Peeling is a procedure to remove the outermost layer of skin, so that it can be replaced with a new layer of skin. The goal is to make the skin look smoother, younger, and brighter, especially in the face, neck and arms area.
Peeling is done by applying a chemical solution to the skin area to be treated. The chemical solution will exfoliate the old layer of skin, so that a new layer of skin can grow.
Peeling can be done as a single procedure or in combination with other cosmetic procedures. This procedure can actually be easily found everywhere. For example, in aesthetic clinics and in hospitals. However, you should choose a peeling procedure that is carried out under the supervision of a doctor.
Peeling Type
Peeling is divided into three types, based on the depth of the skin being treated. The three types of peels are:
Peeling shallow (light chemical peels)
Shallow peeling is done to remove dead skin cells on the outermost layer of the skin (epidermis). This type of peeling is usually used to treat uneven skin tone, dry skin, acne, and fine lines.
Shallow peels use a chemical solution of a combination of alphahydroxy and betahydroxy acids, such as salicylic acid, glycolic acid, or maleic acid.
Peeling sedang (medium chemical peel)
Peeling is being done to remove dead skin cells from the epidermis and the topmost layer of the skin (dermis). This type of peeling is used to treat acne scars, facial wrinkles, and uneven skin tone.
Peeling is using a chemical solution of trichloroacetic acid or glycolic acid.
Peeling in (deep chemical peels)
Deep peeling is done to remove dead skin cells from the epidermis layer to the deeper dermis layer. This type of peeling is used to treat deeper facial wrinkles, sun damage, scars, and pre-cancerous cell growth.
Deep peeling uses a chemical solution of trichloroacetic acid or phenol that can absorb into the dermis layer of the patient's skin.
Peeling Indication
There are several conditions that cause a person to undergo skin care using the peeling method, namely:
- Acne or blackheads
- Acne scars
- fine lines
- Wrinkles
- Hyperpigmentation
- Scar
- Sebaceous hyperplasia
- Uneven skin tone
- Keratosis pilaris
- Actinic keratosis
- Seborrheic keratosis
- Dilated pores
- Milia
- wart
Peeling Warning
Consult with your doctor first before you plan to undergo peeling. The doctor may delay or not allow the peeling procedure, in patients with the following conditions:
- Suffering from herpes, or other infectious diseases caused by bacteria, viruses, or fungi
- Have a history of inflammation of the skin, such as psoriasis and atopic eczema
- Have a history of scar tissue formation, such as keloids or atrophic wounds, either in yourself or in your family
- Taking oral medications that cause sensitive skin or acne medications, such as isotretinoin, during the past 6 months
- Suffering from skin cancer, especially melanoma skin cancer
- Have a history of heart disease, kidney disease, or liver disease
- Have an open wound on the skin
To get the desired results, a shallow peel may have to be done every 1–4 weeks. Meanwhile, for moderate peeling and deep peeling, the therapy can be repeated in 6-12 months.
Before Peeling
There are several things that will be done by the doctor before carrying out the peeling procedure, namely:
- Checking the patient's medical history, including a history of illness, medications being consumed, and cosmetic procedures that have been done
- Check the patient's skin condition, including skin color and thickness, on the skin area to be treated
- Explain about the peeling procedure that will be carried out, the risks that may occur, the time required for the healing process, and the results that the patient will receive
While the preparations that may need to be done by patients before undergoing peeling include:
- Avoid sun exposure and use sunscreen regularly, to reduce the risk of uneven skin tone after the peeling procedure
- Taking antiviral drugs to prevent viral infections
- Using skin lightening drugs (hydroquinone) and retinoid creams, to reduce the risk of side effects and help the healing process
- Avoiding cosmetic procedures, such as massages and scrubs, or hair removal (waxing) in the area to be peeled, at least a week before peeling
- Invite a family member or friend to accompany and take you home, because the doctor may use a sedative in the peeling procedure
Peeling Procedure
The steps taken by the doctor in the peeling procedure depend on the type of peeling to be performed. Here is the explanation:
Peeling shallow (light chemical peels)
The doctor will first clean the patient's skin. After the skin is cleansed, the doctor will apply salicylic acid or glycolic acid to the treated skin area using a brush, gauze, cotton swab, or sponge.
Next, the doctor will allow the solution for a few minutes to work. At this stage, the patient may feel a stinging sensation. The patient's skin will also react to the peeling fluid by turning white or grayish white in color.
After all the treated skin areas have reacted to the peeling liquid, the doctor will clean the skin area and give a neutralizing fluid (neutralizer).
Medium peel (medium chemical peel)
The doctor will clean the patient's skin first, then apply trichloroacetic acid or glycolic acid. Just like with shallow peels, the patient will feel a stinging sensation during this process.
After the skin reacts, the doctor will apply a cold compress to the area. Even with cold compresses, the stinging and hot sensation on the face may last up to 20 minutes.
Please note, the treated skin area may appear reddish-brown for a few days after peeling. If the doctor adds blue peel with trichloroacetic acid, the patient's skin will appear bluish for several days.
The process of peeling or exfoliation generally occurs 48 hours after peeling and lasts for a week. During this process, the patient must keep the skin moisturized.
Peeling in (deep chemical peels)
In the deep peeling procedure, the doctor will first give a sedative and local anesthetic to numb the skin. The patient's heart rate will also be monitored during the peeling process. Next, the doctor will clean the skin to be peeled gradually.
After the skin is cleaned, the doctor will apply phenol every 15 minutes, to limit the exposure of phenol to the body. After the skin reacts to the peel, the doctor will rinse the patient's face with water. To prevent dry and sore skin, the doctor will apply an ointment to the patient's skin.
After Peeling
After undergoing peeling, patients may experience some complaints. In addition, the healing process can also be different for each patient, depending on the type of peeling performed, as described below:
Shallow peel (light chemical peels)
In shallow peels, the treated skin will experience mild irritation, dryness, peeling, and redness. However, this complaint will disappear after several times undergoing peeling. The healing process of superficial peels generally lasts 1–7 days.
Medium peel (medium chemical peel)
In patients undergoing moderate peeling, the treated skin will be swollen and red. After the swelling subsides, the skin will peel and have brown spots. This condition will disappear 7–14 days after peeling, but the skin can still look red for months.
Peeling in (deep chemical peels)
After undergoing a deep peel, the patient's skin may be very swollen. If peeling is done on the face, the eyelids may be difficult to open due to swelling. In addition, the skin will also be red, peeling, and burning for a few days to several weeks.
Same as in moderate peeling, swelling will disappear in 2 weeks, but redness may not go away after 3 months. The results of deep peeling can be lighter or darker than normal skin and can last up to 10 years.
In order to monitor the healing process, the doctor will advise the patient to check himself regularly. Meanwhile, to overcome the complaints that arise after peeling, the doctor will advise the patient to take the following steps:
- Do not rub or scratch the skin
- Avoid sun exposure by staying at home during the recovery process
- Applying a protective ointment, such as petroleum jelly, to moisturize the skin
- Use an ice pack to relieve stinging or burning on the skin
- Avoid using cosmetics or make-up, until allowed by the doctor
- Cover the treated skin area with a bandage, for a few days after peeling
- Taking pain relievers, such as ibuprofen
- Use sunscreen every time you leave the house
Peeling Risk
Peeling is a safe procedure. However, in some cases, there are risks that may arise after undergoing peeling, namely:
- Skin color is not the same
The color of the treated skin can be darker or lighter than normal skin. This condition can be permanent, and is more common in dark-skinned patients.
- Wound
Chemical solutions used in peeling can cause sores on the skin, especially on the lower part of the face. However, these sores can be treated with antibiotics and corticosteroids.
- Bacterial, viral, or fungal infection
In patients with a history of herpes, peeling is at risk of causing the herpes virus to reactivate.
- Damage to the heart, kidneys, or liver
This risk is higher in deep peel procedures that use phenol.
- The peeling results disappear quickly
This can be influenced by factors of increasing age or exposure to sunlight.