolff started to use chemical peels for acne and acne scars.
In Anatolia, we see that peeling is done on the skin with the effect of fire and heat, and chemical peels are made with curdled milk or fruit juices.
Chemical peeling applications are widely used today with a wide variety of chemical content.
The most commonly used agents in chemical peeling processes are;
Alphahydroxy acids (AHA) ;
Betahydroxy acids (BHA) ;
Alphaketo acids (Pyruvic acid) ;
Retinoic acids ;
Azaleic acid;
Jessner solution;
Resorcinol ;
Trichloroacetic acid (TCA) ;
Phenol;
liquid carbon dioxide and
It is kojic acid.
They can be used alone or in combinations. All of them have different purposes, efficacy and selection criteria according to the patient.
Peeling application areas and session intervals vary from person to person and the depth of the process, but vary between 1 week and 6 months. Again, the number of sessions is determined according to the person between 1 and 8-10.
It is often applied to the face, neck, décolleté and hands, but can be applied to all desired body areas.
What are the clinical uses of chemical peeling?
In the treatment of acne,
In the treatment of acne scars, wounds, burns, scars and scars after surgery and accident,
Correction of enlarged pores,
Elimination of fine lines and lightening of deep wrinkles,
In the removal of melasma, spots, freckles and color irregularities,
In giving the skin a younger appearance (skin rejuvenation - antiaging),
It is used in the treatment of skin diseases such as actinic keratosis (precancerous skin spots due to sun damage) and solar lentigo.
Peeling session intervals vary according to the patient and the peeling depth. Although it varies according to the patient and the application technique, it is applied every 1-2 weeks for very superficial and superficial peels, 1-2 months for medium peels and every 2-6 months for deep peels.
How is Chemical Peel Classification?
Chemical peels are divided into 3 according to the depth of the damage developed after the application. This classification; It also determines the purposes of use and the recovery period of the patient after the application.
1-Deep Chemical Peeling applications (0.6-0.8 mm damage depth on the skin);
Phenols and TCA combinations are used for Deep Peeling.
Deep Peels are used in skin aging symptoms due to severe sun damage, color distribution irregularities, advanced wrinkles and skin sagging due to aging, and severe acne scars.
Recovery time after application; 2-4 months.
2-Medium Chemical Peeling applications (0.45-0.6 mm damage depth on the skin);
Medium Chemical Peeling TCA, TCA+Jessner sol. combination, liquid Carbon dioxide + 35% TCA combination, pyruvic acids are used.
Medium Chemical Peels; It is used in skin aging symptoms due to severe and moderate sun damage, color distribution irregularities, moderate wrinkles and skin sagging due to aging, actinic keratosis and moderate acne scars.
Recovery time after application; It is 2-6 weeks.
3- Superficial Peeling applications (0.06 mm damage depth);
TCA, Jessner solution, AHA, BHA, Azaleic acid, retinoic acid, lactic acid, salicylic acids are used for superficial peeling.
Superficial Peels are used for active acne treatment, skin aging and discoloration due to mild sun damage, light lines and wrinkles, acne and mild acne scars.
Recovery time after application; 1 week.
What are the results of chemical peeling applications?
The results of chemical peeling applications are quite variable. There are many factors that affect the application results. Results may vary depending on factors such as choosing the appropriate patient and chemical peeling method, preparing the patient for peeling, home care after peeling, and the expertise of the doctor performing the application.
How is chemical peeling applied?
Evaluation of the patient, determination of the appropriate peeling method, scheduling of the sessions.
Preparation of the patient for peeling before the application (use of home product for 10-14 days).
After Peeling application;
Cleaning the patient's skin
Removal of sebum (oil secretion from the skin) from the skin in the area of application. (cleaning with alcohol or acetone),
Removal of the dead layer on the skin by scrub, exfoliation or microdermabrasion methods in patients who are deemed necessary,
Protection of the corners of the eyes, mouth and nose (vaseline application). Protection of open wounds, tattoos, piercings in the application area,
Application of the chemical agent and waiting time (depends on the applied solution and the reaction on the skin),
Cleaning the chemical agent from the application area,
Application of more intense chemical components and serums to the target areas in the application area,
moisturizer application,
The use of sunscreen,
Carrying out post-peeling care and preparing for the next planned peeling session.
Is there a feeling of pain during the application?
In very superficial, superficial peelings (due to the acid structure of chemicals), there is only a slight stinging and burning sensation in the application areas. This feeling, which patients can tolerate very easily, disappears in 15-30 minutes. It does not require anesthesia during application. It is sufficient to use only cooling air or cold gels. In medium and deep peels, the stinging and burning sensation may be more intense and even pain may occur. For this reason, it may be necessary for the patient to take relaxing drugs before the procedure, use local anesthetic creams or needles in the application area, and even general anesthesia in some patients.
What will I encounter after the application?
Although it varies according to the depth of peeling, redness and mild edema develop after the application. This redness and slight swelling increase after 24-48 hours and occur more in the neck, especially around the eyes and mouth. After 48 hours, redness and edema regress and disappear. In deeper applications, the skin 2-3-4. days, it leaves itself to a slightly hard mask-like layer with superficial color darkening. This layer is then peeled off. Although the peeling process varies according to the depth of the application, it is completed in 1-2 weeks. After peeling, a slight pinkness occurs on the skin and this appearance disappears within 1-2 months.
While the superficial changes are observed in the early period with the regeneration of the skin of the patient after peeling, the effects on the deeper tissues begin in 1-2 weeks and appear in exactly 1-3 months.
Situations where chemical peeling cannot be applied – what are the contraindications?
In pregnancy and those receiving treatment for pregnancy,
Those with very dark skin tone,
Those with a history of keloid/scar (poor wound healing),
In those with open wounds, herpes (herpes) and active infection in the application area,
Those with severe acne such as cystic acne,
In those with severe general system disease,
Those who have received radiotherapy in the last 1 year at the application site,
In those who have too many capillaries in the application area,
In those who are at risk of intense sun exposure,
Peeling procedures should not be applied in AIDS and HIV carriers.
What side effects are seen in chemical peeling applications?
Although it is one of the procedures that are extremely safe and have the least side effects, the causes of rare side effects are as follows;
Failure to perform patient procedures before and after the application,
Insufficient protection from the sun
The patient has a poor tissue healing structure and this is not evaluated well before the application,
Incorrect selection of chemical peeling method,
Use of wrong peeling agents outside the application areas, etc.
Side effects ;
Edema
After all peelings, mild to severe edema may develop, especially around the eyes and mouth. It appears in the first 24-72 hours and then disappears spontaneously.
Pain
In the first 24 days after the application, mild pain may occur in superficial peelings and sometimes severe pain in deep peelings. This is controlled with anesthetic creams and painkillers.
erythema (redness)
There is redness after all peelings, and the severity and duration of this vary depending on the depth of the peeling. It goes away completely between 2-8 weeks.
Acne
Intense moisturizers used after the peeling application can cause acne-like rashes, but they go away on their own. Rarely, treatment may be required.
Infection
Due to the characteristics of the acids used in peeling, the process is sterile, but the intense creams and pomades used in skin care after the application may increase the development of infection. Antibiotic use may be required.
Herpes (herpes)
Unlike the classical-looking herpes, it starts with direct wounds, not blisters. Medication must be used.
Color changes
After the application, areas of darkness or skin tone may appear.
milia
It develops 2-3 weeks after the application, especially when the skin begins to be repaired. It increases milia development in pomades used after application. It disappears completely with treatment in its formation.
demarcation line
(It is the formation of a sharp border between the peeled area and the non-peeled area.) It is especially observed in deep peelings. This side effect is not observed in the correct application.
Scar (Poor wound healing)
It is the most serious undesirable side effect.
Side effects may develop depending on the content of the chemical substance. For example, tinnitus, headache and dizziness may develop after salicylic acid peels.
What should be done before Chemical Peeling?
The patient should be questioned whether there is an allergy to the peeling agent to be used. For example, milk, sugar, apple, citrus fruits, aloe vera, aspirin, peeling agent that does not contain them should be chosen for allergy sufferers.
Peeling should be started in winter. The time allotted for treatment should not extend to the summer months.
2-4 weeks before the peeling application, the cleaning, sunscreen products and some mandatory drugs (for reducing oil secretion, reducing pigmentation and thinning the upper layer of the skin and accelerating the repair of the skin after peeling) should be arranged and their use should be ensured. These should be cut 2-5 days before the application.
The products used before peeling should also include the products to be used after peeling. Thus, it is observed how well the patient's skin tolerates all products.
The use of acne medications such as isotrethionine should be discontinued 6 months ago.
Epilation, microdermabrasion and electrolysis applications should be interrupted 2 weeks before the application.
The use of hair dye should be discontinued 2 weeks before the application.
In some risky patients, preventive medicine is started for herpes 2-3 days before the application. This drug is continued for up to 1 week after the peeling application.
One week before the application, activities such as sauna, gym, swimming and spa should be minimized or even interrupted.
What should be applied after Chemical Peeling?
The recovery period of the controlled wound created on the skin after the application is the healing phase of the skin called full reepithelialization. Healing in very superficial peels is 3 days, in superficial peels 4-6 days, in medium depths 7-8 days and in deep peels 10-14 days. During this period, proper skin care and protection of the skin are extremely important.
The patient who is applied superficial peeling can return to his daily activities immediately. In these patients, washing the face with a non-drying cleaning product, moisturizing it and protecting it from the sun provide adequate care. In medium and deep peels, the patient can return to his daily activities only after 1-2 weeks. These require different and intensive care products.
Until reepithelialization develops, the patient should not remove the crusts, but should allow the peeling to end by itself.
Post-procedure tension and dryness develop in the application area. A moisturizer suitable for the skin type should be applied.
Sunscreens should be used for at least 6 months (8-10 times a day).
Showering should be started when reepithelialization develops.
Intense edema that may develop on the face, especially on the eyelids, may cause mild double vision called diplopia. The patient should be careful in this regard. The use of cold compresses for 2 days after the application, the patient's lying on a high pillow and the use of anti-edema medication can control this.
Aesthetic interventions to the face (such as botox and filler applications) should be performed 2-4 weeks after peeling, and aesthetic surgeries and ablative laser applications should be performed 3-6 months after peeling, depending on the doctor's evaluation.
Laser epilation and IPL applications can be done after 2-4 weeks.
Pain relievers can be used after chemical peeling.
If erythema (redness) continues after 1 week, the drug should be used.
After the application, alcohol and cigarette use should be reduced or even discontinued for 1-2 weeks.
Intense exercise and excessive sweating should be avoided.
In case of taking a bath, hot water should not be kept directly on the application area, and no scrubbing or fiber should be made.
After the application, the drugs and methods to be recommended for pain should be applied.
Itching occurs in all peeling depths. Therefore, the application area should not be itchy. For this, antihistamines (allergy drugs) can be used.
In order not to adversely affect the results of the application, one should not get pregnant within 6 months after peeling, and drugs such as birth control pills, vitamins A, some antibiotics (tetracycline group) and estrogen that will increase sensitivity to light and sun should not be used.
Applications such as depilatory, wax, depilator should be postponed for 1 week to the application area.
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