Depth of Peel Penetration
There are many physical factors that will affect the depth of peel penetration: pre-treatment with retinoids, glycolic acid, or other strong AHA products; previous peels; variances in skin density; and thickness of the stratum corneum, to name a few. Completing a thorough Patient Profile is crucial in determining these factors for each individual patient. Unless you adequately interview your peel patient, your treatment may penetrate much deeper than you might have anticipated.
Medium-depth and deeper peels have long been used by physicians and can cause blanching (white protein coagulation) that will stimulate a healing response in the skin, which will reveal new skin. Blanching can be the expected and desired end point of higher percentage trichloroacetic acid (TCA) and phenol peels that are performed by physicians. Superficial frosting is a crystal residue of salicylic acid that accumulates on the surface of the skin during treatment. Blanching and frosting are terms that are often used interchangeably by physicians and neither are incorrect.
Peel depth is typically characterized by the type and percentage of acid. The following illustration identifies the general depth of different acid solutions. The penetration of superficial solutions is primarily based on the state of the patient’s skin and the number of layers applied. If full blanching is achieved with the MD Peel (CCl3), it is likely penetrating to the deeper epidermis and maybe the upper papillary dermis, depending on the patient. The more prominent the white appearance is, the deeper the solution has penetrated (e.g. light grayish appearance is not as deep as a solid white appearance). The deeper the peel, the more critical post-procedure care becomes. An occlusive barrier product needs to be applied following ablative treatments until the skin is re-epithelialized when the post-procedure kit can be utilized. The kit should be used immediately following superficial treatments. Using The Post-Procedure Solution, Hyaluronic Acid Boosting Serum, and Dual Action Redness Relief for the first three to five days or until flaking has resolved (longer with a medium-depth peel), will ensure optimal outcomes.