Proper evaluation and a photographic documentation of the patient’s profile are necessary before you go in for treatment. And this includes the consideration of the severity of acne damage, the depth and the number of rhytides, and whether there is any need for any additional or alternative treatment. Traditional rhytidectomy works better for a patient with deep rhytides and facial skin laxity. Chemical peel is best for a patient with moderate or severe photo damage and medium or fine rhytides. A lot of people may even benefit from both these procedures as rhytidectomy addresses skin quantity, whereas peeling addresses skin quality. However a minimum of 3 months is recommended between procedures to allow enough time for the wounds to heal.
A thorough look medical history and review of the patient’s medical file must be done before the treatment is taken forward. Previous cardiac, hepatic, and renal disease may decide also what you are supposed to use for chemical peels. The use of exogenous estrogens, oral contraceptives, and other photosensitizing medications often change how your skin reacts to peeling. That is the reason why such agents should be avoided for some time before and after a chemical peel. It is also in your best interest to allow any existing lesion to heal properly before proceeding with any chemical peel.
Patients should be able to comply and cooperate with the post chemical peel regimen which is essential for your wounds to heal normally. Patients who are likely to be noncompliant or find it difficult to avoid sun exposure because of their work are not suitable candidates to get a chemical peel. Men are also considered unsuitable candidates to get a chemical peel because of their thicker, oilier skin that may lead to uneven penetration of the peeling agent. Men too, are less likely to be willing to use camouflage makeup in case there are pigmentary disturbances. Patients with a reduced number of epithelial appendages from a radiation treatment or present Accutane use are not likely candidates as healing will be slow and scarring will be more likely. Recent use of Accutane is an absolute contradiction to medium to deep chemical peels. You should wait for at least a year after stopping Accutane to allow sufficient regeneration of epithelial appendages before going in for chemical peels.
Even though the technique of chemical peeling is simple, the challenge really lies in patient and peeling agent choice. The more severe the acne damage or advanced the aging, the quicker the treatment should be. Once the patient is ready to undergo a chemical peel, consent is obtained after discussing the possible complications that may come up. Preconditioning the skin is an important as it improves overall results.
The patient is required to follow the instructions of the doctor before the actual chemical peel process. You cannot afford to be casual about how you approach this treatment. Even after the peeling is done, you need to take sufficient care of it. Chemical peels, although rewarding requires a bit of thinking to be done, before you go in for treatment.