COSMETIC SURGERY FOR AGEING SKIN: CHEMICAL PEELING AND LASER RESURFACING
Like dermabrasion, chemical peeling is used to rejuvenate sun-damaged skin. Chemical peeling can be performed to various depths using different concentrations of peeling solutions. The deeper the peel, the more effective the procedure but the greater the risk of complications. To obtain the best results from peeling, Retin-A should be used for several weeks beforehand. Chemical peeling is most suitable for fair-skinned people, while those with olive or dark skin are more likely to develop abnormalities in the skin’s pigmentation. All people must avoid sun exposure for at least three months after the procedure.
Superficial chemical peelingLight or superficial chemical peeling is done mainly to lighten brown blotches and create a fresher, ‘rosier’ appearance. It can be repeated every few months if necessary. Recovery is very quick with complete healing in three to five days. Light peeling has minimal risks and is usually performed in the doctor’s surgery.
Medium-depth chemical peelingMedium-depth peeling is the most popular chemical peel as it effectively removes fine wrinkles, brown blotches and freckles. The agents used are Jessner’s solution and Trichlorecetic acid, which penetrate to the level of sun-damaged collagen and elastin. This procedure can be done either in the doctor’s surgery or as a day patient procedure, and the healing time is from seven to ten days.
Deep chemical peelingDeep chemical peeling is a more risky procedure but is effective for deep wrinkles and severely sun-damaged skin. Day hospitalization and heart monitoring are necessary and recovery usually takes about fourteen days. Although the results can be excellent, there is a small risk of pigment change and scarring.
The Obaji techniqueRecent publicity has promoted Obaji peeling as the panacea for all skin ailments. Dr Obaji is a Californian dermatologist who has marketed his ‘secret’ formula for chemical peeling to the American public and to some Australian physicians. This formula consists of various strengths of Trichlorecetic acid and Retin-A. Although Dr Obaji claims to use other special ingredients, there is no published scientific evidence to demonstrate that these are any different to the regular combinations of Trichlorecetic acid and Retin-A. Because he uses Trichlorecetic acid in high concentrations (that is, over forty per cent), there is deeper penetration and several cases of scarring have been seen. The Obaji technique is by no means a completely new or risk-free procedure.
Laser resurfacing of the skinLike dermabrasion and chemical peeling, carbon dioxide lasers can now be used to resurface the skin, to eliminate the signs of sun damage such as wrinkles and brown blotches. This is an exciting development because lasers cause no bleeding and less swelling. Early results look very promising and there also appears to be less risk of scarring or pigment change. However, laser surgery should only be performed by those with specific expertise and training, which is not the same as for plastic surgery or dermatology. If you are seriously contemplating laser resurfacing of your skin, make sure your doctor has proper laser training certificates and is a member of a recognized laser society.
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