SKIN CELL TURNOVER

Every square inch of your skin contains 19 million cells, about 1,000 nerve endings, 20 blood vessels, and around 600 sweat glands. The complex mix of water, proteins, fats, and minerals your skin contains, give it the strength, glow and smooth appearance.
Most of the time, we don’t even realize when the skin is taking care of itself through its own biological processes.
What we refer to as “skin cell turnover” is the process of your skin constantly getting rid of dead cells to reveal new, younger cells that replace them to maintain its overall health. This turnover process happens roughly every 28 days for young adults roughly age 30, and is vital for skin health, as the outer layers are constantly damaged by external aggressors like UV radiation, bacteria, air pollution, and harsh chemicals.

When your skin cell turnover is fast, as in childhood, the skin is smoother, supple, and more radiant, but as we age the cycle becomes slower and less efficient. For every decade over age 30, our cell turnover is about one week slower.

As skin cell turnover stagnates, we end up with blocked pores, dull skin, uneven texture, acne, hyperpigmentation, milia, and an increased risk of developing wrinkles.

HOW CAN WE MAINTAIN OUR CELL TURNOVER / IMPROVE OUR SKIN HEALTH?
Measures to maintain bright, healthy skin, we can:
• Use chemical or mechanical exfoliants to scrub away the dead cells.
• Apply products containing strong ingredients such as retinols that accelerate cell turnover, or vitamin C products to undo damage from free radicals.
• Improve your diet by consuming healthy, vitamin- and mineral-rich foods along with plenty of water to help flush toxins out of the body and reduce your sugar intake to control inflammation.
• Exercise regularly to enhance blood circulation and cleanse the skin.
• Make sure that you’re getting enough rest. You need at least seven hours of good sleep each night to give your skin time to repair itself and generate new cells.

CHEMICAL PEELS

A chemical peel, also known as chemexfoliation or derma-peeling, is a facial resurfacing procedure in which a chemical solution is applied to the skin to remove the damaged outer layers to improve and smooth its texture.
Chemical peels are used to treat wrinkles, discolored skin and scars — usually on the face. They can be done alone or combined with other cosmetic procedures. And they can be done at different depths, from light to deep. Deeper chemical peels offer more-dramatic results but also require a longer recovery time.

WHY IT IS DONE.
A chemical peel is a skin-resurfacing procedure. Depending on the issues you’re addressing with the procedure, you’ll choose a chemical peel in one of three depths:
• Light chemical peel. A light (superficial) chemical peel removes the outer layer of skin (epidermis). It’s used to treat fine wrinkles, acne, uneven skin tone and dryness. This can be repeated every 2-5 weeks.
• Medium chemical peel. A medium chemical peel removes skin cells from the epidermis and from portions of the upper part of your middle layer of skin (dermis). It’s used to treat wrinkles, acne scars and uneven skin tone. You might need to repeat the procedure to achieve or maintain the desired result.
• Deep chemical peel. A deep chemical peel removes skin cells even deeper. Your doctor might recommend one for deeper wrinkles, scars or precancerous growths. You won’t need repeat procedures to get the full effect.

RISKS:
A chemical peel can cause various side effects, including:
• Redness, scabbing and swelling. After a medium or deep chemical peel, redness might last for a few months.
• Scarring. Rarely, a chemical peel can cause scarring — typically on the lower part of the face. Antibiotics and steroid medications can be used to soften the appearance of these scars.
• Changes in skin color. Hyper and hypopigmentation.
• Infection. A chemical peel can lead to a bacterial, fungal or viral infection, such as a flare-up of the herpes virus which causes cold sores.
• Heart, kidney and liver damage.
A chemical peel isn’t for everyone. Avoid chemical peels if you:
• Have taken the oral acne medication isotretinoin (Myorisan, Claravis, others) in the past six months
• Have a personal or family history of ridged areas caused by an overgrowth of scar tissue (keloids)
• Are pregnant
• Have frequent or severe outbreaks of cold sores

Before your peel, you might also need to:
• Take antiviral medication for those that prone to cold sores. Your doctor might prescribe an antiviral medication before and after treatment to help prevent a viral infection.
• Use a retinoid cream. You may need to start to start using a retinoid cream, such as tretinoin (Renova, Retin-A) for a few weeks before treatment to help with healing.
• Use a bleaching agent. Your doctor might recommend using a bleaching agent (hydroquinone), a retinoid cream, or both before or after the procedure to reduce the risk of side effects.
• Avoid unprotected sun exposure. Too much sun exposure before the procedure can cause permanent irregular pigmentation in treated areas. Discuss sun protection and acceptable sun exposure with your doctor.
• Avoid certain cosmetic treatments and certain types of hair removal. About a week before the peel, stop using hair removal techniques such as electrolysis or depilatories. Also, avoid hair dying treatments, permanent-wave or hair-straightening treatments, facial masks, or facial scrubs in the week before your peel. Don’t shave the areas that will be treated beginning 24 hours before your peel.

WHAT ARE THE PROS AND CONS OF CHEMICAL PEELS?

Pros
• Chemical peels like VI Peels can be a powerful anti-aging tool, simultaneously treating multiple concerns, including fine lines, enlarged pores, dullness, skin discoloration, breakouts, and acne scars.
• You’ll see results as soon as skin stops peeling, about a week after your treatment.
• Compared to other in-office methods of treating the same skin conditions, such as laser resurfacing, VI Peel is far less expensive and has little downtime.
• A built-in anesthetic makes the treatment more comfortable than other medium-strength peels. “It stings a bit for about two minutes while the peel is being applied, but it’s very mild and easily tolerated.
• It can be used anywhere on the body, including the neck, chest, and hands.
Cons
• Expect to have a few days of “social downtime,” starting three to five days after the treatment when your skin starts to peel—especially if you get the stronger VI Peel Precision formula.
• Peeling or picking off flaking skin could leave you at risk for infection or scarring, so resist the urge.
• People with acne-prone skin may have new breakouts, commonly called purging, following the treatment. The VI Peel can cause blemishes to surface, but the solution will purify blemish-prone skin and clear up the acne below the surface as well as acne scars.
• It’s not uncommon to experience post-inflammatory hyperpigmentation two- or three-weeks following treatment. It can make discoloration you’re trying to treat (such as melasma) temporarily darker, but it’s rarely permanent. The pigmentation often fades away on its own, but it can also be treated to resolve faster.

WHAT IS THE COST OF A CHEMICAL PEEL?
• Range: $150-425
• Our medical grade VI PEEL is $275 per treatment. Like other cosmetic procedures, insurance will not cover the cost of a chemical peel. Purchasing a series of peels upfront will be more cost-effective.

WHAT TO EXPECT
Before the procedure
A chemical peel is usually done at an office or in an outpatient surgical facility. Before the procedure, your provider will clean your face, protect your hair, and cover your eyes with ointment, gauze, tape or goggles.
Pain relief isn’t typically needed for a light chemical peel. If you’re having a medium peel, you might receive a sedative and painkiller. For a deep peel, you might have a sedative, something to numb the treatment area and fluids delivered through a vein.

WHAT TO EXPECT
During a light chemical peel:
• Your provider will use a brush, cotton ball, gauze or sponge to apply a chemical solution typically containing glycolic acid or salicylic acid. The treated skin will begin to whiten.
• You might feel mild stinging while the chemical solution is on your skin.
• Your provider will apply a neutralizing solution or wash to remove the chemical solution from the treated skin.
During a medium chemical peel:
• Your provider will use a cotton-tipped applicator or gauze to apply a chemical solution containing trichloroacetic acid, sometimes in combination with glycolic acid. The treated skin will begin to whiten.
• After a few minutes, your provider will apply cool compresses to soothe treated skin. You might also be given a hand-held fan to cool your skin. No neutralizing solution is needed, however.
• You might feel stinging and burning for up to 20 minutes.
During a deep chemical peel:
• Your provider will use a cotton-tipped applicator to apply carbolic acid (phenol) to your skin. Treated skin will begin to turn white or gray.
• To limit your exposure to phenol, your provider will do the procedure in portions at about 15-minute intervals. A full-facial procedure might take about 90 minutes.

AFTER THE PROCEDURE
After a chemical peel of any depth, your skin will be red, tight, irritated or swollen. Follow your provider’s directions for sun protection, cleansing, moisturizing and applying protective ointments to your skin. And avoid picking, rubbing or scratching your skin. It may take several months before your skin color returns to normal and you can see the full results of the peel.
After a light or medium chemical peel, treated skin will be red, dry and mildly irritated — although these effects might be less noticeable with each repeat treatment. Your provider might apply a protective ointment, such as petroleum jelly, to soothe the skin. You can usually wear makeup the next day if you wish for a light chemical peel and 5-7 days for a medium chemical peel.
Following a light peel, new skin might temporarily be lighter or darker than normal. The treated areas then take about 1-7 days to heal. For a medium chemical peel, the treated skin will begin to form a crust and might darken or develop brown blotches. Treated areas take about 7-14 days to heal, but redness might last for months.
Use ice packs for comfort. Over-the-counter pain-relieving medication, such as ibuprofen (Advil) and naproxen (Aleve)may help reduce any discomfort.

RESULTS
A light chemical peel improves skin texture and tone and lessens the appearance of fine wrinkles. The results are subtle but increase with repeated treatments. If you have a medium chemical peel, treated skin will be noticeably smoother. After a deep chemical peel, you’ll see a dramatic improvement in the look and feel of treated areas. Results may not be permanent. Over time, age and new sun damage can lead to new lines and skin color changes.
With all peels, the new skin is temporarily more sensitive to the sun. Always remember to wear your sunscreen and avoid unnecessary sun exposure following your treatments.

VI PEEL

A VI Peel is a medium-strength, medical-grade chemical peel from Vitality Institute Aesthetics. This in-office treatment minimizes signs of sun damage and aging, including fine lines, wrinkles, and uneven skin texture and tone.
It also targets acne—in fact, the peel’s creator, Dr. Abdala F. Kalil, formulated it as a way to treat his teenage daughter’s stubborn breakouts. It works by removing both the epidermis (the top layer of skin) and the uppermost section of the underlying dermal layers, allowing them to be replaced by smoother, brighter skin.

WHAT IS A VI PEEL?
The VI PEEL formula contains a proprietary blend of active ingredients, including salicylic acid, trichloroacetic acid (TCA), phenol, vitamin C, and retinoic acid. The combination can deliver dramatic results more quickly than chemical peels that include only one of these ingredients, with less downtime than deeper peels.
It’s a much stronger acidic solution than at-home chemical peels, so it needs to be administered and monitored by a medical professional.

HOW SHOULD YOU PREPARE FOR YOUR VI PEEL TREATMENT?
For the week leading up to your peel, you’ll be asked to stop using prescription retinoids as well as any products that contain alpha hydroxy acids, like glycolic acid; beta hydroxy acids, like salicylic acid; or benzoyl peroxide.
You’ll also need to avoid waxing, electrolysis, depilatory creams, and laser hair removal for a week before the procedure.
These ingredients and treatments can temporarily weaken the integrity of the skin’s protective barrier and make skin more prone to burning and irritation.

Immediately after your peel, your skin will look darker, as pigmentation is brought to the surface.
By day two and three (before your skin starts to peel), it won’t be so apparent that you’ve had a chemical peel, and you’ll be able to return to your regular activities. But it’s important to follow your provider’s recovery guidelines closely.
Prior to exfoliation, the treatment area feels tight and a bit dry. Using a moisturizer recommended by your provider can help ease that feeling and mask the flakiness and peeling when it begins, usually within two to three days after the treatment.
Exfoliating can be anything from flaking to full strips of skin coming off. Moisturizing can help ease the sensation of itching.
The peeling process will continue for about a week, possibly a little longer. Some providers suggest scheduling your treatment on a Wednesday, so you’ll have the worst of the peeling over the weekend.

The length of exfoliation depends on individual skin types—for example, if your skin is drier or oilier—as well as whether the patient is in the habit of using Retin-A or vitamin C, which already causes the outermost layers of skin to be peeled off.
As tempting as it may be, don’t pick at your skin while it’s peeling; just allow the skin to slough off naturally. Picking or peeling can increase your risk of bleeding, prolonged redness, hyperpigmentation, and even scarring.
The best thing you can do to get rid of the flakes is to apply more moisturizer. This helps the flakes come off without damaging the new skin underneath.

WHAT CAN YOU EXPECT DURING VI PEEL RECOVERY?
Because the peel is medium depth, your “new” skin will be sensitive, and it may look red if you have fair skin. After the initial peeling, the remaining skin flaking, and redness should be much easier to cover and hide.
The level of peeling you experience doesn’t mean that the treatment is any more or less effective. Everybody reacts differently. The good news is, the VI PEEL works deep in the dermis to undo damage, so how much you peel is not an indicator of if it ‘worked’ or not.

Avoiding sun exposure while your skin heals is also key to optimal results. Chemically peeled skin is very sensitive. Strict sun avoidance is advised after a peel and during the initial healing process. After that, the use of a strong broad-spectrum sunscreen is critical. Always use a sunscreen with an SPF of 30 or higher.

HOW LONG DO VI PEEL RESULTS LAST?
You’ll see your final results about seven days after the peeling stops, and the length in which your results last will vary from person-to-person. Many patients can see results, often dramatic, after only one peel.

HOW MANY SESSIONS WILL YOU NEED AND HOW OFTEN?
Every individual’s response to a VI Peel varies, which then varies the number of sessions needed to achieve optimal results. Generally, most patients achieve effective results after two or three treatments.
The suggested initial number is a series of up to four treatments. The frequency will depend on your skin type. Some patients can tolerate VI PEELs every two weeks, while others can only do so every four weeks.
After you achieve the results you want, a follow-up treatment every three months is recommended. Your results can be extended if you take good care of your skin and remember to always wear a strong sunscreen daily.

WHAT ARE THE RISKS AND POTENTIAL SIDE EFFECTS OF A VI PEEL?
The VI Peel a medium peel is considered safe, with a few risks and complications. Like all chemical peels, changes in pigmentation, in which patches of skin turn darker or lighter than the surrounding skin can occur. You can reduce this risk by avoiding exercising, sweating, or raising your body temperature significantly for the first three or four days after your treatment. These activities could cause blistering or hyperpigmentation.
Brown skin is prone to hyperpigmentation. While this risk is lower with the VI PEEL than other medium-strength peels, hyperpigmentation is still a concern.
Luckily post-peel hyperpigmentation usually resolves on its own, but topical products can help resolve it more quickly.

The chemical solutions in the peel can also harm eyes, which is why wearing protective eyewear during the treatment and keeping your eyes closed is often suggested.

Rarely, scarring can occur after a VI Peel. The best way to mitigate scarring is to let peeling or flaking skin slough off on its own, during the recovery phase.

Finally, if you’ve experienced cold sores (HSV-1) in the past, there’s a risk of reactivation. To reduce the risk of a flare-up, an antiviral medication can be prescribed for you to be started just before your treatment.