Chemical peels

What is a chemical peel?
Chemical peeling is a technique used to improve the texture and tone of the skin. A chemical solution is applied to the skin, which causes it to separate and peel off, allowing new skin to regenerate in its place. The new skin is smoother, less wrinkled, and more even in colour.
 
Glycolic acid peels
 
What can glycolic acid peels do?
Also known as Alpha Hydroxy Acid (AHA) peels, glycolic acid peels rejuvenate environmentally damaged skin by gently lightening irregular brown pigmentation, freckles, age and sun spots, and reduce fine lines, pores and mild acne scars, leaving the skin with a smoother, more radiant look.
 
What happens during the procedure?
You should arrive with a clean face, without any makeup or moisturizers. We will thoroughly cleanse your skin, protect your eyes and hair, then apply varying concentrations of glycolic acid (a naturally occurring fruity acid) or alpha hydroxy acid (derived from sugar cane) to your skin in a series of 8 applications, each 2-3 weeks apart. You’ll see a gradual improvement with each session.
 
We leave the peel on until your skin has a hint of pinkness. You will feel a tingling sensation. Then, to neutralize the acid, we wash your face with water and apply a PH normalizer, which significantly reduces any discomfort following the procedure.
 
You must wear sunscreen on a daily basis and avoid tanning.
 
How long will my skin take to heal?
Healing depends on your skin type and the length of the time the acid is left on your skin. However, in general, your skin will stay pink or red for about 5-7 days. Some dry flaking or thin crusts may form – but these should resolve in 3-10 days. Most patients are able to return to their regular activities right away.
 
In some cases, patients experience facial swelling – if needed, we can prescribe topical steroids. Some patients may also notice that their acne temporarily gets worse, or their skin darkens.
 
Is a chemical peel right for me?
Most skin types can benefit from a chemical peel – glycolic acid peels are especially useful for oily skin with dilated pores. Older or dark-skinned patients tolerate peels very well. Younger or fair-skinned patients tend to be more sensitive and may experience slight to moderate amounts of burning, crusting, swelling or redness.
 
You should avoid chemical peels if you are pregnant or breast feeding, are taking photosensitive medications such as Vibramycin, Tetracycline, Minocin, NSAIDS or Thiazides, taking Accutane (you should wait 6 months to begin treatment), or if you have facial eczema or rosacea. If you are prone to facial cold sores, Dr. Nield will prescribe an oral antiviral treatment.
 
Vitalize Peels®
 
What is a Vitalize® Peel?
The Vitalize^TM peel combines the benefits of alpha hydroxy acids (lactic acid), beta hydroxy acids (salicylic acid), resorcinol and retinoic acid into a unique blend to target photo-damaged skin, pigmentation, dilated pores, and superficial acne. It stimulates the production of collagen and improves the penetration of skin rejuvenation products.
 
This peel is ideal for patients who have started and maintained a consistent skin rejuvenation program involving home product use and exfoliating treatments. It is suitable for most skin types and can also be used to maintain the benefits of other treatments such as photorejuvenation. Vitalize^TM Peels offers improved skin texture, tone, lessening of superficial lines. and a healthier, more youthful look.
 
What can I expect after a treatment?
Immediately after your treatment, you will notice a yellow tinge to your skin that will last an hour or so. Most patients will spend the rest of the day at home, but you can return to work the next day. Your skin may feel tight, as if you have been exposed to the sun or wind. You can wear makeup, but you will need to moisturize frequently, and we suggest you avoid strenuous exercise for 2 to 3 days afterwards, since perspiration may irritate your skin.
 
The degree of peeling will vary according to your skin type. Some people will not experience any peeling, while others may peel for several days to a week. Your fresh, newly exposed skin will be delicate, so apply sunscreen several times a day. Avoid scrubs, AHAs, Vitamin C and retinoids while flaking or peeling.
 
You will notice a marked improvement in texture in tone after your first peel, but for maximum benefits, you should have 4-6 Vitalize^TM Peels, scheduled every 3-4 weeks.
 
Cosmelan^TM Depigmentation Peel 
 
What is the Cosmelan^TM Peel?
The Cosmelan^TM Depigmentation Treatment has a very high success rate in reducing the appearance of melasma and sun-related pigmentation disorders such as lentigines. It improves skin texture and tone, and reduces facial pores and oily skin.
 
The Cosmelan^TM peel inhibits tyrosinase, an enzyme needed to produce melanin, and can help get rid of excess pigmentation. When compared with other depigmentation products on the market, Cosmelan^TM offers a number of advantages:

• It’s an effective treatment for epidermal melasma, and will reduce the appearance of mixed melasma (epidermal-dermal).
• The safe, easy peel application is compatible with all skin types, and allows the skin to appear more luminous and rejuvenated.
• Peeling and erythema may be significant, but not painful or prolonged.
• Treatment can start and be used all year round.
• No Hydroquinone or TCA in the product.

We fully evaluate every patient prior to treatment. If you have a history of facial cold sores, we will prescribe antiviral medication to use before and after the peel.
 
Who is a candidate for the peel?
We do not recommend peels if you are pregnant or nursing. If you have facial eczema or rosacea, you are probably not a candidate for the actual peel, but you may benefit from the at home products.
 
What can I expect after the peel?
All patients must commit to the strict protocol following the peel, which will be outlined in your consultation. You will come in for follow-up appointments one, six and twelve weeks after the initial peel. Usually, only one peel is necessary but some patients elect to have a second peel – it can be performed no sooner than one to  three months after the first one.
 
One week after starting the CosmelanTM depigmentation treatment, you’ll see a noticeable improvement. It may take a full three months to see a marked improvement.
 
There are two components to the treatment; the in-office treatment and the home treatment.
 
1. Office treatment (Cosmelan 1)
We start by thoroughly cleansing the surface of the skin and removing dead cells and oily residue. Then we apply the facial mask. The length of time it needs to remain on your skin is based on your skin type, and ranges from 6 to 10 hours.
 
2. Home treatment (Cosmelan 2)
The depigmentation treatment is followed by application of the Cosmelan 2 cream. The cream ensures the permanence of the initial depigmenting treatment, and is great for treating mixed and oily skin. You’ll apply the Cosmelan 2 cream to the entire treated area twice a day for the first two weeks. 15 minutes after you apply the cream, you will apply Hydra-Vital K cream, which is very moisturizing and can be applied more frequently to combat your dry, peeling skin.
 
In the first 24-48 hours, your skin may become very red (like a significant sunburn, but not sore or itchy). The redness may be followed by significant peeling and dryness that can last up to 2 weeks. You must not pick at the skin if it peels.
 
By week 3, you can decrease your Cosmelan 2/Hydra-Vital K cream applications to once a day. You’ll continue with this routine for 3 months, and you’ll notice that the pigmentation will gradually continue to fade. Without the creams, the pigmentation may reappear. You can use other facial creams like Kinerase^TM or Vivier^TM serum, but please speak to us first – every facial product must be approved in advance by our office to eliminate the possibility of side effects. Products with hydroquinone are not to be used.
 
Please note that melasma can redevelop, especially if you expose unprotected skin to the sun. It is vital to wear sunblock all the time. You can reapply the Cosmelan 2 cream any time in the future after sun exposure to help keep the melasma from reappearing.
 
Can I use Cosmelan 2 cream on its own?
Patients with rosacea or facial eczema are usually not candidates for the Cosmelan 1 peel treatment. However,the  Cosmelan 2 cream can be very useful on its own when combined with the Hydra-Vital K cream. Apply both creams (first the Cosmelan 2, then the Hydra-Vital K 15 minutes later) twice a day for 2-3 weeks. After that, use them once a day for 3 months to reduce pigmentation, then use them intermittently, depending on sun exposure.
 
Cosmelan 2 is also an effective treatment following photorejuvenation. One week after your last treatment, apply Cosmelan 2 on a daily basis to reduce the likelihood of the pigmentation returning.