Pigmentation Treatment

Chemical peels
A brief overview of chemical peels?
The safest peels, with least downtime, essential when treating pigmentation particularly, are natural AHA time dependent peels, providing rapid absorption, easily tolerated, a more gradual sustained improvement for all skin conditions. AHAs diminish corneocyte adhesion in the stratum corneum, ‘ungluing’ the outer horny layer working gradually down to the basal layer where melanocytes and healthy new cells are made, dramatically accelerates cell removal process, achieves true rejuvenation. Peeling promotes collagen and elastin synthesis, thickening, re-elastisizing skin, helping eliminate fine lines and smoothing wrinkles. Natural acids attract more moisture into the skin, plumping out wrinkles and are beneficial for all skin types, all ethnicities, all skin problems, all age groups.

Can all skin types with excess pigmentation be treated with chemical peels?
Clients with darker skins, Fitzpatrick IV to VI are particularly at risk of exacerbating a pigmentation problem if there is harsh or invasive treatment. Also, interestingly it has been found that clients with brown eyes, who may be blonde and have a lighter skin colour, can be more prone to pigmentation and caution should be taken when treating with either peels, laser or microdermabrasion. The chemical peel of choice is the critical factor. AHAs have proven to be safe, caution with TCA on these skin types as pigmentation can return with a vengeance 6 to 8 weeks after a treatment.

What are the advantages of chemical peels pigment removal?
Although treatment may be gradual they are a very safe method of treatment, ensuring a long term better result.

What are the disadvantages of chemical peel pigment removal?
If harsh chemicals are used pigmentation may be worsened or, as with TCA peels, it may be removed initially but in many cases it returns and is worse.

How successful is the treatment?
If the client is patient then a more gradual treatment can be 100% successful if the therapist chooses a formulation with a proven track record. Citric acid is known to have a beneficial effect on hyperpigmentation, it has AHA and BHA action so an acid of choice for all skin types, whether normal or problematic.

Will the pigmented areas come back post treatment?
Again, this depends on the type of peel used. In 23 years I have seen some dreadful results following TCA and phenol. If clients are informed that it is safer and in their better interest to be treated more conservatively then they will achieve a perfect result. The short sharp shock can end in tears.

Are there any contraindications of chemical peeling treatments?
This would depend on the chemical peel used. Clients must be informed that when treating pigmentation initially the skin may look darker before it looks better, this is only because of the outer horny layer detaching from the basal layer as it dries out in
the process.

Are there any side effects or risks associated with chemical peeling treatments?
If harsh peeling formulations are used these can cause hypertrophic and keloid scarring, hyperpigmentation and, worse still, hypopigmentation.

Are there any specific types of chemical peels that work best for pigmentation?
Natural AHAs have an excellent reputation and track record. When treating pigmentation, Citric Acid is one of the most effective AHAs.

On average how many treatments are required with what recommended intervals between sessions?
The number of treatments would depend on the severity of the pigmentation, whether the cause has been eliminated ie. If the Pill is the cause then contraceptive method has been changed. Client tolerance of the treatment plays an important role in how often a treatment can be given and the length of the treatment. Some peels such as 20% AHA concentration may be applied weekly, upto 90% AHA which can be applied 4 weekly. (Never use the 70% Peel & Heal for treatment of pigmentation)

Is any maintenance programme required?
A good home care regime must be in place to compliment the peels, laser or microdermabrasion treatments. When treating pigmentation certain types of product are critical: A day product containing UVA & UVB sunscreen, between SPF 15 and 30. Caution with higher SPFs as some could cause irritation, leading to exacerbation of pigmentation. A pigmentation product containing Vitamin C (ascorbic acid) is ideally applied am and pm under day and night products. Vitamin C is renowned for successfully treating pigmentation. A night preparation containing AHAs should be applied. NEVER if treating pigmentation should one apply an AHA in a daytime product as this can lead to worsening of the hyperpigmentation.

Combination treatments
Can you describe how the above treatments can be combined to achieve even better results?
With experience we have found that a combination of treatments can work extremely well for the clients who may have a number of skin problems. The general rule is that treatments should be 2 weeks apart, a peel at one session and laser/IPL 2 weeks later, but never on the same day. That would cause excessive peeling which would definitely be contraindicated for pigmented skins.

Topical applications
Do topical treatments work? Can you explain the science behind those products that do work?
Yes. See ingredients and the explanations