Chemical Peel Treatment for Acne Scars, Dark Spots

Best chemical peel for acne scars is the application of one or more chemical agents on to the skin resulting in dry desquamation or moist maceration followed by its exfoliation and subsequent resurfacing of the epidermis along with remodelling of collagen and elastic fibres and the deposition of glycosaminoglycans during the repair process in the dermis. The idea of chemical peel for acne marks is to wound the skin to bring it to a desired level, which is deep enough to cause exfoliation of the layers, while being superficial enough to allow regeneration from the appendageal structures and papillary dermis through wound healing, and reduce acne scars.

MECHANISM OF ACTION OF PEELS

The outer skin layers are removed through keratolysis and kerato coagulation. In keratolysis, the peeling agents such as glycolic acid or lactic acid penetrate through stratum corneum, break the intercellular desmosomal band and disrupt the keratinocyte cohesion. In kerato coagulation, the peeling agent such as TCA destroys the surface cells through protein denaturation and keratinocyte coagulation. Most of the very superficial and superficial peels primarily cause epidermal wounding whereas medium and deep chemical peels cause both epidermal and dermal wounding.

STAGES

  • Coagulation and Inflammation
  • Reepithelialization
  • Granulation Tissue Formation
  • Angiogenesis
  • Collagen and Matrix Remodelling

Indications

  • Acne
  • Post-acne Hyperpigmentation
  • Superficial Scarring following Acne
  • Acne Excoriate
  • Comedolytic acne

Contraindications

  • Active infection (herpes labialis/bacterial)
  • Open Cuts
  • Patient on Photosensitive Drugs
  • Non Co-operative Patients
  • Unrealistic Expectations

Pre Procedure

1.Selection of the depth of the peel required

  • Determine the colour complexion (fair, wheatish, semi-dark or dark)
  • Assess the depth of the lesion (epidermis, dermal or both)

2. Priming

Preparing the skin for the best chemical peel for acne scars is an important part of the procedure, as it contributes in achieving optimum results. This can be achieved by using topical drugs at least 2 weeks prior to the planned day of the peel.

3. Sun Protection

  • Sun restriction with minimum sun exposure.
  • Use of hat, cap, scarf, umbrella, etc.
  • Sunscreens - Broad spectrum sunscreen blocks both ultraviolet A(UVA) and ultraviolet B (UVB).
  • Patients are advised to follow the above instruction for at least 10-15 days prior to the peel.
  • Working professionals should plan the procedure ahead of a weekend because the skin peels for 2-3 days after the procedure.

Procedure:

1.Peel

  • Peeling agent is applied on the full face gently.

Reaction:

  • Takes several minutes to appear and consists of erythema, blanching, and white frosting. Frosting is caused by denatured proteins of the skin.
  • Appearance of uniform white coast of frosting is a good sign
  • The water is wiped off the eyelids and the patient is asked to open his/her eyes.
  • Patient then continues to dab cold water on the face till the burning sensation subsides.
  • Rubbing is to be avoided, frosting disappears and normal skin colour returns in half an hour.

2. Post-peel

  • At home: Cold water/ice compresses or calamine lotion are given for drying and soothing. Promote epidermal desiccation and separation for the first 24-48 hours and restrict emollients.
  • Day 1 and 2: Skin becomes dark brown-black, desquamates completely in 5-10 days (there are early and late peelers).
  • Once skin starts peeling, there is a sense of tightening and cracking. Apply emollients and keep the skin moist.
  • On completion, underlying skin is erythematous. Protection from sunlight with sunscreen and moisturizers is advised for 1-2 weeks.
  • Use of a very mild soap on the face is recommended.

Schedule:

  • No set rule, no limit to the number of light peels.
  • Once in 3 weeks, for 6-10 sessions.
  • Maintenance as and when required.
  • In case of partial recurrence the patient shall go for additional light peels, at necessary intervals.
  • It is advisable that you talk to your dermatologist about chemical peel for acne scars cost and compare it with other options and opt for a viable one.
  • Chemical peel for dark spots and chemical peel for deep acne scars are 2 of the most preferred treatments.