explains in detail about the different chemical peels

1. By:
Dina Aziz
B.Sc. Pharmacy
M.Sc. Pharmaceutics

2. Introduction
• Exfoliation occurs naturally as outworn stratum corneum
cells detach and are removed from the skin’s surface.
• Replacement of stratum corneum cells occurs by a self-
renewal process as epidermal cells move upward from the
basal layer, the stratum basalis, and through the subsequent
two layers, the stratum spinosum and stratum granulosum,
to reach the stratum corneum.

3. Introduction

4. Introduction
The Stratum Corneum is comprised of layers of keratin-
rich corneocyte cells , which is shed naturally in a
complex process called desquamation.

5. How can we Affect Desquamation?
Mechanical Peeling
Chemical Peeling

6. Chemical Peeling
 Chemical peels are substances that cause skin cells to
desquamate at an increased rate
 Chemical peeling is a procedure used for the cosmetic
improvement of the skin.

7. Chemical Peeling
 During this procedure, a chemical agent of a defined
strength is applied to the skin, which causes a
controlled destruction of the skin layers (epidermis
and/or dermis) with subsequent regeneration of the
tissues, resulting in improvement of texture and
surface abnormality.

8. Chemical Peels Classification
 Chemical peels are classified into three categories,
depending on the depth of the wound created by the
peel:
(a) superficial peels
(b) medium-depth peels
(c) deep peels.

10. Chemical Peeling Agents

11. Superficial Peeling Agents
 AHAs ( lactic acicd, Glycolic acid,..)
 BHAs (Salicylic acid)
 Pyruvic acid
 Resorcinol

12. Superficial Peeling Agents
 Jessner solution?

13. Superficial Peeling Agents
AHAs
 causes decreased corneocyte adhesion.
 it promotes epidermolysis.
 AHA requires neutralisation to terminate its
action.
 AHA do not induce a frosting pattern.
 Glycolic acid is the most common concentrations
between 30-70%.

14. Superficial Peeling Agents
AHAs
 Burning sensation and erythema during application
 Necrotic ulcerations if time of application is too long
and/or skin pH is reduced

15. Salicylic Acid
 Salicylic acid has mild analgesic, antimicrobial,
keratolytic and anti-inflammatory effects.
 For superficial chemical peeling, salicylic acid is used
in concentrations of 10–30%.
 Given the appearance of the white precipitate,
 uniformity of application is easily achieved

16. Salicylic Acid
 After several minutes the peel can induce an
anesthetic effect whereby increasing patient tolerance
 Limited depth of peeling
 Minimal efficacy in patients with significant
photodamage

17.  is used in concentrations of 40–70%.
 resulting in decreased epidermal thickness.
 Over a long term it induces increased collagen, elastic
fibre and glycoprotein deposition in the papillary
dermis.
 Pyruvic acid causes intense pain on application and its
vapour is pungent and irritating
Pyruvic Acid

18.  Very mild erythema
 Mild desquamation
 Short post-operative period
 Intense stinging and burning sensation during the
application
 Neutralization is mandatory
 Pungent and irritating vapors for the upper
respiratory mucosa
Pyruvic Acid

19. Resorcinol
 Resorcinol disrupts the hydrogen bonds of keratin.
 This accounts for its keratolytic and bactericidal
properties. Resorcinol is used at concentrations of 10–
50% for chemical peeling and induces frosting pattern.

20. Resorcinol
 Desquamative effect aesthetically unacceptable
 Resorcinol may be a sensitizing and toxic agent

21. Medium-Depth Peeling Agents
Tricholoro acetic acid (TCA)
 precipitates epidermal proteins and causes destruction
of the upper dermis
 Medium- depth peeling is performed with TCA
35–50%

22. Trichloracetic Acid
 Stinging and burning sensation during the application
 Hypo/hyperpigmentation can occur

23. Deep Peeling Agents
Phenol
 The main advantage of deep chemical peel is in the
treatment of photodamaged skin with wrinkles,
 Facial scars such as acne scars
 The main disadvantage of deep peel is the special set
up needed for the procedure, due to the potential
cardiotoxicity of phenol.
 In addition,special training is needed

24. Indications of chemical peeling
Acne Actinic keratoses

25. Indications of chemical peeling
Melasma Photoaging

26. Indications of chemical peeling
 Post-inflammatory Hyperpigmentation

27. Indications of chemical peeling
Rosacea Solar lentigos

28. Pre- Peels Caution
 Chemical peeling is usually a safe procedure when
performed by qualified and experienced professionals.
However, these procedures are not recommended
for everyone.
 Patients should visit their dermatologists and find out
whether this treatment is indicated for them.

32. Pre-peel care
• Skin should be well prepared before peeling for achieving
good results .
• Priming of the skin
 These activities enhance patient compliance, detect
intolerances and reduce the risk of complications such as
post-inflammatory hyperpigmentation and scarring.
 Patients should be instructed to avoid waxing, and
dermabrasion for a minimum of 3–4 weeks prior to
chemical peeling

33. Pre-peel care
• Patients should be instructed to limit their UV
exposure and apply a broad-spectrum sunscreen with a
sun protection factor of 50+.
 Sunscreen should ideally be instituted 3 months prior
to the procedure and continued indefinitely thereafter.

34. Pre-peel care
Pretreatment of the skin should begin at least 2–4 weeks
before the chemical peel and ceased 3–5 days prior.
Tretinoin 0.025–0.05% cream should be applied for a
minimum of 2 weeks
Hydroquinone 2–4% cream is inititated at least 2
weeks before a chemical peel and re-introduced 1–2
weeks post peel
 other agents include glycolic acid 5–10%, salicyclic
acid 5–10%,

35. Post-peel care
• They should be instructed to wash their face with a
non-soap cleanser and to avoid rubbing, scrubbing,
scratching their skin.
• A bland emollient should be applied regularly to the
skin until peeling is complete.
• topical antibacterial agent may be prescribed.
• Sun avoidance and daily application of sunscreen
should also be encouraged.

36. Complications
 dermatitis
 hyperpigmentation
 Infections
 Scarring

37. Thank You