In 3500 B.C., a papyrus manuscript promoted the benefits of abrasive pastes; the Egyptians used a solution of milk and honey with alabaster particles. In other words, men and women have always wanted to eliminate certain superficial skin imperfections (lines, scars, keratosis, dark spots) by smoothing the skin’s surface and so trying to improve or preserve its freshness and rejuvenate it.
This smoothing corresponds to abrasion, and today’s abrasion techniques can be:
• Mechanical: Dermabrasion
• Chemical: Peels
• Thermal: Laser abrasion.
Peels make use of vegetable or chemical substances that, according to the strength of the active ingredient or concentration, or according to the length of application time, will destroy the superficial layer of the skin, that is, all or part of the epidermis, and may go down to the upper dermis depending on the result sought.
The various peels:
• Fruit acid peels (glycolic, lactic, mandelic, etc.)
• Peels with so-called weak acids (lactic, salicylic), the action of which stops at the granular layer, with a significant but moderate exfoliating effect
• Resorcinol peels like Unna’s paste, the active principle of which is 50% resorcinol.
• Peels with phenol (hydroxybenzene) and croton oil, the concentration of which allows a light, medium or deep peel to be done depending on the area to be treated, the extent of the defect to be corrected, the quality of the skin and the purpose. The toxicity of phenol, especially cardiac, hepatic and renal, is well known by your practitioner and necessitates a well-standardised application protocol.
• Trichloroacetic acid (TCA) peel, the concentration of which also allows a light, medium or deep peel to be done.
Objective of the treatment:
• Fruit acid peels improve the skin’s radiance.
• Light and superficial peels make the skin peel, causing exfoliation, and have a refreshing effect on the complexion. They involve only one part of the epidermis.
-A scrub involves only the superficial corneal layer of the epidermis.
-Exfoliation involves the granular layer of the epidermis.
• Medium or deep peels, on the other hand, perform real abrasion that can destroy the epidermis and the superficial portion of the dermis, the papillary dermis; they are a controlled chemical burn. Your surgeon controls this through the choice of the type of peel, its concentration and its application time. This depends on the extent of the defect to be corrected, the area to be treated, the quality of the skin and the aim.
This destroyed epidermal or dermo-epidermal layer will then restore itself naturally from the elements of the dermo-epidermal basal membrane and the pilosebaceous annexes; this involves a healing time in which the skin remains fragile and needs attentive care.
This restoration of the skin’s surface creates a smoother look by eliminating to a greater or lesser degree the imperfections that one desires to treat.
Moreover, the dermal-epidermal healing will cause a certain retraction of the skin, producing a real “firming” effect on the skin, variable and more or less significant according to the case.
• Depigmenting Peels
The existence of pigmented spots resistant to standard treatments, especially hormonal spots in young women (melasma, chloasma), has led to development of a rapid treatment causing very little peeling.
(=Largely symmetric hormonal spots in women)
Dark skin responds well to this treatment.
This type of peel can only be performed in a doctor’s surgery.
It is very important to stress that although the result is obtained rapidly, maintenance treatment will always be necessary, as the pigment cells (melanocytes) have a long memory. They must be monitored and “silenced” for months at a time.