To Peel Or Not To Peel
The major purpose of the skin is to form a protective barrier to prevent the loss of body fluids. Yet the barrier must be permeable to certain fluids and gases and must constantly regenerate. The desquamation is the natural shedding of the top layer of the skin to allow for the skin renewal process to continue.
A little bit of skin anatomy
The basal layer is a fully active, multi-potential layer of cells, capable of almost endless replication to supply new cells to the outer surface.
The spiny layer is where the cells take the first step of cellular differentiation. The immature cells develop into a fully functional end cell, no longer able to divide or grow.
The granular layer is the second cellular differentiating step in which the cell nucleus is completely taken apart and degraded and new, tough keratin fibers start to form.
The corneum layer is the last differentiating step of the process in which the young keratocyte is formed into a hard, water resistant cell.
This process of migration from the basal layer to the corneum layer takes approximately 28 days, which is the renewal time for the skin.
The cells are hooked together by cell adhesion proteins called desmosomes. As the living cells move to the top of the skin, these desmosomes should become weaker so certain enzymes could effectively break their bonds and free the cells to flake off. Changes in lipid composition, water content, PH imbalance, and the action of certain enzymes are known to affect the desquamation process and imbalance the natural cell turnover process.
With advancing age, the enzymes that allow the skin cells to slough off became less efficient so old, scale, skin remains in place longer. This gives the face a dull, yellow appearance.
While daily cleansing, hydration and moisturizing of the skin is very important to maintain good hygiene and the fragile balance of the protective barrier, superficial peels can remove the scale skin, improving radiance, increase smoothness and create a more even appearance.
So, how did we get here? A short history of peels.
Chemical peeling or skin resurfacing is an ancient practice probably dating back to the early Egyptians. While only Fruit Acids and Lactic Acid from milk were available to the Egyptians, physicians began using Salicylic Acid, Resoscinol, Phenols and TCA in 1882.
Antoinette La Gasse introduced chemical peels to the United States in 1930. This was the first time phenol based chemical peels were used to remove wrinkles. Throughout the years, deep surface chemical peeling became more popular with dermatologists and plastic surgeons but during the 1930s, the superficial peel was developed in Europe and brought to the United States by European trained estheticians.
While the Resoscinol based peel known as Jesner has changed very little since its discovery, newer hydroxyl based peels and cocktailed combinations have entered the market to safely remove the scale cell layer of the skin.
The newest in the skin resurfacing is the Korean based Fractional Cellular Regeneration or FCR Peel which uses Coral Calcium spicules combined with botanicals and alpha hydroxy acids to activate the desquamation process and remove acne scars, fine line and wrinkles and sun damage.
So, what is the peeling process?
Chemical resurfacing involves the use of acidic agents to remove layers of the skin in a controlled fashion. The key is to remove skin only in the desired layers and not deeper. Superficial peels should only remove desquamating cells on the surface to allow the skin to glow and absorb more nutrients.
Deeper peels intend to induce skin damage and allow healing to occur such that the damaged skin is replaced by newly healed more aesthetically pleasing skin. The goal is to leave the skin looking and feeling better.
The five stages of wound healing after a chemical peel are:
Coagulation and Inflammation - superficial peel
Re-epithelialization – superficial and mild peels
Granular tissue formation - mild and deep peels
Angiogenessis (development of new blood vessels) - mild and deep peels
Collagen remodeling – deep peels
These stages could take from a few hours to two weeks depending of the peel and peel strength.
When should you choose a peel?
You should choose a chemical peel if your skin is sun damaged, comedonal (blackheads and whiteheads and acne) minor pigmentation abnormalities and aging skin (fine lines and wrinkles)
Severely sun damaged ski, collagen remodeling and granular tissue formation (scars) responds best to mild and deep chemical peels performed in a dermatologist office while fine lines, Re-epithelialization and minor abnormal pigmentation can safely be treated in an esthetician office.
Best ways to care for your skin after a chemical peel
Once the old, unattractive skin has been peeled off, now you have a new canvas to work with. Continue using antioxidants, bioflavonoids which reduce enzymatic destruction of collagen and elastin and vitamin C. Do not use aggressive antiaging products as the skin needs time to adjust to the recent trauma instead use moisturizers that are simple, without active ingredients such as retinol, retinA or glycolic acids.
As cold weather is the best time to peel, call your dermatologist or your esthetician and schedule your perfect day to peel away.
source: “Physiology of the skin” Zoe Diana Draelos MD and Peter T. Pugliese MD
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I spent my life in this industry and I've seen a lot of myths and pure misinformation. My goal is to bring you the truth about skin care and the latest beauty procedures