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Professional Cosmetic Surgery and Healthy Ageing Clinic

Mr Jeya Prakash M.S. F.R.C.S.(Ed) 94 Harley Street London W1G 7HX
020 7224 1622

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Facial Skin Rejuvenation

1.  What are peels?
2.  Signs of Healthy Skin
3.  Brief History of skin peel
4.  What peels can achieve?
5.  What peels cannot achieve?
6.  What are the types of peels?
7.  What is the down time?
8.  Common reactions and side effects
9.  What are the contraindications for having a peel?
10. What are the complimentary procedures that are usually undertaken with peels?

What are peels?

Peels are a means of skin rejuvenation by removing the top layer of dead cells and stimulating the neighbouring cells to rejuvenate with newer cell s (better quality). The skin can be divided into 3 main components namely the epidermis , the mid dermis (and the deep dermis layers. There are different kinds of peels based on the layer of the skin that they act upon, the base composition of the peeling agent and the mechanism.

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Signs of Healthy Skin

Smooth- with optimal kerotanisation
Firm – with abundant functioning collagen and elastin
Evenly coloured – due to properly functioning melanocytes
Properly hydrated – moist without the use of moisturisers
Not damaged from medical conditions or the environment (no sun damage, large pores, acne)
Functions properly with efficient and continuous renewal (new cells regularly come up to  replace the old, has good circulation)
Tolerant to external factors – repairs itself quickly when scratched, scraped or otherwise injured because of an intact barrier function.

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Brief History of skin peel

The concept of abrading the skin, or removing the upper layers, for skin rejuvenation dates back to ancient times with plant and natural products. Microdermabrasion dates as far back as 1500 BC, when Egyptian physicians used a type of sandpaper to smoothen scars.In the early 1900's in Germany, Kromayer used rotating wheels and rasps to remove the upper layers of the skin. In the mid 1950's motorized version replaced their human-powered predecessors and the use of dermabrasion became more popular. The first micro dermabrasion machine was developed in 1985 in Italy.  Microdermabrasion machines were introduced in America by Mattioli Engineering in the mid-late 1990's, and the production of microdermabrasion machines has exploded.  Throughout the 1980s and 1990s continuous wave carbon dioxide (CW CO2) laser was being used to resurface photo damaged skin by removing the sun-damaged skin layer-by-layer and allowing the growth of new, smoother and more evenly toned skin. Further developments in the field of skin resurfacing within the last 10 years have seen a huge growth in the different technologies available. The concept of using a chemical agent to resurface the skin for purposes of improved appearance dates as far back as ancient times.The modern  history of chemical peel starts with the turn of the century using phenol to treat scars.

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What peels can achieve?

  • Improve skin texture, quality and appearance of skin
  • Improve circulation, hydration and tolerance of the skin
  • Reduce fine static lines
  • Smoothen skin and improve firmness
  • Radiant, glowing, vibrant skin
  • Restore even colour tone and reduce marks on the skin
  • Regular peels can reduce the occurrence of acne and reduce acne scarring
  • Slow down the signs of aging    

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What peels cannot achieve?

  • Reduce dynamic expression lines (Botox can do this)
  • Reduce facial veins or redness.
  • Does not treat active acne. Patient can only be treated with skin peels to reduce acne marks once the acne is no longer active.
  • Peeling is a qualitative improvement of the skin and does not reduce quantitative sagginess. 

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What are the types of peels?

Mechanical Peel :

Microdermabrasion (often referred to as Microderm) is a procedure in which the stratum corneum (dead outermost surface of the skin) is partially or completely removed by light abrasion, to mostly remove sun-damaged skin and to remove or lessen scars and dark spots on the skin. It works by means of the mechanical property of friction. 

Salt Peel:

Among the various methods of microdermabrasion salt peel is the best choice because it uses natural salt as the abrasive (not metal beads that may produce sensitization or toxicity in the skin, in some individuals). Following the microdermabrasion , an AHA and vitamin based masque rich in anti-aging ingredients is massaged into the skin using ultrasound. The nutrients in the masque then penetrate deeply and encourage an increase in collagen and elastin production. The treatment is not painful and the results can be seen from the very first treatment. The skin may become slightly blushed during the treatment, but after completion the complexion will correct itself with the skin looking fresh and with multiple treatments a natural glow can be achieved. To achieve maximum results on conditions such as acne, stretch marks, lines and wrinkles normally 6 – 7 treatments at one week intervals is recommended.

Chemical Peel :

It is a type of peel to exfoliate and tighten the skin, build-up the skin matrix and smoothen the uneven surface especially the deep wrinkles and scars by levelling. The different chemical peels are AHA base (30% to 70%), TCA base ( 15% - 20 %), Phenol base (49%), Tretinoin base, Phytic acid base, salicylic acid base, Ascorbic acid base.

The following are the combination of chemical peel compositions mainly used and their purposes –

AHA and 15% TCA exfoliates the skin.
20% TCA and 49% phenol does skin tightening and levelling.

Tretinoin, phytic acid and vitamin C do matrix buildup

Herbal Peel :

Herbal peel is based on pure plant extracts, free of any chemical or synthetic additives and can be used to treat any needed area of the body. Natural deep herbal peel, exfoliates the first three layers of the epidermis as well as stimulating blood circulation around the treated area. The results will be visible after 5 days, but the treatment continues to work deeper into the skin’s subcutaneous layer for a further 16 days.

Laser Peel:

Laser has the ability to emit light as a wave. Applied in a defocused pulse mode with proper spot size and power density, laser ablates and excises precise amount of layer of the skin, without damaging the deeper structure. You may need one or two passes of multiple pulses to achieve the desired level of vaporisation. The heat generated after laser application to the surrounding tissue improves collagen formation.

There are different kinds of lasers used for skin resurfacing eg Erbium Yag laser, Co2 laser, Fraxel Combination. They differ in the pulse width and the depth of penetration. Better results are achieved with deeper penetrating lasers. For further information please click here.

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What is the down time?

Mechanical Peel :  Microdermabrasion 2-3 days
Chemical Peels : Mild peel 5 days. Strong peel 10 – 14 days
Herbal Peel : Depending on the strength of peel  5 -10 days
Laser Peel : Erbium laser 5-10 days. Co2 laser 10 -14 days

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What are the contraindications for having a peel?

  • Presence of infection like Herpes Simplex
  • Poor compliance to skin conditioning program
  • High unreasonable expectation
  • Some peels may cause excess sensitiveness and may not be suitable for some individuals.
  • Certain peels can cause prolonged redness in some cases.
  • Certain peels can sometimes cause allergic reactions
  • Can increase pigmentation in certain types of skin

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What are the complimentary procedures that are usually undertaken with peels?

Botox, Fillers & Facelift

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