Cosmetic Skin Peeling Treatments

• These notes cover key aspects of cosmetic skin peeling treatments.
• They range from safety and legal considerations to practical application and potential complications.
• Also included is relevant anatomy and physiology.

General Guidelines & Safety

• Always adhere to supplier/manufacturer guidelines when using new clinic products/equipment.
• To maintain valid insurance for cosmetic skin peeling, obtain informed client consent before the initial treatment.
• Sterilization is required to eradicate all living organisms from equipment.
• Using regulated treatment products past their expiration date can cause harm/injury to the client.

Chemical Peel Agents

• Chemical peel agents include high acid bases that have the potential to harm the skin.

Potential Risks

• Possible risks after skin peeling treatments: prolonged erythema and acne rosacea.
• Staff must be trained in the health/safety aspects of skin peeling products to minimize hazards/risks.

Treatment Procedures

• Following supplier instructions ensures the observation of both desirable and undesirable clinical endpoints.
• Therapists must consider legal age for treatment of clients.
• The timing of a skin peeling treatment is mainly impacted by the treatment objective.
• The treatment plan should be agreed upon by both the client and the operator during consultation.
• Details from previous salon treatments support the planning of the first cosmetic skin peeling procedure.

Contraindications

• Isotretinoin usage within the last 6 months before treatment is a contraindication to cosmetic skin peeling.
• A restrictive contraindication to cosmetic skin peeling is fake tan applied 7 days prior.

Pre & Post-Treatment Considerations

• Telangiectasia is an example of a vascular lesion.
• Clients should be informed about potential post-treatment appearances like tightness, mild peeling, itchiness and discomfort.
• Prior to a skin peeling treatment, skin sensitivity testing demands peel application, timing, and neutralization.
• Hydroxy acids include AHAs, BHAs, LHAs, and PHAs.

pH Importance

• pH determines the strength and penetration of the cosmetic peel.
• Alkaline products reduce antibacterial defenses and assist exfoliation.
• The most important consideration in preparing products for peels is checking peel type, strength, and concentrate.
• Application of peeling products includes dividing the face into sections, avoiding overlap, and feathering at the hairline.
• Neutralization slows down the activity of the acid and renders it ineffective.
• Salicylic acid at a high concentration requires neutralisation.

Effects of Treatment

• Improved skin texture
• Lightening of hyperpigmentation
• Refining of open pores
• Reduction of oil production
• Improvement of photo damaged skin
• If herpes simplex occurs post-treatment, the client should apply antiviral cream for up to 3 days.
• Tyrosinase inhibitors recommended for clients with Fitzpatrick skin types 3-6 to avoid post-inflammatory pigmentation.
• A minimum sun protection factor of UVB SPF 30 and UVA is recommended before/after peels.
• PPE, single-use items, and recovery products during treatment prevent infection and promote healing.
• Red light emitting diode (LED) can be used as part of treatment progression for collagen synthesis and cell repair.

Anatomy & Physiology

• Structures within the dermis: extracellular matrix.
• Reepithelialization begins within a day of the injury as part of stage two of the wound healing process.
• Lymph components: water and protein molecules.
• Blood regulates heat production and regulation.

Skin & Product Knowledge

• Hyaluronic acid keeps skin hydrated.
• Increased vascular reactivity is characteristic of sensitive skin.
• Medical referral is required for anti-coagulant medication contraindication.
• When seeking information from clinicians, do not alarm the client or diagnose the suspected contraindication.

Treatment Sensations

• During the treatment, clients might experience a tingling, prickling, or stinging sensation.
• To prevent product 'pooling' on sensitive facial areas, apply petroleum-based product in the area of soft folds.
• Mildly acidic products exfoliate and stimulate collagen synthesis.
• A stronger acid relates to a lower pKa of the peel.
• With dehydration as the skin condition, a skin peel may only show limited results.
• Septicaemia, blood poisoning is characterized by bacteria entering the bloodstream.
• An aneurysm is a weak point in an artery wall, causing localized swelling.
• When referring a client, do not alarm them or diagnose the suspected contraindication.

Skin Types

• Vascular skin expects an exaggerated inflammatory response upon peel application.
• Tyrosinase inhibitors benefit Fitzpatrick skin types 3-6 prior to peels by reducing post-inflammatory pigmentation.
• Cleansing the skin prior to treatment degreases the skin surface and exfoliate keratinised cells.
• Salicylic peel is derived from the same substance as aspirin.
• When selecting the peel type Fitzpatrick skin type needs consideration, to evaluate the risk of post inflammatory hyperpigmentation.
• The supplier and manufacturers instructions dictate the length of time a peel is left on the skin.
• During skin peel treatment avoid the inside the periorbital bone.
• Brighter skin provides a benefits of with improved skin texture after a cosmetic skin peeling treatment.
• Blanching is a potential risk of incorrect application of skin peeling products.
• Pre and post-treatment products enhance the effects of the peel and improve the skin condition.
• It is important to have knowledge of Fitzpatrick skin type and response to treatment so far, before recommending future skin peeling treatment.

Cells & Physiological Functions

• Melanocytes produce melanin in the skin.
• Keratinocytes in the epidermis trigger the inflammation cascade.
• Lymphocytes function to fight infection.
• Arteries have thick muscular walls to withstand the pressure from blood leaving the heart.
• Thyroxine's main function is to regulate metabolism.
• Oestrogen causes the increase of melanin in the skin causing hyperpigmentation.
• Fitzpatrick skin type 6 most commonly develops dermatosis papulosa nigra.
• Endocrine disorder myxoedema is associated with underproduction of thyroxin and weight gain.