Every year, the facial peeling procedure finds an increasing response from people who want to improve their appearance without drastic interventions. At first glance, a harmless manipulation can become a problem in the hands of an unqualified specialist, since modern peelings contain chemical acids. In almost every case, the skin’s reaction to an acid peel is redness, as the burn is targeted.
Why might there be a side effect after peeling?
The goal of all peeling procedures is to renew the surface layers of the skin. differ in mechanism and depth of action. Chemical peels may contain one or more chemical acids of varying concentrations in their formula. The concentration of the acid and its pH play a decisive role in achieving a therapeutic effect. The higher the percentage of acid in the peeling and, at the same time, the lower the pH, the more active the peeling is. The more active the peeling, the more aggressive its effect on skin cells and the brighter the changes on its surface. The choice of peeling type is based on the condition of the skin, its thickness, phototype and the patient’s wishes for the result.
The organic acid in the peeling formula, acting on the skin, depending on the concentration and exposure time, dissolves the keratinized cells of the upper layers of the epidermis, and sometimes the entire epidermis, down to the basement membrane. This suggests that you should not underestimate the possibility of side effects after peeling. Complications can be predictable or unpredictable.
Predicted complications
Erythema. This is redness of the skin. The severity and duration of erythema is determined by the depth of exposure to chemical peeling and the chemical agent itself. After superficial peels, redness persists for about 1-3 hours, after superficial-medium peels – 1-3 days, after medium peels – for a period of 5 to 7 days. This complication is eliminated by applying cold compresses and maintaining the skin’s moisture level with emollients.
Swelling. It may occur 1–3 days after the procedure as a reaction to a violation of vascular permeability and the release of the liquid part of the blood into the tissue. Swelling is typical mainly for medium peels. Anti-inflammatory drugs and diuretics will help eliminate swelling.
Peeling. The most expected skin reaction to chemical peeling. The “used” stratum corneum of the skin dies and peels off. The exfoliation process can take from several days to several weeks, depending on the concentration of the exfoliative drug. The following can reduce discomfort from peeling and tightness of the skin: thermal water, vitamin B3 and pantothenic acid.
Hyperpigmentation. It is expressed by the appearance of dark areas of the skin and is typical for patients who neglected sunscreen in the post-procedure period. The occurrence of post-traumatic hyperpigmentation can be explained by the fact that in the cleaned epidermis, cells become more active, while the protective function of the stratum corneum weakens after peeling.Therefore, when UV rays penetrate the surface of the skin, it is not able to protect itself from the action of free radicals. The appearance of excess pigment on the surface of the skin can only be avoided by using sunscreens with a high protection factor (more than 50) during the entire rehabilitation period.
Hypersensitivity. Characteristic of patients with thin skin, with reduced regeneration. Excessive sensitivity occurs as a reaction to temperature changes in the layers of the skin when exposed to acids. Sensitivity can last from 1 to 3 weeks, but cases with an indicator of 6–12 months have been recorded. Microcurrent procedures and the use of cosmetics with omega-6, ceramides, hyaluronic acid, panthenol, etc. are recommended as restorative therapy.
Unpredictable complications
Herpes. The case of exacerbation of the herpes virus is typical for persons exposed to it at least twice a year. Peels with retinoids or trichloroacetic acid can often provoke an exacerbation. This viral skin rash in some cases can lead to the formation of scars of an atrophic or hypertrophic nature. To avoid such risks, it is recommended to carry out antiherpetic therapy with Acyclovir or Valtrex before the peeling procedure. If prevention of exacerbation of herpes was not carried out before the peeling procedure, and after the procedure rashes appeared, then the patient should undergo pulse therapy with Acyclovir or Valtrex, 1 g per day for 1–5 days.
Infections. Infection is most often caused by non-compliance with the rules of asepsis and antisepsis during manipulation, as well as during the post-peeling recovery period. Based on the nature and type of infection, antibacterial therapy is prescribed.
Allergic reaction. It can be expressed by a complex of symptoms: skin itching, redness, rashes, Quincke’s edema, etc.. The auxiliary components of peeling can often cause this complication. If the patient is prone to allergies, on the eve of the peeling procedure it is recommended to test the chemical composition on the inside of the arm. Self-medication in this case is contraindicated. The doctor should prescribe antihistamines and external therapy in the form of steroids.
Marbled skin color.The complication appears as a consequence of the destruction of a large number of melanocytes during an incorrectly performed chemical peeling procedure (for example, if an overly harsh reagent is chosen or the protocol is violated). Persons with skin phototypes IV–V are most susceptible to this complication. The result is difficult to correct, but superficial and superficial-medium peels will help to slightly even out the skin tone.
Persistent erythema. This consequence is most likely to occur when performing medium and deep peels on patients with rosacea. Persistent redness can be observed for up to 1 year, then it goes away on its own. You can shorten the reaction time by following a number of rules: avoid visiting baths and saunas, avoid sun exposure, minimize physical activity, and exclude spicy foods and alcohol. It is also recommended to take strengthening drugs for the walls of blood vessels.
Exacerbation of acne (acne) and seborrhea. A side effect may occur in patients with oily skin, since this is the environment favorable for the development of multiple bacteria. These patients do not need auxiliary therapy, since in 90% of cases sebum production decreases on its own 2–3 months after peeling. If acne elements of an inflammatory nature occur, they should be stopped by a dermatologist by using antibacterial drugs and sebum regulators.
Hypertrophic and keloid scars. They appear as a reaction of skin prone to scarring to aggressive peeling (medium TCA, phenol) or the result of a violation of the algorithm and technique of peeling by the doctor.Another reason for tissue scarring can be the patient’s post-procedure behavior, namely the self-removal of crusts on the skin.
If used incorrectly and uncontrolled, products with retinol can cause side effects: irritation, allergic reactions, thinning of the skin, dryness, pigmentation and sunburn. In addition, the component has an “adaptation period”, during which those new to retinol may notice flaking, redness, a feeling of tightness, and the appearance of new inflammations.
The main disadvantage of retinol is, first of all, that we cannot use it in sunlight. If a person does end up under the sun, then it is imperative to protect yourself with an SPF factor, otherwise there is a risk of hyperpigmentation. Also, if the skin is too dehydrated and dry, then a high concentration of retinol can lead to increased dryness, flaking and discomfort. Retinoids have side effects – they irritate the skin, which manifests itself in the so-called “retinoic dermatitis”: redness, itching, peeling, inflammation and, as a result, skin sensitivity, worsening rosacea, and the appearance of hot flashes.
Our clinic can solve any problem that arose with skin trauma after aggressive peeling with preparations with retinol or other acid, which gave undesirable results on the condition of the skin.
For treatment, we use fibroblasts, exosomes, and comprehensive skin restoration programs based on placenta or stem cells. The treatment program depends on the degree of skin damage.