Cotswold Cosmetic Clinic

CHEMICAL SKIN PEEL: this regenerates collagen,reduces lines and wrinkles and generally restores a youthful complexion for up to 18 months. This peel is done over 1-4 visits, so each time there is a minimal post treatment inflammation. Simple to do, tried and tested. £180-£750.

SKIN PEEL: PLEASE SEE BEFORE AND AFTER PHOTOS AT BOTTOM OF PAGE
1) 4 stage TCA peel ie - 1 peel each week for 4 weeks.
This will obtain similar results to the one off medium dermis peel normally provided under anaesthetic when having a face lift.

N.B. A cream is recommended to be used by the company that manufactures the peel as part of the peel protocol.

2) 1 stage TCA peel, ie. a quarter of the treatment.
N.B. After using this peel for some years now, Dr Rowland has found that for many people the majority of the overall skin improvement is obtained after the first peel.

You will be advised during your consultation which peel is best for you.

Overview:
Chemical skin peeling is a safe and controlled medical procedure which can be performed on the face and other areas of the body. Every day skin accumulates dead skin on it's surface making it look dull, dry and aged. Peeling removes this dull outer layer so the skin appears smoother, pinker and tauter, with a more uniform texture. Other advantages of this procedure include the blanching of "sun spots" and the smoothing of wrinkles, some of which may disappear completely depending on the depth of the peel and the depth of the wrinkles. Skin cells called fibroblasts are stimulated by the peel itself to produce more collagen which keeps us looking young.

When is skin peeling used?
It is normally used to treat sun damaged skin and wrinkles. For fine lies (lentigines) a superficial peel is sufficient. For deeper wrinkles a deeper peel is needed. It can also improve acne and abnormal pigmentation such as dark blotches on the face caused by melasma (pregnancy mask). It does not solve the problem of very loose sagging skin that gives the face a "droopy" look. Only surery can improve such cases.

Skin depth and degrees of peel:

• Very superficial peels involve only the epidermis.
• Superficial peels include the epidermis and the outer dermis.
• Medium peels go deeper into the dermis.
• Deep peels can reach to half the depth of the dermis.

EPIDERMIS: The outer layer of the skin which is continuously dividing from it's bottom layer of new cells to the top layer of dead cells. This insulates the body from the outside world.
DERMIS: This is thicker and underneath the epidermis and is made up of collagen and elastin fibres (which give the skin it's youth and elasticity) as well as blood vessels, nerves, sebaceous and sweat glands and the hair follicles.

SKIN REGENERATION: If the peeling is superficial the skin regenerates from the bottom of the epidermis. If the peel is deeper the new skin grows from the epidermal cells deep down in their hair follicles.

Note: as a general rule the deeper the peel the better and longer lasting the result, but the chances of abnormal skin regeneration increases as well.

THE DEPTH OF THE PEEL DEPENDS ON: The chemical used, the concentration and the length of time it is in contact with the skin.

PREPARATION PRIOR TO PEELING: The skin may require a regime of cleansing and neutralisation prior to having the peel. This increases the chances of getting a uniform result and is usually started two or three weeks before.


LEVELS OF DISCOMFORT ASSOCIATED WITH PEELING:Superficial peels carry little or no discomfort at all. Obviously the deeper the treatment goes so the more discomfort is experienced. A medium depth peel can be obtained by having several shallower peels, a week apart, in succession. There is a minimum of discomfort with the effect of a much deeper peel.

Note: It is generally best to begin with a superficial peel with little or no discomfort. If there is any untoward reaction to the peel chemical used, it will be mild and, therefore quickly reversible.

THE HEALING PROCESS: The speed of healing is directly related to the peel depth, e.g.:

A very superficial peel applied before a special event e.g. a birthday party leaves a slight redness to start with but should heal in just a couple of days.

A superficial peel may take three or four days to heal and is usually done before a weekend. After treatment the skin becomes red and feels tight, just like a mild sunburn. Then it crinkles and peels. Moisturisers and makeup can be employed to mask these effects. This can be repeated to obtain the collagen response of deeper peels.

Note: The deeper the peel, the more collagen production is increased, the longer it lasts and since collagen gives the skin it's elasticity, the longer you look younger. The results of a four stage superficial peel usually last for up to eighteen months. Most patients have one a year.


MAKE UP AFTER PEELING: Each skin peel method carries with it it's own recommended make-up products and after-care procedures. Your doctor will advise you. Generally, it is best to use the lotions developed by the same manufacturer who has produced the peel. They have tried and tested the method they advocate and it generally works.

After a peel the skin should not be scratched or rubbed as this can cause uneven healing and even scarring. The manufacturers advice should be followed closely and the products recommended to alleviate any discomfort should be used.

CONTRAINDICATIONS TO PEELING:

• Patients who scar easily.
• Patients with darker skin types.
• Smokers, as their healing capacity is impaired.
• Patients who have unrealistic expectations of the treatment's outcome.

POSSIBLE SIDE EFFECTS OF PEELING:
Infection: If the patient is careful not to scratch or to contaminate the healing site there should be no problem. If there is any anxiety the doctor should be contacted.

Pigmentation: Skin colour may become lighter, darker or "blotchy". This usually applies to darker skin types. In general the skin will be "pinker" as it is "newer", this can sometimes be difficult to blend in with the patient's own skin colour when peeling a smaller area within a larger area, e.g. chest or back. The physician can "feather" the borders to achieve a blend, but this is difficult on darker or tanned skin types.

Herpes viral infection: A skin peel can cause the onset of a herpes (cold sore) infection. A course of an antiviral drug should be given before treatment.

The skin can be more sensitive to cold following a peel.

Itching and redness of the peeled area is a normal post peel effect and should be alleviated with the recommended lotion or a cold compress. Avoid scratching.

Sunlight should be avoided as much as possible after a skin peel, as exposure can cause abnormal healing and changes in pigmentation. A big hat is a good idea., or even better, stay indoors. A factor 30 sunscreen should always be worn in the day time, for up to 3 months after the skin has healed and a factor 60 if on holiday in the sun.

Cosmetics can be worn after the skin has healed. Discuss which products you can wear with your doctor.