©2003 Texas Trade and Industrial Education1 Types of Peeling Agents Chemical Peel Techniques

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques2 Chemical Peels  A chemical peel is an accelerated form of exfoliation  It uses an enzyme to help speed up the breakdown of keratin, which is the protein in skin  The stronger the strength of the peel, the deeper or more layers of the skin are affected  Most chemical peels do not penetrate the dermis layer of skin.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques3 Ingredients of Peels  Two of the more common enzymes  Papain (puh-PAY-in)  which is derived from the juice of the papaya fruit  Pancreatin (pan-KREE-uh-tin)  which is derived from beef by-products  Another product are the alphahydroxy acids  These are derived from plants, mostly fruits  These AHA peels are safe for all skin types  They help prevent excessive build-up of dead skin cells.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques4 Skin Types Skin TypesSkin ColorCharacteristics 1whitealways burns, never tans 2whiteusually burns, tans less than average 3whitesometimes burns, tans average 4whiterarely burns, tans more than average 5brownrarely burns, tans profusely 6blacknever burns, deeply pigmented

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques5 Skin Types  Skin types can be easily classified by asking what happens with sun exposure  Generally, clients with skin types 1-3 do not develop post-inflammatory condition  Nor do they tend to have increased hyper pigmentation  Clients with skin types 4-6 have a greater risk of these factors  This does not mean they cannot receive the treatment; they are at higher risk for developing these abnormalities or should use AHA acids

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques6 Occasions for a Chemical Peel Oily, clogged skin with blackheads & whiteheads Superficial wrinkles on the face, neck, upper chest, arms, etc. Enlarged facial pores Age spots Superficial facial scars Dry, dehydrated skin Dull, lifeless-looking skin Uneven pigmentation Those desiring a smoother skin appearance

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques7 Chemical Peel Steps 1. Cleanse face and throat thoroughly. 2. Exfoliate skin with a scrub. 3. Directions: 4. Cleanse face with an oil-free cleanser or a foaming gel cleanser and pat dry. 5. Apply enough exfoliator to cover the area - Avoid eyes, lips, and mucous membranes. Do not rub into skin. 6. Leave on for minutes depending on skin sensitivity. 7. Rinse well with luke warm water 8. Apply Moisturizer containing Sunscreen (SPF 15). 9. Repeat every week

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques8 Chemical Peel Steps 1. Apply freshener/ toner to all areas 1.. Witch Hazel extract Versus SD Alcohol: 2. Unlike some other Peel products which may contain SD alcohol, we use Witch Hazel which is derived from natural sources. SD alcohol is a denatured alcohol which is toxic if taken internally and we feel it had no place in our products. Since the skin does have a tendency to absorb, it would make sense to use a more natural and gentle substance than SD alcohol (ask your supplier for ingredients). 3. Witch Hazel is an astringent with the following properties: Reduces the Skin's Pore Size Prevents Irritation and Inflammation Soothes and Calms the skin 2. Apply peel (25-40% strength) to areas using cotton swabs or a masque brush according to manufacturer’s directions. For the first treatment, usually peel is applied for 5-10 minutes.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques9 Peel Steps  Subsequent treatments may require longer application timing or applying more layers of peel to the skin. ALWAYS follow the manufacturer’s directions.  Cleanse off treated areas, rinsing thoroughly.  Apply freshener.  Apply skin guard/ and or rejuvenating crème to the areas. Follow manufacturer’s directions and products recommended.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques10 Peel Steps  Apply skin guard/ and or rejuvenating crème to the areas.  Follow manufacturer’s directions and products recommended.  Apply gauze mask and treat with warm paraffin.  Allow to dry then peel off.  Apply proper moisturizer and makeup if desired.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques11 After Care Steps Clients will experience a stinging sensation during the first few minutes of application Clients will receive this treatment only once per week Clients will use a mild solution (5 %) in home during the week Always provide directions for clients for this at-home procedure.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques12 After Care Steps Clients should allow 10 weekly treatments in order to see maximum results Clients will continue with the 5% treatment at home Clients must allow at least 30 days before resuming treatments.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques13 After Care Steps During this waiting period, clients should continue their 5% treatments at home Clients should achieve maximum results after a series of treatments Recommend a peel once every three months to maintain results

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques14 Types of Peeling Agents Many different types of peeling agents have been produced Among the familiar agents are glycolic acid, Jessner’s solution, salicylic acid, TCA, and phenol Each agent has its own advantages and disadvantages as a peeling agent Additionally, each one is technique sensitive, meaning that the end result is dependent on the knowledge and kill of the technician As in any procedure, the more often you perform the procedure, the better you get at the process of the treatment and as such the end result for the client

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques15 Types of Peeling Agents Each peeling agent has a specific action on the skin and therefore may be best indicated in certain conditions Knowing the available peel solutions, their actions, and your client’s skin will decrease the variability of peeling When you analyze your client, the skin condition or problem, skin type and aging analysis, you will be able to determine which peeling solution will best suit the situation

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques16 Glycolic Acid Glycolic acid is a fruit acid derived from sugar cane Three basic strengths 30%, 50%,70% Just as important as the % of the acid is the pH of the product Solution for peeling should be at a pH of 2 or less Glycolic acid is indicted for the use of Photodamage Exhibited as dyschromias (Pigment disorders, discolorations of the skin)Pigment disordersdiscolorations of the skin Fine lines Rough textures

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques17 Glycolic Acid Pure Glycolic Acid It works by stimulating new growth of skin and collagen by decreasing the bond that holds dead skin cells on the surface. This allows dead cells to be removed gradually, leaving behind a layer of smoother and softer skin. Glycolic Acid may also be used to treat: Acne, Acne Scars, Blackheads/Whiteheads, Dry Skin, Sun-damaged Skin, Blotchy Pigmentation, Fine Wrinkles, Loss of Elasticity, Large Pores, Bumps, Age Spots/Dark Spots, Eczema, Seborrhea Keratosis, Hyperkeratosis, and Actinic Keratosis. Acne

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques18 Glycolic Acid Please select a strength of Glycolic Acid below (all peels can be used on Acne Prone skin): 50% Glycolic Acid (pH 2.0) Great for mature/aging skin. This is our strongest peel and will give the fastest results, but if you are new to peels, I recommend you to start at at our 40% Glycolic Acid. 50% Glycolic Acid 40% Glycolic Acid (pH 2.2) Used on dry, dehydrated, and normal skin. 40% Glycolic Acid 30% Glycolic Acid (pH 2.3) Used on sensitive, dry, oily, or dehydrated skin. This is our weakest peel and will give the same results as the stronger peels, but is a more gradual process. 30% Glycolic Acid

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques19 Glycolic Acid Doctors Strength These non-buffered Glycolic Acids are only for Doctors or Dermatologists. If you have Rosacea or sensitive skin, then Lactic Acid may be the better choice.Lactic Acid

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques20 Jessner’s Peel Solution is a combination of three different acids 14% salicylic acid 14% resorcinol 14% lactic acid in an ethanol base Superficial peel, focusing on exfoliating and digestion of the debris Great choice for the acne client

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques21 Salicylic Acid (Beta) Peel Hydroxybenzoic acid Found in willow bark, but manufactured synthetically from sodium phenolate Two strengths 20%,30% Effective for treatment of acne

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques22 Salicylic Acid (Beta) Peel Chemical peeling continues to be the gold standard in cosmetic enhancement of facial skin. Chemical peeling of the face has been performed for many years. The ancient Egyptians used particles of alabaster mixed with milk and honey to abrade facial skin to create tightening. In Egypt Cleopatra is said to have bathed in sour milk, while French women have applied fermented wine to their faces to improve the quality of the skin.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques23 Salicylic Acid (Beta) Peel In 1882, Unna, a German dermatologist, reported the use of salicylic acid, resorcinol, phenol and trichloracetic acid for chemical peels. In the early 1990's, Swineheart reported satisfactory results using 50% salicylic acid on the hands and forearms of patients with actinically induced pigmentary changes. Although the literature is replete (full of information) with the use of alpha hydroxy acids as peeling agents, there is dearth (inadequate supply) of published data regarding the efficacy and safety of salicylic acid peels.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques24 Salicylic Acid (Beta) Peel Classification Salicylic acid is a beta-hydroxy acid. It is a hydroxyl derivative of benzoic acid and represents a carboxylic acid attached to an aromatic alcohol, phenol. Salicylic acid is the only member of the beta-hydroxy acid family, so named because the aromatic canboxylic acid has a hydroxy group in the beta position Salicylic acid is derived from willow bark, wintergreen leaves and sweet birch.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques25 Salicylic Acid (Beta) Peel Mechanism of action Salicylic acid is an excellent keratolytic agent. It is thought to function through solubilization of intercellular cement, thereby reducing corneocyte (horny) adhesion. Because of its lipophilic nature, salicylic acid has a strong comedolytic effect. Salicylic acid affects the arachidonic cascade and thus exhibits anti-inflammatory capabilities

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques26 Salicylic Acid (Beta) Peel Indications These include acne vulgaris, enlarged pores, rough and oily skin, melasma, post-inflammatory hyperpigmentation, and photoaging Contraindications A history of allergy to aspirin, and pregnancy and lactation are contraindications Formulations % 2. 2% solution as skin cleanser, and in acne washes 3. Salicylic acid peel 4. Salicylic acid paste (salicylic acid powder USP 50% methyl salicylate 16 drops, Aquaphor 112 g)

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques27 Salicylic Acid (Beta) Peel Preparation As in any other chemical peel, patient selection is important. A good history taking and examination with relevance to peels is mandatory. Photo documentation and a written consent are recommended Priming Patients are pretreated for 2 weeks with 4% hydroquinone for hyperpigmentary disorders and with an alpha-hydroxy acid for acne and photoaging.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques28 Salicylic Acid (Beta) Peel Peel procedure Cleanse the face to remove dirt and grime. A surgical cap is used to pull back the hair and cover the ears. The face is degreased by scrubbing with a cotton gauze piece soaked with ethanol or a pre-peel cleanser Sensitive areas of the face such as the lips and the nasal-alar cheek junction are protected with a thin layer of petrolatum.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques29 Salicylic Acid (Beta) Peel The salicylic acid is applied using a cotton-tipped applicator or a wedge sponge in a predetermined manner on to the facial cosmetic units Starting from the forehead and progressing to the zygomatic cheeks, chin, upper lip, nose and lower eyelids. The whole procedure should be completed within 30 sec.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques30 Salicylic Acid (Beta) Peel At this point the subject experiences a stinging and burning sensation which increases over the next 2 minutes, reaches a crescendo at 3 min and then rapidly decreases to baseline over the next minute; this is considered the end point of the peel. As the hydroethanolic vehicle evaporates, it leaves behind a white precipitate of salicylic acid on the surface of the face which is termed as salicylic acid frost.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques31 Salicylic Acid (Beta) Peel There is very little penetration of the active agent once the vehicle has volatilized.(vapor) At this point there is no burning or stinging as the agent causes a superficial anesthesia to light touch. Wash face with water and pat the face dry. Patients are then sent home with a moisturizer and instructed to limit sun exposure and use sunscreens appropriately.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques32 Salicylic Acid (Beta) Peel Post-peel Patients report a tightness and smoothness immediately post-peel. Peeling usually begins 2 days post-peel and can extend up to 7 days post-peel. Transient hyperpigmentation and superficial crusting may be seen in areas of inflammatory acne.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques33 Salicylic Acid (Beta) Peel Patients with Fitzpatrick skin type III may experience darkening during desquamation due to increased melanin sloughing. Minor side effects include superficial crusting, edema (abnormal accumulation of watery fluid in connective tissue) and transient (not lasting long) purpura (the appearance of red or purple discolorations on the skin)the appearance of red or purple discolorations on the skin in the lower eyelid areas, hypopigmentation, transient dryness and hyperpigmentation, which resolves quickly.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques34 Salicylic Acid (Beta) Peel Intervals of application Peels can be repeated once in 2 weeks for 5-6 sessions Discussion Salicylic acid peel is a superficial chemical peel which is gaining popularity. It has been found to be safe and effective in darker skinned racial ethnic groups Given the predictability, less downtime and efficacy compared with glycolic acid peels, salicylic acid peels are likely to become more popular in future. However, in light of the recognized tendency of darker skin to develop dyschromias( Pigment disorders, discolorations of the skin,) superficial peeling should be approached with care and caution. Pigment disordersdiscolorations of the skin

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques35 Lactic Acid Is a component of the natural moisturizing factor (NMF) Increases the glycosaminoglycans (GAGs)(mucopolysaccharides) connective tissue and the ground substance of the skinmucopolysaccharides

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques36 Lactic Acid Peel Lactic Acid is derived from sour milk, and is much milder on the skin versus other peels. The peeling process is very similar to how Glycolic Acid works.Glycolic Acid It has many important qualities, number one being that it is milder than other peels as mentioned above, so people with sensitive skin can apply this peel and see the same results as stronger peels. If you have Rosacea, this is a better peel for you than Glycolic Acid.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques37 Lactic Acid Peel Also, if you are new to acid peels this may be the one for you. It also can be used for the following: Acne, Acne Scars, Blackheads/Whiteheads, Dry Skin, Sun-damaged Skin, Blotchy Pigmentation, Fine Wrinkles, Loss of Elasticity, Large Pores, Bumps, Age Spots, Eczema, Seborrheic Keratosis, Hyperkeratosis, Actinic Keratosis, and Rosacea. AcneRosacea

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques38 Lactic Acid Peel 50% Lactic Acid (pH 2.0) Great for Wrinkles/Mature skin, as well as all skin types. strongest peel and will show the fastest results, but if you are new to acid peels, we recommend to use the 40% Lactic Acid first. 40% Lactic Acid (pH 2.2) Used on dry, dehydrated, and normal skin. Perfect for first time Acid Peel users.

©2003 Texas Trade and Industrial EducationCosmetology I: Chemical Peel Techniques39 Lactic Acid Peel 30% Lactic Acid (pH 2.3) Used on sensitive, dry, oily, acne prone, or dehydrated skin weakest peel and will show the same results as the above peels, but is a more gradual process. If you have red, sensitive skin, and it is your first peel, I suggest this strength.