Is a skin peeling treatment dangerous?

Chemical peelings - forms, ingredients & possible indications

Expert interview with Dr. med. Stefan Zimmermannon the subject of "chemical peelings"

Dr. med. Stefan Zimmermann is a specialist in plastic and aesthetic surgery and has specialized in surgical and cosmetic beauty treatments at the Aesthetics Private Clinic in Dresden.

The cosmetic treatments that are enjoying increasing popularity include so-called chemical peelings. The long-time expert is particularly familiar with this area of ​​treatment and answers the most important and interesting questions about it in an interview.

Dr.Zimmermann, cosmetic treatments are no longer uncommon - even younger patients now have gentle skin treatments carried out on a regular basis. In particular, chemical peeling has been further developed in recent years. What exactly do you mean by that?

The term chemical peeling is a treatment aimed at peeling off layers of skin down to a certain depth. This allows the skin to regenerate and rebuild itself. After this reconstruction, the skin looks significantly fresher than before.

Besides chemical peeling, are there any other forms that can “refresh” the skin?

Yes, cosmetic peels can be divided into mechanical, physical and chemical Peels. For mechanical peeling, creams or lotions are used to which, for example, some sand or salt crystals are mixed. The topmost corneal cells are removed by the friction on the skin. In return, the substances penetrate significantly deeper with a chemical peel, so that the lower layers of the skin are also reached. This is what stimulates the body's own regeneration processes and the skin builds up again from the depths.

Where did the idea of ​​applying substances to the skin and thus creating a cosmetic effect come from?

In fact, this is a very old process, as people's need for beautiful and clear skin has always been and still is. That is why the first attempts at peeling go back to a wide variety of cultures that are thousands of years old. At that time, for example, the Egyptians used various animal oils, salts and alabaster, to improve the skin's appearance. The Indians used urine and / or pumice stone. Around 1900, various fruit acids and other chemical substances came onto the market that could be used specifically to force the skin layers to renew.

Well, you've already mentioned what mechanical peels are made of. In comparison: what are chemical peelings made of or how are they composed?

Chemical peelings can also be divided into different groups. On the one hand there is the so-called Fruit acid peelingTypical representatives are glycolic acid, alpha-hydroxy acid and trichloroacetic acid (TCA). This name comes from the fact that the acids contained are often found in low concentrations in fruit, for example in apples. The other substance group includes the Alcohols, which in different compositions can penetrate the skin to different depths, this is a typical example phenol.

They talk about the fact that the acids can penetrate to different depths into certain layers of the skin. How is the skin actually structured? What structures are there?

The skin is in a layer system three main layers built: The superficial layer of skin, Called epidermis, renews itself approx. Every 4-6 weeks by producing new skin cells from the basal cell layer (a kind of swelling layer). Over time, these migrate further and further up through several cell layers to the surface of the skin and end their existence as a dead cell layer (a kind of cover), then also called corneal cells. The middle layer of skin, Called dermis, mainly houses the elastic fibers and straps that give our skin its unmistakable elastic properties. The deepest layer of skin is ours Adipose tissue, Called the subcutis, and serves as a shifting layer, buffer and insulation.

Are there different levels of fruit acid peeling?

When it comes to fruit acid peelings, a distinction is made between light, medium and highly concentrated forms. With the light peelings you can achieve a slightly finer complexion by removing the dead corneal cells. The medium-heavy and highly concentrated peelings then penetrate further into the upper and middle layers of the skin, where they partially dissolve and dissolve the cell structure. In other words, to put it simply, these skin cells no longer have any contact with one another and are detached from the rest of the skin structure. This can be recognized by the fact that larger pieces of skin can be peeled off after a few days. With phenol peeling, the chemical substance penetrates into the middle layer of the skin and, in addition to rejecting the almost entire upper layer of skin, also causes the body to: to form new elastic fibers and collagen structures.

Do you have to go to a doctor or surgeon for a chemical peel, or is a cosmetic studio sufficient?

As well ... as. It always depends on what the patient wants to achieve with a chemical peel. Many beauty salons offer fruit acid peelings, which are classified as superficial, light peelings. The fruit acids are usually so concentrated that there are very few risks. But that also means that a Refreshing effect the skin only possible to a certain extent is. If you want a better effect through a higher concentration of acid, you can use peeling can only be carried out by a doctor.

What does it look like if the patient has extensive scars or pigmentation disorders on the face? Do you think a chemical peel would also make sense in such a case?

I would separate that: Scars and pigment disorders are two different complexes of issues. In the case of pigment disorders, it is always important to know how deep the skin is. Superficial pigmentation disorders can be easily reached with a peeling. The skin cells that cause a pigmentation disorder can also be removed. Accordingly, deeper-lying pigment changes are very difficult to achieve, so that a peeling is no longer sufficient here. The cause of the pigment disorders also plays a major role: If this is caused by too intense UV radiation (e.g. sunbathing or solarium), it can come back after a successful peeling treatment when you are exposed to the sun again. On the other hand are the scars, which must also be differentiated in terms of their nature: Acne scars can be improved by a medium-depth or deep peeling by making the scar funnels smaller. However, this does not mean that the scars will go away completely. Do I have a extensive burn scar On the face, a peeling cannot usually do anything either, as the structure of the skin is destroyed at this point and is accordingly subjected to a peeling measure cannot renew.

Would an enzyme peeling be more suitable in such a case?

In an enzyme peeling, protein building blocks are broken down by enzymes. This means that you can usually reach and remove the top layer of skin, e.g. the cornea, but nothing more. We therefore recommend laser treatment or medical needling to all patients who are bothered by large scars in order to improve the overall appearance of the scars.

In addition, is everyone eligible for a chemical peel, or are there certain groups of people you would advise against having such a treatment?

Here, too, a distinction must be made between the different peelings. D.he superficial peelings, which are also available in stores for home use or from beauticians, are generally suitable for everyone. Pregnant women are a special exception and should be particularly careful about the substances they let on their skin, as their skin reacts very strongly in every direction due to the influence of pregnancy hormones, e.g. with pigmentation disorders. With the medium-deep and deep peels, the patient should be in general basic health and not suffer from specific skin diseases. Skin type is also a factor that should be taken into account before peeling. People with a rather dark skin type, who are already very prone to pigment shifts, should generally be more careful, as their skin can produce more pigments as a result of such a treatment. Very light skin types have a greater tendency to sunburn after a peeling and have to stay on for a long time sufficient in front of the sun protect.

Now we come to the process of chemical peeling. How can such a treatment be imagined for you? Do you use certain devices or materials in your practice?

Let's assume we're talking about a medium to deep peel. Depending on the skin type, some pre-treatment may be necessary. This then looks like the patient should not go to the solarium or into the direct sun a few weeks before the peeling. Furthermore, he has to shut down the pigment activity of the skin with UV blockers and blending whitening creams. Herpes prophylaxis using tablets should also be carried out a few days before the peeling, as the stress stimulus on the skin can trigger a herpes infection in virus carriers. Once all of these preparations have been made, the peeling can be carried out. For the time after the peeling, we give each patient an individually made protocol, which they can read off when they should use which creams. These include above all UV blockers, blending whitening creams and other care products.

How much irritation is the skin with a peeling? Is an anesthetic necessary?

As a rule, the peeling can be carried out without any anesthesia. The medium-deep and deep peelings can cause a slight burning sensation on the skin. However, this only lasts for about two to three minutes and is usually tolerated well by every patient. Once you have achieved the desired peeling effect, a special ointment is applied that neutralizes the acid immediately and instantly suppresses the burning sensation. However, some patients take up the peeling treatment two to three hours after all Painkiller back, as the skin can “re-fire” a little.

In the media you often read about the so-called Frosting. Does this effect always set in or is it only the case with the phenol peeling?

First of all, I would like to explain what is meant by the Frosting understands: When the acid reaches a certain depth of the skin, the chemical processes that take place can cause temporary white spots to form on the surface of the skin. This is identified with the term “frosting”. Because of this effect the practitioner knows that the acid has reached a certain layer of the skin. However, frosting only occurs with medium-deep and deep peels.

How long does it take after a frosting to be fully socially acceptable again?

The frosting fades after just a few hours. As a result, the skin is initially reddened and the patient notices a slight feeling of tension. A few days later, the skin begins to peel. Once the peeled layer has completely peeled off, you are usually fully socially acceptable again and can also use makeup to possibly feel more comfortable. In other words, you can say that after a peeling that has created a frosting, you are only socially acceptable again after four or five days.

Can you see the final result after this time?

After this time, the fresh skin is initially rosy to reddish, comparable to an abrasion from which the scab has just come off in the healing phase. Depending on your skin type, it takes two to four weeks for the skin to normalize completely. With a phenol peel, however, one speaks of ten to fourteen weeks until patients can see a final result and the skin has returned to the "normal" range.

Would it be possible, for example, to combine a phenol peeling with medical needling or laser treatment in order to further improve the result?

Since the phenol peeling stresses the skin to a certain extent, you can additional treatment measures not in the same session be performed. If you want to have a medical needling or a laser treatment, you should allow a certain amount of time to pass between the respective applications.

Can the gentler peeling methods be better combined with other treatments?

Yes, the gentler scrubs can be done in the same session problem-free with other treatment methods combine. In many cases this is even an option, as a superficial peeling removes the corneal layer. The substances that are to be brought under the skin, for example by needling, can then penetrate much better and thus work more effectively.

You have already mentioned that UV blockers and other creams should usually be used after treatment. What about the choice of makeup? What should patients pay attention to during follow-up care?

Because the skin after the treatment first very dry and sensitive you should use makeup that you already know from previous use and not dare to experiment again. Furthermore, you should still have your skin Maintain more intensively in the morning and evening, you should pay particular attention to the moisture content and UV protection.

The phenol deep peeling creates a crust that comes off after about 10 days after the treatment. Should certain creams be used that ensure that this crust can peel off more quickly?

Yes, it is highly recommended. In the case of a phenol peeling, the attending physician will give the patient an exact treatment plan, at what time and with which product he should treat the treated skin areas.

Finally, we would like to talk about the cost of a chemical peel. Can you tell us what is the range of costs for a chemical peel in your practice?

With a superficial and medium-deep peeling you should per session with around 200 euros calculate. Patients should calculate around three sessions for this. Since the phenol peeling involves a greater effort and an inpatient stay in our clinic, the costs for this are incurred at 3000 euros and up.

The inpatient stay that you just mentioned, how long is it?

Patients should definitely use it one or two nights calculate. Of course, always depending on the scope of the treatment.

Since a chemical peel is a purely cosmetic procedure, it can be assumed that the health insurance company will not cover the costs, right?

Right, I am not aware that the health insurance company will cover the costs of a chemical peel.