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How Chemical Peels Rejuvenate the Skin

Sun exposure can cause discoloration of the skin as well as roughness and wrinkling. This damaged skin can be repaired to a large degree with a variety of rejuvenating treatments.

One of the methods that restores the skin’s natural beauty without significant downtime is a chemical peel. Peels are a great way to brighten the skin and reduce discoloration.

History of Chemical Peels

Interestingly these procedures have been performed for centuries.  The ancient Egyptians used acids to peel the skin as early as 1550 B.C. Dermatologists have been doing the modern day version for more than half a century. The procedures we use today have been greatly refined, and so has our approach to using them.

Modern Chemical Peels

Peels can be tailored for skin type and the type of skin damage. It’s not a “one size fits all approach to anti-aging. Peeling agents include an alphabet soup of  some combination of the following: salicylic, retinoic, mandelic, phytic, and tricholoracetic acids. We choose an agent or agents based on the tone and condition of the skin as well as the desired outcome.

Today’s chemical peels often infuse the skin with ingredients that encourage its own natural processes such as building collagen to diminish wrinkles and improve tone. They can also be combined with other procedures such as microneedling to enhance the penetration of active agents.

Different Types of Chemical Peels

Here’s a primer on peels.  A light peel, commonly called a lunchtime peel, gently exfoliates only the outer layer of skin. This treatment can improve mild discoloration as well as refresh the face, neck, chest or hands. Regular light  peels for acne work well with other treatments and can help reduce the need for prescription oral antibiotics. Light peels are also an excellent solution for patients of color looking to lighten the skin.

To get the results you seek from a light peel, you will need multiple treatments, depending on your goals. Melasma or hyperpigmentation on the face will require several sessions of chemical exfoliation to eliminate the pigment.

A medium peel penetrates the outer and middle layers of skin to improve age spots, fine lines and wrinkles, freckles and moderate skin discoloration. It also can be used to smooth rough skin and treat precancerous skin growths such as actinic keratoses.

Deeper peels are also designed to penetrate the middle layer of skin to remove moderate lines, age spots, freckles and shallow scars.

Preparing for a Chemical Peel

Preparation for a peel is as important as the peel itself.  You may be given instructions on a skin care plan- especially if you have darker skin tones- for the 2-4 weeks preceding a peel. After your peel you we will tell you how to care for your skin, when it’s safe to begin wearing makeup and what you should be using to maintain the benefits of your peel.

Peels are a customizable approach to healthy anti-aging and a natural aesthetic.

Contact us with questions and to book your appointment.

melasma example dark spots on cheek

What is Melasma & How to Treat It

melasma example dark spots on cheek

In addition to wonderful memories, summer can leave behind unwanted darkening of the skin.  Persistent hyper-pigmentation of the face, called Melasma, occurs on the cheeks, bridge of nose, forehead, upper lip and occasionally the forearms.  It is similar in appearance to age spots, but the dark patches cover a larger area.

Melasma occurs in all skin types, but especially in skin of color.  East Asian, Southeast Asian, Hispanic and Blacks populations have the highest rates.  Up to 30 % of middle-aged Asian women exhibit Melasma.  In general, women are affected more frequently; the American Academy of Dermatology estimates that 90 % of Melasma sufferers are women.  Men are not immune; nearly 35 % of men from Central America – particularly Guatemala – develop the condition.

What causes Melasma?

Sunlight is the principal trigger.  The greater the sun exposure, the greater the risk.  Age increases the potential as does a history of vitiligo and the existence of multiple moles or birthmarks.

The second most important cause is female hormones.  Not only is Melasma more common in women, it’s also more severe.  It occurs during pregnancy (the “mask of pregnancy” or Chloasma) and with the use of oral contraceptives and hormone replacement therapy (HRT).  Unfortunately discontinuation of the medication doesn’t necessarily reverse the pigmentation.

Why does Melasma differ by ethnic group?

Skin color is determined by the density and distribution of melanin, or natural pigment, in the skin.  All ethnicities have a similar number of melanin producing cells, or melanocytes, in their skin.  What differs is the level of melanocyte activity and how closely the cells are grouped together.  Skin types with more melanocytic activity, or darker skin types, react to inflammation or UV exposure with more robust melanocytic activity, leading to hyper (increased) and sometimes hypo (decreased) pigmentation.

How is Melasma treated?

Sun protection is the cornerstone of Melasma prevention and treatment.  Daily use of a broad spectrum (at least SPF 30) sunscreen that blocks both UVA and UVB is critical.  These should be applied at least 20 minutes before and 30 minutes after sun exposure.  Products  should contain one or more of the following ingredients in order to protect against the long UVA wavelengths: Zinc Oxide, Titanium Oxide, Ecamsule and/or Avobenzone (Parsol 1789).  Protection can also come from wearing iron oxide-containing makeup.  Hats with a 2-3 inch brim along with sunglasses are helpful in reducing UV light exposure.  It’s important to remember that damaging sun rays penetrate through a car window.

Topical skin bleaching agents such as prescription-strength Hydroquinone, either alone or in combination with topical retinoids and steroids, are very useful in treating Melasma.  Their efficacy is enhanced when combined with a series of peels with either Glycolic Acid, Salicylic Acid or Trichloroacetic Acid.  Peels and topicals should be adjusted according to skin type for best results.

Other agents also have a role in reducing pigmentation including vitamin C and E, Azelaic Acid, licorice, Kojic Acid, Ellagic Acid and Arbutin.  Lasers are often promoted for Melasma treatment but they are not as effective as they are for solitary age spots or blood vessels.

Oral medications, such as Tranexamic Acid, are also helpful as an adjunct treatment for some patients.

Summary:

I find that a multi-modal approach, tailored to a patient’s ethnicity, location of pigment in the skin and underlying health status leads to significant and durable improvement in Melasma.  The good news is that if Melasma bothers you, it’s not something you have to live with!