Dermatology

Randy J. Jacobs, M.D., F.A.A.D.

Phone: (951) 672-ROSE (7673)

 

How Does the Sun Damage Your Skin?

Over time, the sun invisibly penetrates your skin, burns, and causes damage to your microscopic skin cells. The fibroblast cells (the cells that produce collagen and elastic skin tissue) are damaged. This causes collagen damage and elastic tissue damage and results in wrinkles. The basal and squamous cells are also damaged. This causes precancer and skin cancer. The melanocytes (pigment cells) are damaged. This causes melanoma and problems with your skin’s pigmentation.

 

 

How Can a Skin Peel Help?

 

A skin peel can remove old layers of sun damaged skin, revealing new skin, and can help repair damaged fibroblast skin cells. New collagen is formed. New elastic tissue is formed. Pigmentation is evened out and fine wrinkles are smoothed. This type of repair helps rejuvenate and restore your skin. In some cases, sun induced precancers are also removed, and skin cancer may be prevented. However, a skin chemical peel is not always the best answer for precancers, and, Dr. Jacobs may need to prescribe other ways to treat precancers before doing a skin peel on you. 

 

“Freshening” Skin Peels

Lifting Off the years

Your skin is a living organ made up of millions of cells. Everyday, thousands of cells die, fall off, and are replaced by new cells from below. Unfortunately, as we age, this type of peeling cell replacement becomes a slower and more haphazard process. With aging and too much sun, your skin becomes overwhelmed by dark blotches, sun damage, and a dull, lifeless complexion. The goal of a skin peel is to create an even, controlled shedding of several layers of skin cells. Peeling exposes a new fresh layer of skin with more even color and a smoother texture. This rejuvenating process can both decrease wrinkling and can prevent skin cancer. For people with sun damaged skin, a light to medium chemical skin peel can stimulate new collagen and elastic tissue to grow, thereby tightening the skin. This results in decreased wrinkles. For people with acne, a light peel may improve the complexion, soften scars, and decrease acne breakout. For people with color irregularities of the skin, a light peel may help restore evenness of color. After a careful examination, Dr. Jacobs may suggest one or two types of peels for your condition, each using a different chemical to create this peeling effect. Light to medium depth peels may be accomplished by using a Salicylic Acid or TCA peeling solution.

 

Indications for Peeling

Skin peels can improve many conditions:

 

         @Dull, weathered skin

         @Freckling

         @Blotchy pigmentation

         @Sun “damaged” skin

         @Fine wrinkles

         @Shallow acne scars

         @Melasma

 

What Peels Can and Cannot Do

1. A skin peel cannot change pore size, if anything a peel might temporarily increase pore size.

2. A skin cannot improve lax skin. Removal of fine wrinkling and cross hatching may not make a difference if there is profound lax skin that needs a face lift.

3. A light or medium skin peel cannot improve deep scars. Dermabrasion, laser, grafting, deep peels, or excision of scars are more effective.

4.  Skin peeling may not always remove skin hyperpigmentation in darker skin

5.Skin peeling cannot remove “broken” blood vessels (telangiectasias).

 

What Type of Peels Does Dr. Jacobs Do? Dr. Jacobs does two basic types of skin peels. 1. TCA and 2. Salicylic Acid. Briefly, with either peel, if you have a history of HSV cold sores, Dr. Jacobs will need to premedicate you, as a peel can precipitate an outbreak of cold sores.

 

For the TCA peel, Dr. Jacobs applies the solution to your skin, there is some pain like a sunburn, then, your face will go through a one week peeling process in which you apply face lotion many many many times per day while your skin peels. DO NOT PICK! Your skin should just peel off naurally.

 

For the Salicylic Acid peel, Dr. Jacobs applies the solution to your skin, there is some minor pain like a sunburn, then, your face most likely will not go through the visible one week peeling process. You will still need to apply face lotion many many many times per day fow a few days. DO NOT PICK! Note: Salicylic Acid peel is more of a microscopic “invisible” individual cell peel. Read ahead and you willl learn more about why the Salicylic Acid peel does not cause the same visible peeling as does the TCA.

 

What Is TCA?

TCA is an acidic chemical which has been used to perform skin peels for many years. TCA peels are deeper than the average glycolic acid peels and microdermabrasion, and lighter than phenol peels. Unlike deeper types of peels, light to medium depth TCA skin peels have the additional advantage of recreating a fresh restored natural appearing complexion, while preserving the normal skin color. For this reason they are often referred to as “freshening

peels.” Comparing TCA medium  & light peels to phenol, TCA does not go as deep, but is a safer peel. “Deep” phenol peels can give more remarkable results, but their incidence of scarring and side effects may be more than most patients would like to accept.  Compared to laser, for wrinkles, many doctors feel that phenol peels can give the better results. Dr. Jacobs can refer you to an associate if you need a deeper phenol peel.

 

Note: Because a TCA peel stimulates new collagen growth, and your body actually grows improved collagen for months following your peel, you may not see your maximum anti-wrinkle effect until six months after your TCA peel. Also, Also, TCA peels are additive. Multiple peels over time will give you a better result than one single peel. Please be patient, although one peel can significantly improve your appearance, some people’s skin problems may require more than one TCA chemical peel to achieve their best.

 

 

Who is a Candidate for a TCA Peel?

Women and men may both benefit. The best candidate for a TCA Peel is a fair skin sun damaged person. These people will receive the best results. Unfortunately, the TCA does not work so well for darker skin people. With TCA, darker skin people tend to get blotchy in color. Thus, for darker skin people, Dr. Jacobs may suggesst a Salicylic Acid Peel.

What is a Salicylic Acid Peel?

A Salicylic Acid Peel can work wonders on your skin. It takes just five minutes, but its visible results appear to lift years off your face. A Salicylic Acid Peel lifts individual microscopic damaged cells off the surface of your skin. A Salicylic Acid Peel can stimulates a “burst of renewal” within your skin to bring healthy, young, living cells to the surface. A Salicylic Acid Peel is also able to penetrate skin follicles, making the Salicylic Acid Peel a well-suited chemical peel for facial conditions such as acne, rosacea, and enlarged pores.

 

 

Visible Results to Expect

• Fine lines/ wrinkles can be less apparent

 

• Skin tone and color can even out

 

• Texture can become more refined

 

• Oily or acne-prone skin can be improved

 

• Enlarged pores can appear smaller

 

•  Superficial scars appear can reduced

 

• Skin can appear healthier, more youthful

 

Who is a Candidate for a Salicylic Acid Peel?

 

The Salicylic Acid Peel is a very helpful skin peel for people with the following skin needs:

 

• Those who desire a superficial light skin peel for any of the above reasons.

• Those who desire monthly or every other month maximum exfoliation for acne.

• Those with uneven color due to sun or the mask of pregnancy, melasma.

• Those with blotchy skin color.

• Those who failed bleaching creams.

• Those who want facial rejuvenation but are hesitant to try the deeper skin peels.

• Those with darker color skin who are not good candidates for the TCA peel.

 

Minimal “Downtime”

With a Salicylic Acid Peel, there is minimal downtime. You can go back to work right away. Your skin soon looks and feels smoother and tighter. Your face may temporarily appear a bit rosy, and, in a day or two, your face may begin to peel. But, in most people it may not visibly peel. Please Note: WIth Salicylic Acid, the degree of peeling can vary from invisible, to mild, to noticeable peeling and flaking. The degree of Salicylic Acid Peeling will depend on your individual skin and other factors. If you have a question,  Dr. Jacobs can discuss this with you. Please Note: The Salicylic Acid Peel may not give you the dramatic peeling seen with the TCA peel. And, you may not notice any peeling at all. But, do not be discouraged about this. The Salicylic Acid Peel works in a different way at the skin’s surface than does TCA. While TCA removes actual sheets of skin cells, a Salicylic Acid Peel removes individual skin cells by hydrolyzing intercellular bonds that hold skin cells together. Thus, a Salicylic Acid Peel removes individual cells, and you may not actually see any sheets of skin peeling off. However, with a Salicylic Acid Peel, the skin cells do come off one by one and you can find them on your pillow in the morning after you sleep. But usually, because the skin cells are microscopic, you may not see them. Now, some may think that the Salicylic Acid Peel has done nothing. But, rest assured, the Salicylic Acid works in an invisible microscopic way to accomplish the peeling goals. So remember, the Salicylic Acid Peel is a light peel and the peeling may be microscopic and invisible. If you want a more dramatic peel, you may have to advance to the TCA peel, and, this is only possible if you are a fair skin candidate.

The Consultation

If you decide that you are interested in a skin peel, you will need to set up a consultation appointment with Dr. Jacobs. Dr. Jacobs will examine your skin and discuss the potential benefits and risks of a skin peel for your particular skin type and condition. If you have a condition of the skin that may be helped by a chemical peel; and, if you and Dr. Jacobs both agree that a peel would be helpful, the skin peel may be one of the most rewarding treatments you can experience. Also, if Dr. Jacobs determines that you are a good candidate for a skin peel, to help prepare your skin for skin peeling, he may prescribe topical therapy such as Retin-A for one or more months prior to your peel. Careful pre-peel preparation can help you attain your very best results.