How to perform a chemical peel
Always check with your doctor or dermatologist before beginning any skin care regimen.
First off, I’d like to say that I am of the opinion that “SOLUTIONS USING MORE THAN 10% FORCE SHOULD NOT BE PERFORMED AT HOME. In most states, estheticians are licensed to perform glycolic, lactic acid, and lactic acid peels.” and other alpha hydroxy up to 30% potency.” They can also use a Jessner peel at a 14% level and can apply up to 3 layers. Trichloroacetic (TCA) should only be performed by dermatologists or plastic surgeons. Use a licensed professional who is experienced in chemical peeling. Serious consequences can occur.
Clients who want a stronger than 10% professional chemical peel/peel should use an 8%-10% peel solution at home for two weeks before receiving a stronger chemical peel. They should also use a night cream with Retin-A (vitamin A) as an ingredient. Proper preparation will give the best results and please your client. Remember that “pre-planning prevents poor performance”.
I would also like to point out that my intention with this article is to provide information to licensed estheticians and other skin care professionals. This article is not intended for the general public. However, education is crucial for a better understanding. As a general rule, no one should use exfoliating agents on themselves, but inform them of a standard protocol that a licensed skin care professional would provide if this service were provided. (See my link for the TV show “LOS DOCTORS”).
Consult the Fitzpatrick Scale and determine if the client is an ideal candidate for a chemical peel. Allow the client to read and sign an informed consent form. This is very important. DO NOT PERFORM STRONG PEELS ON FITZPATRICK TYPES VI, V or VI. Also, know your contraindication before administering a peel. Do not perform any chemical peel on inflamed, irritated, or broken skin. The best advice I can give you is this: “WHEN IN DOUBT… DON’T DO IT.”
With that said, let’s get started.
1. Remove make-up: Usually the best option is a milky cleanser that is placed on a gauze or cotton pad and glided over the skin. Repeat until makeup is removed. Do not use petroleum jelly due to its occlusive properties.
2. Cleanse the skin: The esthetician should thoroughly cleanse the skin with warm water and a mild but effective skin cleanser. This cleanser should not be too strong, but it should be strong enough to remove dirt, debris, and sebum (oil). I recommend a gel or foaming cleanser for oily, combination, and problem skin because the surfactants help break down oil. For dry and sensitive skin, I recommend a milky lotion or cleanser. Rinse the skin with lukewarm water several times and pat the skin dry. DO NOT RUB SKIN.
3. Degrease the skin – This step involves degreasing the skin by applying 70% or 90% isopropyl alcohol or acetone to the skin with a gauze pad or cotton pad. Be careful when using 90% isopropyl alcohol and acetone as they are very drying. I usually use 90% or acetone on oily and combination skin. Removing oil from the skin allows the peel solution to absorb more evenly as the peel solution does not have to pass through the sebum. Let the solution evaporate completely before continuing to step 4.
4. Prepare the treatment area for the peel: This is a crucial step in performing chemical peels. There is nothing worse than not being prepared. Make sure you have a neutralizing product on hand or a bowl of cold water mixed with about 3-4 tablespoons of baking soda (baking soda). Any of these products will be a lifesaver if something goes wrong. They will neutralize the chemical peel solution, which will help prevent further skin damage. Prepare your eye pads using standard butterfly cotton pads or large eye pads soaked in cold water. Use a Q-tip to put a small amount of Vaseline as close to the bottom of the eye and on the upper lid as possible. This will prevent the peel solution from being absorbed. Place protective eye pads over client’s eyes. Give the customer a portable fan and turn it on. The fan will help relieve discomfort as the chemical peeling agent is applied to the skin. You are now ready to apply the chemical peel agent.
5. Peeling Agent Application: After ensuring the client’s eyes are protected, begin applying the peeling agent. Use a square of gauze or a large paring swab to apply the solution. You should usually start at the forehead and slide your finger across. Then go down the nose and along the cheeks, then to the chin area. Use a small cotton swab soaked in the peel solution to swipe under the eye area. NEVER APPLY PEELING AGENT TO THE UPPER EYE. If you are using glycolic acid; lactic acid; or an alpha hydroxy acid (AHA) solution, the amount of time it remains on the skin has a direct correlation to the strength of the solution applied to the skin. In other words, a 10% solution can be left in longer than a 30%, 50%, or 70% solution. The stronger the solution, the less time it spends on the skin. Also, if this is the client’s first time receiving a peel, then you may not want to leave the peel solution on for as long. In general, most AHA, glycolic, and lactic acid exfoliating solutions can be left on for up to 10 minutes. Lactic acid is the best option for dry and sensitive skin, as it tends not to dry out. Watch for increased redness and irritation. Then remove by rinsing with cold water. Rinse skin at least 3-6 times. Then use the water and baking soda mixture to stop the chemical reaction. Dry the skin. DO NOT RUB SKIN.
If the peel solution is a beta-hydroxy acid (BHA) such as salicylic acid, time is not the only factor in determining when to end the peel. You MUST look for the “frosting”. Glazing is the process of breaking down keratin in the skin. Typically, the skin will turn white like icing on a cake. One coat may be enough, at some point 2 or 3 will be needed. If more than one coat is needed, wait 45 seconds to 1 minute before applying additional coats. Note that you are not looking at precipitation of salicylates. It looks like frosting, but it’s just the salicylic acid reacting with air. The frosting will look more pinkish white. Once the frost sets in, allow it to remain on the skin for about 1-3 minutes, then rinse with cool water. DO NOT RUB SKIN. DRY. BHA peels cannot be neutralized. A cold towel applied to the skin is usually enough to relieve discomfort.
If the peeling agent is a Jessner’s solution, it must be a 14% solution. Jessner’s peel consists of 14% salicylic acid, 14% lactic acid in a resorcinol solvent. This peel is strong and provides great results when used correctly. Similar to a salicylic peel, the Jessner peel is ideal for clients who want to improve skin tone, acne, and fine lines and wrinkles. Glazing also occurs with this shell. The use of a fan is required with this peel. Wait about a minute between coats. Esthetician can usually apply up to 3 layers, while doctors can apply more and can use higher force. Once again, this peel is ideal for clients who have oily or combination skin. Once the glaze appears, do not apply any more solution. Allow it to stay on the skin for about 3 minutes, and then apply a cold towel to the skin.
If the chemical peel is a trichloroacetic acid (TCA), a doctor must administer the peel. Beauticians should not perform this peel. If you want information about this peeling, go to your dermatologist or your doctor. I am sorry.
Now that the peeling has been done, what’s next? Well, in my opinion it is crucial to apply a hyaluronic serum on the skin. Hyaluronic acid is a hydrophilic (water-loving) ingredient that does not dry out. It is essential for all skin types. In fact, hyaluronic acid is found naturally in the deepest tissues of the skin. Originally discovered in the comb of a rooster, it is now produced synthetically for cosmetics. It’s silky, smooth and helps plump the skin. Make sure you have a product on hand that contains it.
After you have applied the hyaluronic acid serum, apply sunscreen to the client’s skin and send them home. Your client should take home products to aid in the healing process. Hyaluronic serum, a skin lightener (alpha arbutin), Retin-A, moisturizer, and most importantly, an anti-aging sunscreen with SPF 30+. Follow-up with the client during the next 3 days by phone. Approximately 10 days after the peel, the client should return to the salon for a follow-up visit and facial. This is when you, the esthetician, can assess the peel. During the healing process, you want to reassure the client that what is happening to their skin is expected. Give them a take home form that reminds the client that what they are experiencing is normal. Encourage your client to keep their skin clean and moisturized. Make sure they use enough moisturizer and sunscreen. Advise them to avoid prolonged sun exposure for the next month. Manual brushes should not be used to wear down or speed up the peeling process. The slower the peeling process, the healthier.
Remember that peels can produce different results for any individual. It is your responsibility to obtain an informed consent form from your client. By carefully evaluating your clients and using the right tools (ie Fitzpatrick scale), you should be able to provide excellent anti-aging skin care to your clients.