Facial Peels

Aesthetic Practitioners under AAIC guidelines can perform light to medium lactic, salicylic, mandelic and TCA peels. The peel is a chemical process undergone to destroy the superficial layers of the skin (exfoliation) so as to erase some skin blemishes, especially signs of ageing (superficial or medium wrinkles, scars, keratoses and liver spots).

There are three types of smoothing in aesthetic medicine: mechanical smoothing or dermabrasion; chemical smoothing or peeling; and thermal smoothing or laserbrasion. Additionally, there are several types of peels available:

  1. fruit acid peels: The fruit acid peel improves skin tone and causes a simple scrub (this affects only the superficial horny layer of the epidermis). These must be repeated, they are light and have no decisive action on skin ageing.

  2. light and superficial peels: So-called weak acid peels (using lactic and salicylic acid). Their action is moderate. Light and superficial peels are mild and cause exfoliation of the skin (they will destroy the skin up to the granular layer of the epidermis). The skin will peel. The purpose of a light or superficial peel is to produce a cooling effect on the skin tone. This kind of peeling will more or less smooth certain imperfections in the skin’s surface such as wrinkles and have a minor effect on skin ageing. A light or superficial peel requires no anaesthesia. The aftermath of the procedure is simple and tips are given on classic sun protection. Both types of peels can be applied without restriction zone and complications are rare.

  3. medium or deep peels: Controlled chemical burn, real abrasion that can destroy the epidermis and the superficial dermis. This is a procedure that needs to be carried out by a qualified plastic surgeon who will choose the type of peel, its concentration and the duration of the application according to the defects to be corrected, the area treated, the skin type and the aim sought. The phenomenon of restoration will be achieved through the natural healing of the undamaged parts of the base membrane of the dermis and pilosebaceous annexes. The healing time is delicate; the skin is fragile and requires constant care.

Medium or deep peels themselves have a number of different types:

  • resorcinol paste (Unna) peels
  • Phenol peels (high cardiac, liver and kidney toxicity – to be used only by qualified plastic surgeons)
  • Croton oil peels (the concentration of the croton oil is adapted to achieve a light, medium or deep peel)
  • Trichloroacetic acid (TCA) peels with adjustment of the concentration to achieve a light, medium or deep peel

Medium or deep peeling is a procedure performed alone or in combination with eyelid surgery (blepharoplasty) and facelifts but also with surgical techniques such as medical treatment of wrinkles by the injection of Botulinum toxin or fillers.

A medium or deep peel is performed by a qualified plastic surgeon, and it is, like any surgical procedure, performed after preoperative assessment and consultation with an anaesthesiologist (Performed by a registered plastic surgeon – check www.baaps.org.uk for details).