Mechanism of effect of cosmetological peeling and required frequency

Peeling is a treatment method that promotes turnover, which is the metabolism of the skin, by artificially peeling off the keratin accumulated on the surface of the skin , and is expected to improve dullness and acne .

While it is a relatively easy cosmetological treatment, there are many reports of skin problems such as inflammation after treatment. In order to aim for smooth skin by peeling, it is important to know its effect and appropriate frequency.

Peeling action to artificially remove dead skin cells

Peeling means "peeling" and "peeling". In the field of cosmetology, it is a treatment method that artificially removes old keratin accumulated in the stratum corneum and approaches skin metabolism that has declined due to external factors and aging .

The role of turnover that is arranged by peeling

The skin spawns new cells in the basal layer of the epidermis, pushing it up in a cycle of about 28 days, eventually becoming horny and eventually peeling off. This is called "turnover", and it is also due to turnover that scars and sunburn are restored to their original state.

However, if lifestyle-related disorders such as stress, eating habits, smoking, and sleep, external stimuli such as drying by ultraviolet rays and air conditioners, and skin turnover are disturbed with age, old keratin will accumulate without peeling off. I will.

Then, the skin loses its moisture and stains and wrinkles occur, and it is said that the pores are clogged with sebum, leading to skin problems such as acne.

Skin troubles that can be treated by peeling

• Spots and dullness
• Sebum clogging and darkening of pores
• Strawberry nose (clogging of nose pores)
• Acne / acne scars
• Rough skin
• Opening of pores
• freckles
• Red face
• scar
• Small wrinkles on the surface and medium depth
• Actinic keratosis

Peeling prevents the rate of epidermal cell renewal and regulates turnover disturbances that lead to skin problems.

When the turnover is adjusted normally by peeling, the water retention function of the skin is maintained. Healthy skin with water retention has a barrier function, so it can be said that skin problems such as acne and age spots are less likely to occur.

References: A Practical Approach to Chemical Peels-Practical approach to chemical peels

Available parts for peeling

• face
• Decorte
• back
• Upper arm
• Elbows / knees
• Hip
• Thighs
• Calf
• Heels

Peeling can treat any part of the body.

In areas where sebaceous glands are developed, such as the face and back, excessive sebum secretion often causes the pores to become clogged with sebum, causing acne. It is said that peeling improves the sebum clogging of pores, leading to smooth skin that is less prone to acne .

In addition, the elbows and knees have few sebaceous glands, but since they are joints, they have many opportunities to move and are susceptible to external stimuli. It is said that inflammation occurs due to irritation to the skin caused by elbows and knees, and the keratin becomes thicker, which causes darkening and dryness. Peeling removes excess keratin, leading to smooth skin with less darkening.

Those who are not suitable for peeling

Depending on the original skin quality and the current symptoms of skin troubles, peeling treatment may not be possible or may lead to deterioration. Therefore, it is necessary to be careful when using a commercially available peeling agent based on easy self-judgment.

• Extremely sensitive skin
• Those who have just or plan to get a sunburn
• Scratches, cuts, etc.
• Shaving the day before
• Keloid / autoimmune disease
• Crater-like acne scars
• Chloasma / freckles

• Pregnant / lactating
• Those who have eczema such as herpes
• Those who are extremely likely to have scars
• Those who have undergone laser or phototherapy within one month
• Those who shave or scrub face the day before

Number of peels and appropriate frequency

There are individual differences in the improvement of skin quality by peeling, and it is generally said that the turnover can be adjusted by repeating the treatment once every 2 to 4 weeks about 6 times . After the skin has turned over, it is not necessary to continue the peeling procedure.

It is important to remove unnecessary keratin, but if you remove immature keratin by peeling for a short period of time to accelerate turnover, the barrier function of the skin will deteriorate and skin problems such as age spots and inflammation will occur. Please follow the instructions of the medical institution as it may cause .

Number and frequency of peels in acne treatment

The effect of peeling acne treatment depends on the drug used and the severity of acne. It is said that the rate of new acne will decrease by repeating the treatment about 6 to 10 times on average, and it is said that it will improve the skin quality.

According to the announcement on the efficacy and safety of superficial chemical peels in the treatment of active vulgaris , glycolic acid chemical peels are a well-tolerated and safe treatment for active vulgaris. Salicylic acid peels are said to be useful in treating patients with darker skin and have shown a significant and faster improvement than glycolic acid.

In conclusion, chemical peeling with glycolic acid is a well-tolerated and safe treatment modality in active acne vulgaris while salicylic acid peels is a more convenient for treatment of darker skin patients and it showed significant and earlier improvement than glycolic acid

Source : Efficacy and safety of superficial chemical peeling in treatment of active acne vulgaris

Treatment period by peeling in spot treatment

It often takes months to years to treat age spots, so it may be desirable to use it in combination with other treatments such as laser.

Peeling type and peeling machine

Chemical peels performed at medical institutions have different concentrations from esthetics and commercially available peeling agents, so they are performed under the guidance of a doctor.

In addition to chemical peels that use acidic chemicals, medical institutions also use machines to remove unwanted dead skin cells. There are machines that can handle skin types that cannot be used with drugs, so treat with appropriate peeling under the diagnosis of a doctor.

Types of peeling

There are various types of chemical peels, including chemicals that use a type of acid (AHA) contained in fruits and natural lactic acid. The following describes the types and characteristics of each of the typical chemical peels.

Glycolic acid (AHA) peeling

It is said to be one of the typical chemical peeling agents and is also called fruit acid (AHA). According to a research presentation on the action of glycolic acid peeling on acne, which is known as the causative agent of acne, glycolic acid has been shown to have a growth inhibitory and bactericidal action on acne.

Our results demonstrate that glycolic acid has moderate growth inhibitory and bactericidal effects on P. acnes

Source : Glycolic acid chemical peeling improves inflammatory acne eruptions through its inhibitory and bactericidal effects on Propionibacterium acnes: National Library of Medicine

In addition, AHA peeling agents are said to have originated in the United States in the 1990s, and have been approved for import [*] by the Ministry of Health, Labor and Welfare in Japan since 1994.

Glycolic acid has been confirmed to be effective and safe in medicine, and because it has the smallest molecule of AHA, it has good penetration into the skin . It removes accumulated old keratin and activates epidermal cells to regulate turnover and also acts on the production of skin collagen, which is said to lead to firm skin. In addition, peeling treatment with glycolic acid can be applied immediately afterwards.

[*] Consumer harm prevention measures for chemical peels in esthetic salons

Lact peeling

It is said that lacto peeling using natural lactic acid is mild and can treat sensitive skin. Natural lactic acid is also a type of fruit acid and can be classified as an AHA peeling agent, but it has a larger molecular size than glycolic acid and is suitable for the treatment of symptoms in the shallow layer of the skin .

It removes accumulated old keratin, regulates skin turnover, and is said to have moisturizing and whitening effects, leading to improvement of pigmentation and uneven skin tone.

Salicylic acid macrogol peeling

Salicylic acid (BHA) is a drug that acts more strongly than glycolic acid, but it is highly irritating during treatment and requires downtime of about a week . According to a research presentation on the effect of salicylic acid peeling on acne, multiple patients with acne on the face were treated three times at 2-week intervals, and the number of inflammatory acne and non-inflammatory acne Has been shown to decrease in proportion to the duration of treatment.

Methods: Thirteen patients (13 men; mean age 22.6, range 20-28) with facial acne were enrolled. Jessner's solution was applied to one side of each patient's face and 30% salicylic acid to the other in three sessions at 2-week intervals A blinded investigator counted noninflammatory and inflammatory lesions before treatment and 2 weeks after each treatment. Results: Inflammatory and noninflammatory acne lesion counts decreased in proportion to the duration of treatment.

Source : Salicylic acid peels versus Jessner's solution for acne vulgaris: a comparative study

Salicylic acid macrogol peeling is a combination of salicylic acid and macrogol, which is used as a base for ointments, to suppress the irritation of salicylic acid and regulate skin turnover without damaging the skin. From clogged pores to inflammatory acne, it works gently and efficiently, and can be said to be a peeling that leads to smooth skin in a short period of time.

There is no domestically approved salicylic acid peeling agent, but it is a safe and effective peeling agent for many dermatological and cosmetic problems such as acne, chloasma, photoaging and freckles.

References: Salicylic acid as a stripper: Comprehensive review

Milk peel

A chemical peeling agent developed by Dermashtic of France that contains 3 types of glycolic acid, salicylic acid, and lactic acid. It is said to be a peeling that maximizes the merits of each of the three acids, and is characterized by high effectiveness and almost no downtime .

Although it is an unapproved peeling agent in Japan, it is expected to have the effect of removing unnecessary keratin and adjusting the turnover, and can be expected to have the effect of improving the firmness of the skin.

Massage peel

Peeling using "PRX-T33", a peeling agent developed by WiQo med of Italy, is called massage peel or collagen peel, and has the function of promoting collagen production in the dermis.

Apply a drug containing high-concentration trichloroacetic acid (TCA), low-concentration hydrogen peroxide (H2O2), and kojic acid, and massage the skin. It is said to be a peeling that penetrates deep into the skin and supports collagen production in the dermis, leading to a firmer skin quality, opening pores, and improving fine lines and sagging.

In addition, although it is an unapproved peeling agent in Japan, it is shown as a medical device registered by the Italian Ministry of Insurance and has obtained the CE mark [* 1].

[* 1] Indicazioni PRX-T33 della linea WiQomed commercializzato da GPQ: WiQo med

River peel

River Peel is a chemical peel that has been improved to act on liver spots with PRX-T33, a massage peeling agent. Also called chloasma peel, it penetrates into the outer layer of the epidermis, deep epidermis, and dermis by using three kinds of drugs, leading to improvement of chloasma and chronic pigmentation .

It is often difficult to improve chloasma at one time, so it is necessary to repeat the treatment. Please note that this is an unapproved peeling agent in Japan, and if you are receiving tretinoin treatment, you need to discontinue the treatment 2 weeks before reverse peeling.

Machine peeling performed at medical institutions

Hydra Facial

A peeling machine using water flow developed by Edge Systems of the United States is "Hydra Facial", a medical device that has not been approved in Japan but has been approved by the US FDA (US Food and Drug Administration). [* 2].

[* 2] Establishment Registration & Device Listing: FDA

Hydra Facial is a three-step procedure. First, it softens the skin, lifts dirt, cleans deep into the pores, and gently exfoliates. After that, it moisturizes while removing sebum clogging of pores with a spiral water flow without irritating the skin. At the end, it replenishes beauty ingredients and prepares the skin. It is especially effective for darkening of pores and clogging of sebum, and it can be said that it is a less irritating peeling compared to treatment with drugs.

Peeling procedure flow and precautions

Precautions before peeling

Avoid shaving, face shaving, and scrub facial cleansers, as chemical peels can work deeper than necessary if the skin surface is damaged. Also, if you receive other treatments such as laser treatment or phototherapy within one month, you may not be able to peel with the drug and machine, so be sure to consult with your doctor and receive the appropriate treatment.

Peeling procedure flow

Introducing the flow of chemical peeling that applies chemicals.

The flow of the peeling machine and hydra facial is explained in "Skin turnover that knows and prepares the number and frequency of effective hydra facials" .

After peeling, moisturize and protect against UV rays to prevent skin problems

Peeling is a treatment that artificially exfoliates the dead skin cells. After the treatment, the skin may become sensitive to some redness and tingling, so it is necessary to take proper measures against UV rays and moisturize.

It is said that the barrier function of the skin temporarily deteriorates because the keratin is peeled off after peeling. Therefore, it is easily affected by friction and ultraviolet rays, and the skin becomes sensitive to irritation. If you are stimulated, pigmentation is likely to occur, so you need to take proper measures against UV rays and be careful to avoid excessive face washing.

In addition, the skin immediately after peeling is in a state where moisture easily evaporates due to the removal of unnecessary keratin. For this reason, moisturize well.

Refrain from making up for about 12 hours after applying salicylic acid macrogol peeling. Other peels are allowed to be made immediately after the procedure, but please follow the doctor's instructions.

Approximate price of peeling

Depending on the medical institution, you can get a chemical peel for about 5,000 to 10,000 yen for the whole face, and a hydra facial for about 20,000 to 30,000 yen for the whole face . In addition, optional fees such as initial consultation / re-examination fee and iontophoresis may be charged separately, so please contact the medical institution at the time of consultation.

Treatment that can be used in combination with peeling

Immediately after peeling, old keratin is removed and beauty active ingredients can easily penetrate, so you can improve the effect by using various beauty agents and cosmetological treatments together.

Iontophoresis

After the peeling treatment, old keratin is removed and the skin becomes easy for the beauty active ingredients to penetrate. Therefore, it is said that a synergistic effect can be obtained by infiltrating a drug that suits skin problems by iontophoresis.

Phonophoresis

It is a treatment that introduces a large amount of cosmetological active ingredients by applying ultrasonic vibrations about 3 million times per second to the skin and temporarily causing a hollowing phenomenon in the barrier of the stratum corneum.

Laser and phototherapy

It is said that when the keratin is smoothed by the peeling treatment, the diffused reflection of light when irradiating with a laser or light is reduced, so it is possible to approach the target stains more.

Compared to peeling at home or at a beauty salon

Peeling type and peeling machine

Difference between beauty treatment and beauty treatment peeling

It is said that there is a difference in drug concentration between peeling performed at an esthetic salon and peeling at a medical institution.

According to the material released by the Ministry of Health, Labor and Welfare in 2000, it is clearly stated that chemical peeling that artificially peels off the surface layer of the skin using chemicals is a medical practice, but on the other hand, doctors such as beauty salons It has been shown that there are cases where chemical peels are provided by unlicensed businesses.

References: Questions under the Medical Practitioners Act

On the other hand, "chemical peeling" is prohibited in esthetic salons. Glycolic acid can be treated if the pH is 3.0 or higher and the drug concentration is 10% or lower, but in order to avoid skin problems, a medical institution should undergo a peeling treatment under the diagnosis of a doctor. Can be said to be safe.

Difference between self-peeling and cosmetological peeling

Commercially available peels include soaps and peeling gels, many of which contain an ingredient called fruit acid (AHA). It is said to be less irritating than peeling at medical institutions, but there is a considerable risk of causing new skin problems by removing even the necessary keratin due to incorrect peeling at your own discretion .

Peeling treatment at a medical institution can be said to be a highly safe and effective treatment because the doctor diagnoses and performs the medicine and treatment suitable for each skin type and symptom .

Even if a commercially available peeling agent does not suit your skin, it is said that the symptoms may be improved by receiving a peeling at a medical institution. In order to properly adjust the skin turnover and improve the skin quality, it is safe to perform appropriate peeling treatment under the diagnosis of a doctor at a medical institution.

(Updated January 2021)