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Chemical Peels, pushing the limits in chemical peeling for skin rejuvenation
Published 04/23/2023

Why did I decide to write this blog? Why I think it will help not just the consumer but also medical and cosmetic practitioners who opt to #chemicalpeeling versus another resurfacing modality available in the marketplace. Chemical peels are my preferred method of facial rejuvenation and corrective procedures such as removal of #acnescars, dark spots, pigmentation, seborrheic keratosis, chemical peels for hypertrophic scars or #keloids since 1979. The difference between then and nowadays is that my peeling technique is more perfecting, and the peeling solutions are much improved regarding composition, potency and carrier or delivery system. So, it makes it quite easy for the practitioner to pick up the right peeling solution precisely for the right skin problem to perform optimum results. Today the consumer is somehow scared about the zillion offerings of chemical peel. Posts on YouTube and other social media platforms confused people as well. Salicylic acid versus Glycolic peel, medium depth peel versus Superficial peel, enzyme peels versus chemical peels, DIY peel versus professional peel. Chemical peeling is the application of a chemical agent to the skin, which leads to the controlled destruction of the epidermis with or without the dermis. This leads to skin exfoliation and the removal of tissue followed by regeneration of both the epidermal and dermal tissues. There are some limitations to their use in dark-skinned patients (Fitzpatrick skin type IV, V) and when resorcinol acid composed with alcohol is used produced prolonged pigmentation and unpleasant adverse effect.

Recently I attended a lecture on chemical peeling. The moderator was a doctor from France and the panel doctors from Israel, UK, France all utilizing daily peels in their practices with fabulous results but not one chemist producing finished chemical peel solution was invited. The moderator presented a few bad results from peeling. That upset somehow the panel and I was urged to post my opinion on the matter. So, this is what I typed. “There is always possibility of mild to serious scaring not just with chemical peeling but with lasers as well and if you burn the skin, you must know how to cure the burn right away.” The moderator just mention that phenol peel was used but did not have the knowledge of the composition precisely (there is many phenols formulation options), he has no way of knowing if the patient followed up the post peeling instructions, in fact he has no way of knowing what the patient was doing after leaving the doctor’s office. Rehabilitation must be clearly outlined before the procedure. I call the patient in 48 hours after medium level peel to make sure that all my post peel instructions are executed. Regarding prepping the skin with multiple products before the procedure, I consider this approach pointless because what is the purpose of prepping since I must peel the skin, except chemical peel for #melasma. The usual treatment for melasma is a triple combination therapy composed of hydroquinone, retinoic acid and a topical steroid. For example, tretinoin limits the oxidation of hydroquinone and improves epidermal penetration while the steroid reduces irritation and, as a result, triple therapy leads to a faster response with fewer side-effects when combined with chemical peel. The topical steroid used is frequently of a low potency, this is because higher potency steroids have been shown to have both a higher side-effect profile and a higher relapse rate and should be prescribed with caution. It’s better to splurge on good products in the post-peel period a) for faster recovery and b) to maintain optimum skin rejuvenation. I use Osmotic Peel SP alcohol-free control delivery chemical peel with no side effects of any kind to prep the skin for medium depth peel for instance. Any peeling agent dissolved in alcohol with multiple sessions will only smooth the skin, but the brown spots, pigmentation of any kind will still be there. The most efficient peels today are complex compounds made for comfort not for pain, for results not for publicity, “double action peel, organic cream peel “is all gobbledygook. I have documented hundreds of before and after with impressive results. Posting these cases on my website or social media requires consent from the patient. Privacy is another issue to keep good relations with the patrons. There are no current trends in chemical peeling but new peeling innovative solutions with old peeling agents. Knowledge of anatomy is imperative in chemo- abrasion and peeling. Aging of the face is a non-synchronized process and segmented peeling techniques should be performed with different peeling solutions in one session for optimum patient satisfaction. Satisfied customers, happy practice. Chemical peels have been around for decades, and they are the most popular and pocket-friendly choice for many people. 

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