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Peeling - means for exfoliating the skin.

The procedure for exfoliating the skin is called peeling. Carrying out this procedure, they act on the surface layers of the skin with a certain set of drugs.

There are several types of peels that differ in the direction of exposure:

Super-superficial (intracorneal) - only the stratum corneum (epidermis) is involved in it. As a result, the rows of scales that are on the very surface of the skin are exfoliated. Such peeling works sparingly.
Superficial and mid-surface (intraepidermal) - affects the entire depth of the stratum corneum (except for the basement membrane).
Deep (intradermal) - spreads into the dermis.

It should be noted that the peeling procedure is not indicated for patients with inflammatory skin diseases, such as acne, as it can exacerbate the disease. Also, peeling is not used simultaneously with bleaching agents . Peeling and whitening should take place at different time periods with a difference of several months.

In general, peeling is a rough procedure for the skin, some of its varieties cause moderate pain. This is especially true for mid-surface and deep peels. Often, the peeling procedure causes complications, which manifest themselves in the form of soft tissue edema (lasting up to 2 days), increased skin sensitivity. And these are the mildest manifestations of complications. More severe complications are associated with exacerbation of various chronic skin diseases, including dermatitis, acne, rosacea , allergies, herpes and other infections. Delayed complications are associated with the formation of scars, persistent facial erythema, depigmentation or, conversely, hyperpigmentation.

There is a so-called pre-peeling preparation. It includes measures to adapt sensitive skin to the upcoming impact; procedures for preliminary reduction of the thickness of the stratum corneum. For these purposes, alpha, beta, polyhydroxy acids are used daily at night. Such preliminary preparation takes from a week to a month. It is also recommended to use agents that reduce the production of melanin: ascorbic acid, azelaic acid, topical retinoids, benzoyl peroxide, glabridin and other agents similar in action. Patients are also advised to avoid sun exposure and tanning beds.

There are three ways to carry out the peeling procedure:

physical
chemical
mixed (combines elements of previous peeling methods)

During physical peeling, the skin layer is affected, with special peeling - creams, creams - scrubs. And also carry out microcrystalline dermabrasion, that is, polish the skin surface with inert crystals of aluminum oxide powder; dermabrasion - removal of skin cells using rotating abrasive nozzles.

Scrubs are designed to mechanically remove dead cells from the skin surface. Scrubs are water and oil based and contain particulate matter that exfoliates the skin cells.

In past years, a bodyag (coelenterate animal - freshwater sponge) was considered a popular means for mechanical exfoliation of the skin . Porous, consisting of needles of silica connected by a substance - spongin, the sponge easily turns into powder, which is used as a scrub.

Contraindications to the use of bodyagi:

acne
hairy surfaces
dermatitis

Today, laser skin resurfacing is considered a modern and convenient tool. The process of laser treatment of the skin surface is based on the effect of a monochrome light beam on the desired area and heat absorption, accompanied by the evaporation of skin cells (fractional photothermolysis). There are two ways to carry out laser resurfacing: “cold laser” (Erbium) and “hot laser” (Carbon dioxide).

Erbium laser has a smaller heat-affected zone, its action is selective and focused on the skin layer up to 1 μm deep. At the same time, adjacent areas of the skin do not overheat, which makes it possible to use it in the décolleté, eyes, neck. The action of this type of laser is gentle. The maximum time for rehabilitation is ten days.

Carbon dioxide laser , unlike Erbium laser , affects a wider area of the skin and penetrates to a depth of 20-30 microns. In this case, tissue coagulation is possible. Usually this type of laser is used fractionally, which reduces the rehabilitation time after the procedure from two weeks to several days. The procedure requires anesthesia.

After undergoing laser resurfacing, it is necessary to treat the affected skin areas with special creams and gels that accelerate skin rehabilitation.

There are a number of contraindications to the use of laser resurfacing:

oncological diseases
diabetes
infectious diseases of the skin
acute and chronic skin diseases
keloid scars
period of pregnancy

Chemical peeling is essentially a burn- like damage to the skin , but only under strict control of this process.

.To carry out this method of peeling, special reagents are used in various combinations:

Phenols
Resorcinol
Trichloroacetic acid
Alpha hydroxy acids
Enzymes
Enzymes

Depending on the use of the reagent, the depth of the damage to the skin varies.

Super-surface chemical peeling is carried out using enzymes of plant and animal origin: bromelain, papain, trypsin, etc., which are extracted from pineapple, papaya, Mucor Mieli mushroom, from the pancreas of cattle and pigs. Also polyhydroxy acids or their esters are used. This is the most gentle type of chemical peeling.

For superficial and mid-surface chemical peels, use 30-70% solutions of alpha hydroxy acids, 15% trichloroacetic acid, Jessner's solution.

Classic Jessner's solution includes 100 ml of 96% ethyl alcohol 14 gr. Lactic acid, 14 gr. Salicylic acid, 14 gr. Resorcinol. Koic acid and hydroquinone are sometimes added.

Trichloroacetic acid is used as a solution of the appropriate amount of crystals per 100 ml of water. Do not use non-aqueous solutions.

With deep chemical peeling, phenols are used (the old method, do it once and is not recommended, since it can cause irreversible disruption of the activity of melanocytes) and 35-50% trichloroacetic acid on a gel basis (also has side effects, but is less dangerous than phenols)

Chemical peels with acids are similar in nature to whitening, but have a more traumatic effect on the skin.

Contraindications to the use of chemical peels:

acute and chronic viral infections
acne
dermatoses

All manipulations associated with the peeling process must be carried out in the conditions of a cosmetology office and with the participation of a doctor with appropriate professional training.