Intraepidermal peel

There is one basic principle to be respected a peel should not be unnecessarily deep or unnecessarily superficial. There is no point completely destroying the papillary dermis when treating a purely epidermal problem, and it is pointless and ineffective to use an intraepidermal peel, even repeatedly, to treat a dermal problem. 

At the other end of the scale, what is the minimum age for having a chemical peel The answer is simple in the majority of cases, a peel is only necessary for young patients if they have acne. Acne responds extremely well to intraepidermal peels or peels to the basal layer of the epidermis. Deeper peels are not recommended when the skin is infected. Very young patients benefit from relatively superficial techniques... 

Comedonal acne (Figure 5.5) can be treated with an intraepidermal peel or a peel to the basal layer. A trichloroacetic acid (TCA) peel to the papillary or reticular dermis could be considered, but such a deep treatment would be pointless for this type of disorder, which can be treated with a lighter peel and, in any case, requires longterm maintenance treatment. 

The depth of the peel applying TCA is painful, but an intradermal peel is far more painful than an intraepi-dermal peel. An intradermal peel should be applied zone by zone for the patient s comfort, while an intraepidermal peel can be done in one go. 

After an intraepidermal peel, to the basal layer or the Grenz zone, the skin regenerates from leftover islets of ker-atinocytes. In the case of a deep peel, the skin regenerates from its appendages. The face has more pilosebaceous units than the neck, and facial skin regenerates more quickly, with less risk of scarring. 

An intraepidermal peel is characterized by the following symptoms erythema without frosting after an AHA peel or erythema and maybe some pinpoint frosting after a TCA peel. Phenol is not indicated for this depth of action. 

Intraepidermal peels do not stimulate melanocytes and never cause achromia. There is no risk of skin discoloration. However, some sensitive skins react to any inflammation by stimulating melanogenesis. The risk of post-peel hyperpigmentation cannot therefore be ruled out completely. ... 

Even if the acid reaches the papillary dermis in places, a large number of keratinocytes survive, allowing the skin to regenerate very quickly. The process of re-epitheHalization is the same as for intraepidermal peels the basal layer keratinocytes are stimulated to grow. 

Open healing is slower than when the re-epithelializing wound is covered. This does not matter for intraepidermal peels, as the dermis is still covered by several layers of living and protective keratinocytes. On the other hand, when it comes to medium or deep peels, this is of major importance. Peels have an advantage over laser or mechanical abrasive treatments in that they leave a layer of skin in place. This layer of skin is of course dead, but it offers pro-... 

The majority of the skin s immune defenses are found in the deep layers of the epidermis and dermis. An intraepi-dermal peel lets in many xenobiotic microorganisms, but all of the skin s defenses remain viable and usually stop any local infection from developing. After an intraepidermal peel, skin regeneration is very rapid and there is not really enough time for infection to set it. Intraepidermal peels are usually repeated once a week or every 2 weeks. Each intraepidermal peel stimulates the skin s regenerative capacities, and the skin finds it more and more easy to resist infection. Therefore, these peels do not increase the risk of infection (or only very little). The risk of herpes is not increased. 

Intraepidermal peels to the basal layer or the Grenz zone do not require such stringent precautions as deep peels, and... 

Intraepidermal peels or peels to the basal layer rarely cause pruritus, except in overpeeled areas, where it may be temporary. Peels to the Grenz zone do not cause much pruritus. There have been no reports of severe pruritus with Easy TCA , except for two cases of allergy to the post-peel... 

Acne can be either treated or triggered by a peel. An intraepidermal peel (Easy Phytic ) or a peel to the basal layer (Easy TCA ) is usually a good treatment for come-donal, papular or even papulopustular acne. Intraepidermal peels or peels to the basal layer do not usually trigger post-peel acne, unlike peels to the papillary dermis, which can promote secondary infections. 

Intraepidermal peels or peels to the basal layer of the epidermis do not create a demarcation line. TCA peels to the papillary dermis can change the texture and color of the... 

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