What To Know About Chemical Peel Pigmentation

What To Know About Chemical Peel Pigmentation

If you’ve been considering a chemical peel, the first thing you’ll want to know is how likely it is that pigmentation will occur afterwards. One of the main reasons people seek out chemical peels and other procedures is because they’re trying to get rid of acne scarring, or unsightly discoloration.

Unfortunately, this type of skin damage can be hard to avoid—even with the best dermatologist around. But there are some things you can do to reduce your chances of developing pigmentation after a chemical peel.

A chemical peel pigmentation is a great way to rejuvenate your face and you skin. If you’d like to have a much younger appearance, without the need for expensive plastic surgery, then this is one option that would be right up your alley. The good news is that everything is simpler and there are far better results than what others may lead you to believe. Read on to learn more chemical peel side effects and skin discoloration after chemical peel.

What To Know About Chemical Peel Pigmentation

A chemical peel is a procedure in which a chemical solution is applied to the skin to remove the top layers. The skin that grows back is smoother. With a light or medium peel, you may need to undergo the procedure more than once to get the desired results.

Chemical peels are used to treat wrinkles, discolored skin and scars — usually on the face. They can be done alone or combined with other cosmetic procedures. And they can be done at different depths, from light to deep. Deeper chemical peels offer more-dramatic results but also take longer to recover from.

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Why it’s done

A chemical peel is a skin-resurfacing procedure. Depending on the issues you’re addressing with the procedure, you’ll choose a chemical peel in one of three depths:

• Light chemical peel. A light (superficial) chemical peel removes the outer layer of skin (epidermis). It’s used to treat fine wrinkles, acne, uneven skin tone and dryness. You might have a light peel every two to five weeks.
• Medium chemical peel. A medium chemical peel removes skin cells from the epidermis and from portions of the upper part of your middle layer of skin (dermis). It’s used to treat wrinkles, acne scars and uneven skin tone. You might need to repeat the procedure to achieve or maintain the desired result.
• Deep chemical peel. A deep chemical peel removes skin cells even deeper. Your doctor might recommend one for deeper wrinkles, scars or precancerous growths. You won’t need repeat procedures to get the full effect.

Chemical peels can’t remove deep scars or wrinkles or tighten sagging skin.

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Risks

A chemical peel can cause various side effects, including:

• Redness, scabbing and swelling. Normal healing from a chemical peel involves redness of the treated skin. After a medium or deep chemical peel, redness might last for a few months.
• Scarring. Rarely, a chemical peel can cause scarring — typically on the lower part of the face. Antibiotics and steroid medications can be used to soften the appearance of these scars.
• Changes in skin color. A chemical peel can cause treated skin to become darker than normal (hyperpigmentation) or lighter than normal (hypopigmentation). Hyperpigmentation is more common after superficial peels, while hypopigmentation is more common after a deep peel. These problems are more common in people with brown or black skin and can sometimes be permanent.
• Infection. A chemical peel can lead to a bacterial, fungal or viral infection, such as a flare-up of the herpes virus — the virus that causes cold sores.
• Heart, kidney or liver damage. A deep chemical peel uses carbolic acid (phenol), which can damage heart muscle and cause the heart to beat irregularly. Phenol can also harm the kidneys and liver. To limit exposure to phenol, a deep chemical peel is done a portion at a time, in 10- to 20-minute intervals.

A chemical peel isn’t for everyone. Your doctor might caution against a chemical peel or certain types of chemical peels if you:

• Have taken the oral acne medication isotretinoin (Myorisan, Claravis, others) in the past six months
• Have a personal or family history of ridged areas caused by an overgrowth of scar tissue (keloids)
• Are pregnant
• Have frequent or severe outbreaks of cold sores

How you prepare

Choose a doctor with knowledge of the skin and procedure — a dermatologist or dermatologic surgeon. Results can be variable and depend on the expertise of the person doing the peel. Improperly done, a chemical peel can result in complications, including infection and permanent scars.

Before you have a chemical peel, your doctor will likely:

• Review your medical history. Be prepared to answer questions about current and past medical conditions and any medications you are taking or have taken recently, as well as any cosmetic procedures you’ve had.
• Do a physical exam. Your doctor will inspect your skin and the area to be treated to determine what type of peel you might benefit from most and how your physical features — for example, the tone and thickness of your skin — might affect your results.
• Discuss your expectations. Talk with your doctor about your motivations, expectations and potential risks. Make sure you understand how many treatments you might need, how long it’ll take to heal and what your results might be.

Before your peel, you might also need to:

• Take antiviral medication. Your doctor might prescribe an antiviral medication before and after treatment to help prevent a viral infection.
• Use a retinoid cream. Your doctor might recommend using a retinoid cream, such as tretinoin (Renova, Retin-A) for a few weeks before treatment to help with healing.
• Use a bleaching agent. Your doctor might recommend using a bleaching agent (hydroquinone), a retinoid cream, or both before or after the procedure to reduce the risk of side effects.
• Avoid unprotected sun exposure. Too much sun exposure before the procedure can cause permanent irregular pigmentation in treated areas. Discuss sun protection and acceptable sun exposure with your doctor.
• Avoid certain cosmetic treatments and certain types of hair removal. About a week before the peel, stop using hair removal techniques such as electrolysis or depilatories. Also, avoid hair dying treatments, permanent-wave or hair-straightening treatments, facial masks, or facial scrubs in the week before your peel. Don’t shave the areas that will be treated beginning 24 hours before your peel.
• Arrange for a ride home. If you’ll be sedated during the procedure, arrange for a ride home.

What you can expect

Before the procedure

A chemical peel is usually done at an office or in an outpatient surgical facility. Before the procedure, your doctor will clean your face, protect your hair, and cover your eyes with ointment, gauze, tape or goggles.

Pain relief isn’t typically needed for a light chemical peel. If you’re having a medium peel, you might receive a sedative and painkiller. For a deep peel, you might have a sedative, something to numb the treatment area and fluids delivered through a vein.

During the procedure

During a light chemical peel:

• Your doctor will use a brush, cotton ball, gauze or sponge to apply a chemical solution typically containing glycolic acid or salicylic acid. The treated skin will begin to whiten.
• You might feel mild stinging while the chemical solution is on your skin.
• Your doctor will apply a neutralizing solution or wash to remove the chemical solution from the treated skin.

During a medium chemical peel:

• Your doctor will use a cotton-tipped applicator or gauze to apply a chemical solution containing trichloroacetic acid, sometimes in combination with glycolic acid. The treated skin will begin to whiten.
• After a few minutes, your doctor will apply cool compresses to soothe treated skin. You might also be given a hand-held fan to cool your skin. No neutralizing solution is needed, however.
• You might feel stinging and burning for up to 20 minutes.

During a deep chemical peel:

• You’ll be given intravenous (IV) fluids, and your heart rate will be closely monitored.
• Your doctor will use a cotton-tipped applicator to apply carbolic acid (phenol) to your skin. Treated skin will begin to turn white or gray.
• To limit your exposure to phenol, your doctor will do the procedure in portions at about 15-minute intervals. A full-facial procedure might take about 90 minutes.

After the procedure

After a chemical peel of any depth, your skin will be red, tight, irritated or swollen. Follow your doctor’s directions for sun protection, cleansing, moisturizing and applying protective ointments to your skin. And avoid picking, rubbing or scratching your skin. It may take several months before your skin color returns to normal and you can see the full results of the peel.

After a light chemical peel, treated skin will be red, dry and mildly irritated — although these effects might be less noticeable with each repeat treatment. Your doctor might apply a protective ointment, such as petroleum jelly, to soothe the skin. You can usually wear makeup the next day if you wish.

Treated areas take about one to seven days to heal after a light chemical peel. New skin might temporarily be lighter or darker than normal.

After a medium chemical peel, treated skin will be red and swollen. You’ll feel stinging. Your doctor might apply a protective ointment, such as petroleum jelly, to soothe the area and prevent dryness. After five to seven days, you can use cosmetics to cover any redness.

Use ice packs for comfort. Over-the-counter pain-relieving medication, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others), may help reduce any discomfort. You’ll likely schedule a checkup soon after your treatment so that your doctor can monitor your healing.

As swelling decreases, treated skin will begin to form a crust and might darken or develop brown blotches. Treated areas take about seven to 14 days to heal after a medium chemical peel, but redness might last for months.

After a deep chemical peel, you’ll experience severe redness and swelling. You’ll also feel burning and throbbing, and the swelling may even make your eyelids swell shut.

Your doctor will apply a surgical dressing to treated skin. He or she might also prescribe painkillers. You’ll need to soak the treated skin and apply ointment several times a day for about two weeks.

Treated areas will develop new skin within about two weeks after a deep chemical peel, although redness might last for months. Treated skin might become darker or lighter than normal or lose the ability to tan.

You might prefer to remain at home while you’re healing from a chemical peel. You’ll likely need several follow-up visits soon after your treatment so that your doctor can monitor your healing.

Once new skin completely covers the treated area in about two weeks, you can use cosmetics to conceal any redness. Use sunscreen every day.

Results

A light chemical peel improves skin texture and tone and lessens the appearance of fine wrinkles. The results are subtle but increase with repeated treatments. If you have a medium chemical peel, treated skin will be noticeably smoother. After a deep chemical peel, you’ll see a dramatic improvement in the look and feel of treated areas. Results may not be permanent. Over time, age and new sun damage can lead to new lines and skin color changes.

With all peels, the new skin is temporarily more sensitive to the sun. Talk with your doctor about how long to protect your skin from the sun.

Chemical Peel Side Effects

hemical peel facts

• A chemical peel damages the skin in a controlled manner, producing a superficial wound.
• As the natural healing process repairs the damage, the skin’s appearance is improved.
• The nature of the chemicals applied to the skin determines the depth at which the damage occurs.
• The type of chemical peel used depends on the nature of the skin problem to be treated.
• Skin problems that respond best to chemical peels are due to chronic sun damage from ultraviolet light.
• Since most skin peels damage the skin, there is a period of recuperation necessary.
• As with any surgical procedure, there are risks, which include scarring, infection, and undesirable color changes.
• Currently, dermatologists often use chemical peels in conjunction with other destructive techniques like laser to diminish the signs of sun damage or acne scarring.

What is a chemical peel?

A chemical peel involves the application of toxic chemical solutions to the skin in a controlled manner, producing controlled tissue death. The desired depth of the wound is dependent upon the condition to be treated. After the peel, the skin regenerates. The damaged skin regenerates from deeper layers of the epidermis and from the superficial dermis.

What are the different types of chemical peels?

Chemical peels are broadly defined by the depth of damage in the skin that they produce. They are categorized as superficial (lunchtime peel), medium, and deep. Superficial peels do not damage skin below the epidermis, the most superficial skin layer. Medium peels may reach to the superficial layer of the dermis, the deeper layer of the skin. Deep peels generally reach the deeper layers of the dermis. 

The years of active breakouts may be behind you, but breaking up with acne is hard to do. Pimples may disappear, but all too often they leave behind an unfriendly reminder of their visit — acne scars.

Acne scars detract from your overall complexion, making many adults feel self-conscious about the way they look. Acne scars are stubborn, and home remedies, like over-the-counter bleaching agents, won’t do the trick. The good news is that acne scars are now treatable.

At Dontage Premier Aesthetic Anti-Aging Specialists in Falls Church, Virginia, we understand the frustration acne scars bring. Skin care specialist Waseem Garbia, PA-C, and his medical team provide warm, personalized care that’s customized to meet your unique skin care needs.

If you’re like most people with acne scars, you’ve done your research and know two top treatments that work to reduce facial scarring are chemical peels and microneedling. But it’s hard to know which is better for acne scars.

Read on to understand the difference between chemical peels and microneedling, and figure out which is better for your acne scars.

WHAT IS A CHEMICAL PEEL?

A chemical peel resurfaces your skin through the use of a chemical solutions applied to the skin. As the chemicals react on your skin, they exfoliate the top layer, causing it to eventually peel off, leaving room for new, smoother skin to grow.

There are three basic types of chemical peel treatments, and each type has different effects and different time required to heal. The choice of peel depends on the results you’re seeking.

Superficial peels use a milder acid and generally work best on mild discoloration. Medium-level peels penetrate the outer and middle layers of skin to lessen the appearance of imperfections, such as age spots and wrinkles. Deep chemical peels penetrate far into the middle layers and remove damaged skin cells for more dramatic results.

Waseem and the team at Dontage will evaluate your skin to ensure you receive the best peel for your unique needs.

Skin Discoloration After Chemical Peel

A chemical peel can cause treated skin to become darker than normal (hyperpigmentation) or lighter than normal (hypopigmentation). Hyperpigmentation is more common after superficial peels, while hypopigmentation is more common after a deep peel.

Superficial and medium depth peels are dynamic tools when used as part of office procedures for treatment of acne, pigmentation disorders, and photo-aging. Results and complications are generally related to the depth of wounding, with deeper peels providing more marked results and higher incidence of complications. Complications are also more likely with darker skin types, certain peeling agents, and sun exposure. They can range from minor irritations, uneven pigmentation to permanent scarring. In very rare cases, complications can be life-threatening.

Chemical peel is the most popular and common non-invasive cosmetic procedure done since the 18^th century. The earliest use of caustic preparations for peeling procedures was described in the Egyptian medicine in the Ebers papyrus as early as 1550 BC.[1,2] Dermatologists began to show interest in peeling in the 19^th century. In 1874 in Vienna, the dermatologist Ferdinand von Hebra used the technique to treat melasma, Addison’s disease, and freckles. In 1882 in Hamburg, Paul G. Unna described the actions of salicylic acid, resorcinol, trichloroacetic acid (TCA), and phenol on the skin.

During the first half of the 20^th century, phenol and TCA were used in several centers. Alpha-hydroxy acids (AHAs) became available as superficial peeling agents in late 1980s and the 1990s. AHAs are used in treating aging skin, melasma, photoaging and acne.

They are classified as superficial, medium, and deep peels. The superficial chemical peels are very safe when used properly but can cause itching, erythema, increased skin sensitivity, epidermolysis, allergic and irritant contact dermatitis, and post-inflammatory hyperpigmentation (PIH). All peels can cause activation of herpes viral infection, whereas medium and deep peels can cause scarring. Deep peels are no longer popular in Indian skin. They can cause milia, secondary infection, and scarring.

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COMPLICATIONS OF CHEMICAL PEELS

Chemical peeling involves the application of a chemical agent of a defined strength that results in exfoliation of the skin followed by regrowth of new skin leading to skin rejuvenation. It is a technique-dependent procedure. Although rare, complications may occur including persistent erythema, milia, scarring, etc.[3]

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CLASSIFICATION

1. Intraoperative[4]
   • Incorrect peel pharmacology
   • Accidental solution misplacement
2. Post-operative
   • Local infection
   • Contact dermatitis
   • Improper care during healing

Based on the time of onset, complications can be immediate or delayed.

1. Immediate (within minutes to hours after peeling):[5]
   • Irritation, burning, pruritus, and pain
   • Persistent erythema
   • Edema
   • Blistering
2. Delayed (within a few days to weeks):
   • Infections (bacterial, herpetic, and candidal)
   • Scarring, delayed healing, milia, and textural changes
   • Hyperpigmentation, hypopigmentation, and lines of demarcation
   • Loss of cutaneous barrier and tissue injury
   • Acneiform eruptions
   • Allergic reactions, toxicity, and ectropion
3. Accidental
   • Ocular complications.

Usually, complications are minor and are more common in dark-skinned individuals. They are seen more in medium and deep depth peels.

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PAIN AND BURNING

Prolonged sun exposure, inadequate application of sunscreen, using topical retinoid or glycolic acid immediately after peels can lead to this complication. Paradoxically, in some patients, sunscreens can themselves cause contact sensitization or irritant dermatitis.[6]

Pain and burning is commonly encountered during a peel procedure in sensitive skin. It can persist up to 2-5 days after the peel till re-epithelialization is completed.

Treatment

1. Immediate ice application reduces the pain and burning sensation
2. Topical calamine lotion soothes the skin
3. Topical steroids such as hydrocortisone or fluticasone reduce the inflammation
4. Emollients to moisturize the skin
5. Sunscreens to prevent PIH.

Persistent erythema

It is characterized by the skin remaining erythematous beyond what is normal for an individual peel. Erythema disappears normally in 3-5 days in superficial peel, 15-30 days in medium peel,[4] and 60-90 days in deep peel. Erythema persisting beyond the above-mentioned time is abnormal and is an alarming sign. It is a predictor of potential scarring.

Causes

1. Usage of topical tretinoin just before and after peel
2. Isotretinoin administration (<0.5 mg/kg body weight) prior to peel
3. Minimal amount of alcoholic beverages[7]
4. Contact dermatitis
5. Contact sensitization
6. Exacerbation of pre-existing skin disease
7. Genetic susceptibility.

It is due to angiogenic factors stimulating vasodilation which indicates that the phase of fibroplasia is being stimulated for a prolonged period of time. Hence, it can be accompanied by skin thickening and scarring.

Treatment

1. Topical, systemic, or intralesional steroids if thickening is occurring
2. Pulsed dye laser to treat the vascular factors.

Pruritus

It is more common after superficial and deep peels, although may occur following re-epithelialization.[8]

1. It may be due to contact dermatitis to a topical agent (retinoid)
2. If papules, pustules, and erythema occur along with pruritus, it is suspected to be contact dermatitis and treatment should start as early as possible to prevent PIH
3. Care should be taken not to start any new topical agent during maintenance period after peel
4. If erythema with pruritus or burning or stinging, rule out active infection or flaring of an underlying skin condition.

Edema

It is more common with medium and deep peels occurring within 24-72 h of chemical peeling. In case of superficial peels, care should be taken while peeling patients with thin, atrophic, dry skin and in the periocular area since edema can occur in these settings because of deeper penetration.[8]

Treatment

1. Usually subsides spontaneously
2. Application of ice
3. Systemic steroids (short courses).

Blistering

It is more common in younger patients with loose periorbital skin and around eyes. Deeper peels, especially AHAs, can cause epidermolysis, vesiculation, and blistering especially in the sensitive areas such as nasolabial fold and perioral area. TCA 50% and glycolic acid 70% can cause blistering [Figure 1].

Figure 1

Blistering seen post-chemical peel on cheeks

Prevention 

The nasolabial folds, inner canthus of the eye, and corners of the mouth should be protected with petroleum jelly.

Ocular complications

Accidental spillage of any chemical peel agents in the eyes can cause eye injuries in the form of corneal damage.

Treatment 

In cases of accidental spillage, the eyes should be flushed copiously with normal saline to prevent corneal damage. If phenol peels have been used, flushing should be done with mineral oil instead of saline. Referral to an ophthalmologist should be done.

Prevention

1. Extreme care should be taken while peeling the periorbital area
2. Dry swab stick should be kept ready to absorb any tears
3. Peeling agents should not be passed over the eyes.

Ectropion of the lower eyelid

It is usually seen after a Baker Gordon phenol peel.[8]

Predisposing factors

1. Older patients with senile lid laxity
2. Patients who have undergone previous transcutaneous blepharoplasty
3. Patients with thin skin.

Treatment

Most of the time the process is self-limiting and corrects spontaneously or with conservative care.

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CONSERVATIVE CARE

1. Massaging of lower lid skin
2. Adequate taping of the eyelid, especially at night
3. Protection of the globe with artificial tears.[9]

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INTRALESIONAL STEROIDS

Surgical repair

Prevention 

Be cautious when using phenol in the periorbital area to avoid burning in the eye.

An assistant should always have a clean dry cotton-tipped applicator in his hand which should be used to absorb any tears that may drip down the face or into the temporal area.[9]

Inherent errors

1. Incorrect peel pharmacology
   • With resorcinol combinations, TCA, or phenol formulas, evaporation of the alcohol or water vehicle base can occur, inadvertently producing a stronger solution.
2. Accidental solution misplacement
   • Avoid accidental spillage of the solution
   • Never move the cotton-tipped applicators directly over the eye area

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INFECTIONS

They are rare in TCA and phenol peels since these peels are bactericidal.

1. Impetigo and folliculitis (streptococcal and staphylococcal)
2. Pseudomonas or Escherichia coli infections.[10]

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PRE-DISPOSING FACTORS

Prolonged application of biosynthetic membranes or thick occlusive ointments and poor wound care.

Clinical features

1. Delayed wound healing
2. Folliculitis
3. Ulceration, superficial erosions, crusting, and discharge.

Treatment of bacterial infections

1. Swab for culture and sensitivity
2. Appropriate antibiotics: Topical and oral
3. Wound cleaning with potassium permanganate soaks or acetic acid soaks three to four times a day
4. Topical mupirocin for gram-positive infections
5. Light debridement.

Candidal infections

1. Recent intake of oral antibiotics is often a pre-disposing factor
2. Superficial pustules can occur in candidal infections
3. Immunocompromised patients Diabetics
4. Oral thrush
5. Prolonged topical steroid use.

Treatment

1. Topical clotrimazole, 1%
2. Systemic anti-fungals (fluconozole, 50 mg/day).

Herpes simplex infection

It is characterized by reactivation of herpes simplex on face and perioral area presenting as sudden appearance of grouped erosions associated with pain.

Collagen, a naturally-occurring protein made by the body, is the key ingredient in keeping your skin looking young, firm, and smooth. As we age, collagen production naturally declines. In addition, collagen production can be prematurely stunted when the skin is injured and then scarred, as with scars caused by acne.

Microneedling is safe to use on all skin types and is a safe and effective way to treat scars and other skin imperfections like wrinkles, sun spots, large pores, and more. Most patients find it to be pain free and experience dramatic results.

Microneedling isn’t a one-and-done treatment, however. Multiple treatments are generally required for optimal results. Waseem will evaluate your skin and recommend the right number of treatments for you. Most patients receive between 4-6 treatments, but each patient’s needs are different.

WHICH IS BETTER FOR ACNE SCARS?

Both chemical peels and microneedling will improve the appearance of your skin. Chemical peels generally work best on superficial imperfections, while microneedling penetrates deeper to improve more troublesome issues.

Many people with acne scars find a combination of microneedling and chemical peels deliver the best results. Microneedling will reach deeper under the skin to promote healing of scarred areas. Once the microneedling treatments are complete, a chemical peel can rejuvenate your skin further, leaving you with clearer, younger-looking skin.

No one treatment fits everyone’s needs. It’s important to meet with skincare professionals, like Waseem and the team at Dontage, to determine which is best for you.

HOW CAN I GET STARTED?

If you’re ready to say goodbye to your acne scars, be sure to seek treatment from certified professionals. With 16 years of professional experience, Waseem can recommend the right treatments to give you the clear, healthy skin you deserve.

Ready to take the first step in reducing the appearance of acne scars? Contact Waseem and the team at Dontage by phone or request an appointment online today.

Microneedling and chemical peel same day

Acne is difficult to overcome. Even after the pimples have disappeared, scars often remain a bitter reminder that we once suffered from this affliction. These scars cause the skin to look uneven, which in turn can lead to many insecurities. Home remedies or whitening creams usually do not work, so it is necessary to resort to professional dermatological treatments. 

Professionals recommend treatments such as chemical peelings and micro-needling to eliminate these marks on the skin. These treatments are highly beneficial both in combination and separately. The question is, can you do a chemical peeling after micro-needling? Keep reading to find out, but first, we will explain both processes separately.

What is micro-needling, and how does it work?

Microneedling is a non-surgical procedure in which the skin receives small punctures with the help of a radiofrequency device with microscopic needles or tools like derma-rollers and derma-pens. This treatment is painless, and the micro-punctures heal almost instantly.  

In microneedling, the punctures are made at the superficial level of the skin to stimulate and raise collagen production and increase elasticity in those specific areas. That promotes rejuvenation and reduction of scars, expression lines, flaccidity, and sunspots, resulting in a firmer, smoother, and younger appearance.

This treatment works on all skin types safely and with optimal results. Note that a single session is not enough, and the number of treatments required may vary for each patient, although usually between 3 and 6 sessions are performed. Even so, results show from the first session.

What is a chemical peeling, and how does it work?

Chemical peeling is a non-surgical procedure that consists of applying a chemical agent directly on the skin in the face, neck, and other body parts. With this powerful treatment, dead cells are exfoliated to stimulate new cells that will give the skin a smoother and younger appearance.

Chemical peels use a solution that “peels off” the top layers of the skin to improve its texture and appearance while diminishing acne marks, wrinkles, sun damage, blemishes, and redness.  

There are superficial, medium, and deep peels, each indicated depending on the desired effect. All of them have a different healing time, and their application will depend on the evaluation of a dermatologist for each patient.

Can you do a chemical peeling after micro-needling?

Absolutely. Combining both techniques will improve the appearance of the skin internally and externally. It is recommended to perform the chemical peel first as this removes all the dead and old layers of skin.

After about 4 to 6 weeks, when the skin have recovered from the peeling, you can start micro-needling sessions to finish improving the most problematic areas.

Some people who have suffered from very severe acne do the treatment in reverse, attending the micro-needling sessions first to start the collagen production. That way, when the deep peeling is done, the skin heals better and has a more even tone.

In either case, it is essential to consult with certified skincare professionals who will recommend the ideal treatments to give your skin the aspect you have always wanted.