peel manual - skinstitut · skinstitut peel manual page 2 of 18 what is chemical peeling? chemical...

Peel Manual Sept, 2013

Skinstitut Peel Manual of 18

What is chemical peeling?

Chemical peeling consists of the application on the skin of exfoliating agents to obtain first, destruction and then regeneration of part of the epidermis and/or dermis. Chemical peels produce a controlled wound that will result in renewal with the reduction or disappearance of sun damage, pigmentation, acne lesions, fine lines and wrinkles and superficial depressed scars. Depth and results depend on the strength of agents used.

Levels of peels

Very Superficial

Superficial

Medium

Deep

Very Superficial

Superficial

Medium

Deep


The Fitzpatrick skin scale

The Fitzpatrick skin scale

I. White - always burns, never tans

II. White - usually burns tans with difficulty

III. White - sometimes mild burn, tan average

IV. Moderate brown - rarely burns tans with ease

V. Dark brown - very rarely burns tans very easily

VI. Black – never burns, tans very easily

Wound healing process

Inflammatory

1-3+ days

Redness occurs, platelets form to prevent further bleeding and commence the release of

growth factors. The motive behind the inflammation stage is to seek and destroy bacteria. The

area is swarmed by an array of substances (white blood cells, neutrophils, macrophages) that

de activate bacteria and activate growth factors.

Skin at this stage is red, warm and swollen.

Proliferative

3-10+ days

Increased fibroblast activity stimulates collagen and fibronectin creating more elasticity in the

dermal layer. New blood vessels are formed (angiogenesis). Skin cells divide and produce new

cells.

Skin starts to flake and peel.

Type 3 collagen is produced


Maturation

28+ days up to 2 years

Collagen is remodelled and realigned creating a plumper dermis. Scar tissue is flattened (if

surgical for example) epidermal layer becomes denser.

Type 3 collagen is replaced by Type 1 stronger collagen.

Skinstitut AHA Enzyme Peel

The AHA Enzyme Peel incorporates the use of peel accelerator to degrease and refine the skin

resulting in a gentle peel. Redness and mild peeling may occur if the skin is not prepped. This

peel is able to be performed on those clients who come into our clinic and are not currently

using the Skinstitut products.

Designed to renew and restore skin’s radiance while soothing, hydrating and micro exfoliating

dry, flaking and sensitised skins

The term "proteolytic" refers to an enzymatic reaction that can digest dead or diseased protein

material without harming living healthy cells.

Unlike abrasive scrubs or other mechanical methods, proteolytic enzymes are selective and

extremely unlikely to cause irritation from pressure or over manipulation.

Contains:

Papain enzymes – Proteolitic enzymes microexfoliate to promote a softer, smoother

skin without irritation

Niacinamide – vitamin B3, strengthens skins immune defence thus reduces sensitivity

and irritation, maintains treatment for hyper pigmentation through inhibition of

melanin transfer and regulates sebum production

Camomile – Soothing and calming

Hylauronic acid – Hydrating

Grape seed extract – Antioxidant and strengthening

D-Panethenol –form of pantotenic acid, provides healing and soothing abilities and

prevents erythema


Skinstitut AHA Enzyme Peel Post Care

No active products for 3 days

(Glycolic Cleanser, L-lactic Cleanser 4%, Glycolic Scrub, Retinol, Vitamin C, Even Blend

Serum)

The following products may be used within the first 3 days:

Gentle Foaming Cleanser

Rejuvenate 15

Multi-Active Mist

Multi-Active Oil

Repair Balm (1/2 a pea size amount pressed over the face for the first 2-3 days)

Age Defence SPF 50+ to be worn daily and reapplied every 2 hours

Moisture Defence

Enzymatic Micro Peel maybe used to remove peeling skin as and when required. After

48hrs


Skinstitut Peel Accelerator

The Skinstitut Peel Accelerator will renew, brighten and smooth the skin while proving

antibacterial support and improving hydration.

This unique peel is suitable for most skin types and can be intensified by layering or customized

with Vitamin C according to specific skin needs. Vitamin C will intensify the peel. This may be

beneficial for sun damaged skins, skins that require anti-oxidant protection or skins that may

have had previous peel accelerator treatments and are requiring a more intensive treatment

Peel Accelerator is used to degrease the skin before each peel and as a peel itself

Contains:

Niacinamide – vitamin B3, strengthens skins immune defence thus reduces sensitivity and

irritation, maintains treatment for hyper pigmentation through inhibition of melanin

transfer and regulates sebum production

D-Panethenol –form of pantotenic acid, provides healing and soothing abilities and

prevents erythema

L.Lactic Acid 20% – Alpha hydroxy acid for a more luminous skin

Glycolic Acid 17% – Alpha hydroxy acid that is known for its anti-inflammatory properties

L.Mandelic Acid 5% – Alpha hydroxy acid that is used for its anti-bacterial properties

Canadian Willowherb – a plant extract that has soothing, anti-inflammatory and anti-

microbial activity and is an excellent free radical scavenger

Witch Hazel Extract – a botanical extract that has potent antioxidant, anti-irritant, anti-

inflammatory and anti-bacterial properties

Kakadu Plum Extract – powerful antioxidant and free radical scavenger

D-Biotin –form of vitamin H, stimulates cell development and growth of nerve tissue


Skinstitut Peel Accelerator pre-peel prep

The following protocol should be followed for 2 weeks prior to the Skinstitut Peel

Glycolic Cleanser 12% (at least once per day)

This will allow the skin to be able to better tolerate peel (less chance of epidermal

sliding or unwanted blanching of the skin)

Even Blend Serum both morning and evening to be used to reduce the risk of

hyperpigmentation. Can be omitted if client never suffers from Post Inflammatory

hyperpigmentation or is a Fitzpatrick skin type 1-2.

* When treating stubborn pigmentation add a rice grain size amount of Vitamin C to the

Even Blend Serum.

Age Defence SPF 50+ morning.

This can be omitted if the client is currently using an SPF

Patients with history of cold sores should be encouraged to prep prior to peel and post

peel with anti-herpetic medication - eg acyclovir and zovirax.

Skinstitut Peel Accelerator Post Care


(Glycolic Cleanser, L-lactic Cleanser 4%, Glycolic Scrub, Retinol, Vitamin C, Even Blend

Serum)



Rejuvenate 15

Multi-Active Mist

Multi-Active Oil



Moisture Defence

Enzymatic Micro Peel maybe used to remove peeling skin as and when required. After

48hrs


Skinstitut Ageless Peel

Anabolic resurfacing treatment. This peel will assist in re building the dermis. Skin Rejuvenating anti-oxidant and amino acid peel

To reduce the appearance of the visible signs of ageing and sun damage. This revolutionary

peel works deep within the skin encouraging healthy new cell production resulting in a

revitalised, smoother radiant complexion

Contains:

Ceramide Complex - a plant derived mixture of phospholipids that restore the lipid

barrier of the stratum corneum, thus provides a balanced moisture content and

improves skin condition

Natural SMEC – a natural delivery system, that is non-irritating and absorbs quickly with

no greasy after-feel while providing excellent moisturising for the skin

L-Mandelic Acid 7% – an Alpha Hydroxy Acid that is used for its anti-bacterial properties

L-Lactic Acid 15% Is an Alpha Hydrox Acid for a more luminous skin. Exfoliates while

assisting in skin hydration.

MDI Complex – inhibits the matrix metalloproteinase enzyme activity that degrades

collagen. It protects against UV radiation and other irritants, thus increasing resistance

to physical assaults on the skin

Oceagen LS – a collagen of marine origin, similar to type 1 human collagen, it smoothes

and softens fine lines and improves moisture levels of the skin

Vit-A-Like 3% – of botanical origin, used as an alternative to retinol without undesirable

side effects such as irritation, photo damage, oxidation and instability. It stimulates

collagen through fibroblasts and enhances proliferation of keratinocytes, contributing to

skin renewal resulting in a smoother, brighter complexion


Skinstitut Ageless Peel Prep

The following protocol should be followed for a minimum of 2 weeks prior to the Skinstitut Peel

Glycolic Cleanser 12% (at least once per day)

This will allow the skin to be able to better tolerate peel (less chance of epidermal

sliding or un-wanted blanching of the skin)

Even Blend Serum both morning and evening to be used to reduce the risk of

hyperpigmentation. Can be omitted if client never suffers from Post Inflammatory

Hyperpigmentation or is a Fitzpatrick skin type 1-2.

* When treating stubborn pigmentation add a rice grain size amount of Vitamin C to the

Even Blend Serum.

Retinol or Rejuvenate 15 to be used at night to stimulate the retinoic acid cell receptors

Age Defence SPF 50+ morning This can be omitted if the client is currently using an SPF

Patients with history of cold sores should be encouraged to prep prior to peel and post

peel with anti-herpetic medication - eg Acyclovir and Zovirax.

Skinstitut Ageless Peel Post Care


(Glycolic Cleanser, L-Lactic Cleanser 4%, Glycolic Scrub, Retinol, Vitamin C, Even Blend

Serum)



Rejuvenate 15

Multi-Active Mist

Multi Active Oil



Moisture Defence


After 48 hours Enzymatic Micro Peel may be used to remove peeling skin when

required.

Peel Precautions

Do not apply over open lesions, eczema, or inflamed psoriasis

Do not use on Accutane patients. Must allow at least 6 and up to 12 months post

completing medication (check oil levels and sensitivity). Anti-inflammatory, hydrating

treatments only

Topical Retinoic Acid– wait at least 3 to 4 days

Facial waxing and hair dyeing, wait at least 7 days

IPL/Laser treated skin must wait at least 2 – 4 weeks

No Salicylic peels for aspirin allergy suffers

No Peels for at least 3 months post facial surgery

Note: Must allow 4 weeks between last dermal peel and surgery

Always wear gloves

Apply Repair Balm corners of the eyes, lips. May apply to flares of nostrils if skin is

irritated. Apply over cosmetic tattoos.

Have a small hand fan handy

When removing peel use a cotton pad /fibrella as this will be much gentler than using

gauze and at that time the skin will be in quite a sensitive state.

When removing the peel do not rub off as this could cause epidermal sliding, use

compression technique

Always use cold water both to soothe skin and remove excess peel

Note: Never perform peels on severely dehydrated skin. There could be extreme

penetration of the peel resulting in an adverse reaction


AHA Enzyme Peel

All Skin Types

A gentle micro exfoliating treatment designed to soothe, hydrate and micro exfoliate dry, flaking and sensitised skins

Pre Treatment Protocol:

A proper consultation must be performed prior to any clinical skin treatment to ensure client is a suitable candidate for the intended procedure

Prepare work station

Pre- Procedure Work Station Set Up

Clean Towels Gauze Head Band

Tissues Timer Peel Accelerator

Glass Dish Cleansing Cloths Disposable Gloves

Protective Cap Fresh Water Enzymatic Micro Peel

Age Defence SPF 50+ Repair Balm Multi-Active Mist

Treatment Protocol:

Steps Instructions

1 Cleanse skin with a pea size amount of Gentle Cleanser on to moist hands and lather over face

to remove makeup. (This step can be omitted if not wearing make-up).

2 Cleanse skin with a pea size amount of Glycolic Cleanser using damp gauze and adjust

pressure as needed

3 Rinse with cool water and repeat step 2 to ensure removal of surface debris

4 Dry skin with tissue

5 Apply 1 pump of Peel Accelerator to skin with 1 piece of dry gauze using circular motions to

degrease and prep. Adjust pressure as needed

6 Apply Repair balm over eyebrows, corner of the eyes and lips

7 Apply a smooth film of Enzymatic Micro Peel to clean face and neck. Massage into the skin for

up to 5minutes.

8 Cleanse off with a pea size amount of Gentle Cleanser on to moist hands and lather over face.

Use a cold compress technique to remove.

9 Apply 1 spritz of Multi-Active Mist to the face, ensuring to cover clients eyes

10 IMPORTANT Follow with half a pea size amount of Repair Balm. Gently press into the skin.

Reapply if needed


11 IMPORTANT Apply liberal amount of Age Defence SPF 50+

Benefits:

Gentle skin exfoliation for a smoother, brighter complexion

Hydrates and softens

Refreshes and re-vitalises

Pro Tips:

Apply Enzymatic Micro Peel to a cleansed skin to micro exfoliate the skin prior to dermal therapy modalities

Apply Enzymatic Micro Peel (no degrease with Peel Accelerator) after microdermabrasion as a treatment mask

Enzymatic Micro Peel can also be used as an exfoliant or treatment mask in professional treatments

Key Active Ingredients in Enzymatic Micro Peel:

Papain enzymes – Proteolitic enzymes microexfoliate to promote a softer, smoother skin without irritation

Niacinamide – vitamin B3, strengthens skins immune defence thus reduces sensitivity and irritation, maintains treatment for hyper pigmentation through inhibition of melanin transfer and regulates sebum production

Cammomile – Soothing and calming

Hylauronic acid – Hydrating

Grape seed extract – Antioxidant and strengthening

D-Panethenol –form of pantotenic acid, provides healing and soothing abilities and prevents erythema

Notes:


PEEL ACCELERATOR

All Skin Types

L-Lactic, Glycolic and L- Mandelic Acid peel to renew, brighten and smooth the skin. 42% Alpha and Aromatic Hydroxy Acid base with a pH of 3.0


A proper consultation must be performed a minimum of 2 weeks prior to any clinical skin treatment to ensure client is a suitable candidate for the intended procedure

Skin must be prepped for a minimum of two weeks prior Glycolic Cleanser (at least once per day)

Even Blend am and pm (vitamin C may be added if treating stubborn pigmentation). The Skinstitut Even Blend Serum will help to both even out pigment and also aid in the prevention of new pigmentation by working as a tyrosinase inhibitor.

Age Defence SPF 50+ to be used in the morning


Pre- Procedure Work Station Set Up

Clean Towels Gauze Head Band



Fresh Water Protective Cap Multi-Active Mist

Age Defence SPF 50 + Repair Balm

Treatment Protocol:

Steps Instructions

1 Cleanse skin with a pea size amount of gentle cleanser on to moist hands and lather over face

to remove makeup (This step can be omitted if not wearing make-up).


pressure as needed



5 Apply 1 pump of Peel Accelerator to skin with dry gauze using circular motions to degrease

and prep. Adjust pressure as needed

6 Apply Repair balm over eyebrows, corners of the eyes and lips


7 Apply 2 pumps of Peel Accelerator to skin with dry gauze using light, sweeping motions

starting at the forehead, sides of face, chin, cheeks, nose and top lip. Up to ¼ tsp Vitamin C

100% may be added to the Peel Accelerator solution at this point to create a more intense

and targeted effect if desired. Leave on for up to five minutes. For an even more intense

peeling effect, Peel Accelerator may be re-applied after five minutes.

8 Remove residue with a pea size amount of Gentle Cleanser and cold compress. Ensure all of

product is removed


10 IMPORTANT Follow with half a pea size amount of Repair Balm. Gently press into the skin.

Reapply if needed


Post Treatment Protocol: Home Care Advice:

Skin will be sensitive for 1-3 days post peel

No active products (AHA’s, Retinol, Exfoliants, Vitamin C) can be used for 1-3 days, or until the skin has healed and is no longer sensitive

Healing Products for Recovery Period: Rejuvenate 15, Multi-Active Mist, Multi-Active Oil, Skinstitut Moisturiser, Repair Balm and Age Defence SPF 50+ to be used 1-3 days post peel

Benefits:

Contains L.Lactic and Glycolic Acid L.Mandellic

Provides anti-bacterial support ,excellent for the treatment of acne and acne related symptoms

Restores the lipid barrier of the epidermis and assists in alleviating dry skin conditions

Improves skin colour, tone and texture

Increased hydration

Strengthens and restores skin resilience

Pro Tips:

Cold water only to be used to avoid further irritation and sensitivity

Peel Accelerator can be performed at 2 week intervals, ensuring the skin has healed and there are no signs of adverse skin reactions

Note for a more intense peel the Peel Accelerator may be reapplied after 5 minutes

For best results a course of 3- 6 is recommended at fortnightly intervals

To maintain results, 1 single treatment every 4-6 weeks may be recommended

Key Active Ingredients:

Niacinamide – vitamin B3, strengthens skins immune defence thus reduces sensitivity and irritation, maintains treatment for hyper pigmentation through inhibition of melanin transfer and regulates sebum production

D-Panethenol –form of pantotenic acid, provides healing and soothing abilities and prevents erythema

L.Lactic Acid 20% – Alpha hydroxy acid for a more luminous skin

Glycolic Acid 17% - Alpha hydroxy acid known for its anti-inflammatory properties



Canadian Willowherb – a plant extract that has soothing, anti-inflammatory and anti-microbial activity and is an excellent free radical scavenger

Witch Hazel Extract – a botanical extract that has potent antioxidant, anti-irritant, anti-inflammatory and anti-bacterial properties

Kakadu Plum Extract – powerful antioxidant and free radical scavenger

D-Biotin –form of vitamin H, stimulates cell development and growth of nerve tissue

Notes:


AGELESS PEEL

Aged, Sun Damaged and dull lifeless skin

A medical grade anabolic restructuring treatment containing potent antioxidant and amino acid complex to target visible signs of ageing and sun damage. This revolutionary peel works on a dermal level to encourage normalised cell production resulting in a revitalised, smoother and more even complexion. pH 3.1


A proper consultation must be performed a minimum of 2 weeks prior to any clinical skin treatment to ensure client is a suitable candidate for the intended procedure

Skin must be prepped for a minimum of two weeks prior with Glycolic Cleanser (at least once per day)

Even Blend Serum to be used am and pm (vitamin C may be added if treating stubborn pigmentation). The Skinstitut Even Blend Serum will help to both even out pigment and also aid in the prevention of new pigmentation by working as a tyrosinase inhibitor.

Age Defence SPF 50+ to be used in the morning.

Retinol or Rejuvenate 15 to be used at night to stimulate retinoic acid cell receptors


Pre Procedure Work Station Set Up

Clean Towels Gauze Anti-aging Peel



Fresh Water Protective Cap/Head Band Multi-Active Mist

Age Defence SPF 50 + Repair Balm

Treatment Protocol:

Steps Instructions

1 Cleanse skin with a pea size amount of Gentle Cleanser on to moist hands and lather over face

to remove makeup. (This step can be omitted if not wearing make-up).


pressure as needed



5 Apply 1 pump of Peel Accelerator to skin with dry gauze using firm circular motions to

degrease and prep. Adjust pressure as needed

6 Apply Repair balm over eyebrows, corners of the eyes and lips

7 Apply 4 pumps of Ageless Peel to skin with gloved hands

8 Massage firmly into skin for up to 20 minutes or until even erythema. To reduce tackiness,


simply wet hands as required, then continue to massage firmly.

9 Remove residue with a pea size amount of Gentle Cleanser and cold compress. Ensure all of

product is removed


11 IMPORTANT Follow with half a pea size amount of Repair Balm. Gently press onto the skin.

Reapply if needed


Post Treatment Protocol: Home Care Advice:

Skin will be sensitive for 1-3 days post peel

No active products (AHA’s, Retinol, Exfoliants, Vitamin C) can be used for 1-3 days, or until the skin has healed and is no longer sensitive

Healing Products for Recovery Period: Rejuvenating Serum, Skinstitut Moisturiser, Repair Balm and Age Defence SPF 50+ to be used 1-3 days post peel

Benefits:

Contains L.Lactic Acid

Provides anti-bacterial support ,excellent for the treatment of acne and acne related symptoms

Restores the lipid barrier of the epidermis and assists in alleviating dry skin conditions

Improves skin colour, tone and texture

Increased hydration

Strengthens and restores skin resilience Pro Tips:

Cold water only to be used to avoid further irritation and sensitivity

Anti-aging peel can be performed at 4 week intervals, ensuring the skin has healed and there are no signs of adverse skin reactions

For best results a course of 3 - 6 sessions, is recommended

To maintain results, 1 treatment every 4-6 weeks is recommended Key Active Ingredients:

Ceramide Complex - a plant derived mixture of phospholipids that restore the lipid barrier of the stratum corneum, thus provides a balanced moisture content and improves skin condition

Natural SMEC – a natural delivery system, that is non-irritating and absorbs quickly with no greasy after-feel while providing excellent moisturising for the skin


L.Lactic Acid 15%-Alpha hydroxy acid for a more luminous skin

MDI Complex – inhibits the matrix metalloproteinase enzyme activity that degrades collagen. It protects against UV radiation and other irritants, thus increasing resistance to physical assaults on the skin

Oceagen LS – a collagen of marine origin, similar to type 1 human collagen, it smoothes and softens fine lines and improves moisture levels of the skin

Vit-A-Like 3% – of botanical origin, used as an alternative to retinol without undesirable side effects such as irritation, photo damage, oxidation and instability. It stimulates collagen through fibroblasts and enhances proliferation of keratinocytes, contributing to skin renewal resulting in a smoother, brighter complexion


Important:

Treatment duration: approximately 30mins

No visible peeling to a light/moderate flaking of the skin that usually begins day 2-Mild erythema

MUST BE PREPPED WITH RETINOL OR REJUVENATE 15!

Notes:

peel manual - skinstitut · skinstitut peel manual page 2 of 18 what is chemical peeling? chemical...

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