Clear all your clinical questions about the cellular renewal and neocollagenesis procedure with Dr. Caroline Minchio, Médica CRM 15578 ES.
Unlike physical home scrubs, a medical peel involves chemoexfoliation. Acidic solutions with a specific pKa are applied to break desmosomes (proteins joining cells). This causes a programmed destruction of the epidermis, generating a beneficial inflammatory peak.
By creating a controlled chemical wound, the skin releases inflammatory mediators and growth factors (like TGF-β). These mediators "wake up" the fibroblasts in the dermis, which begin to massively synthesize type I and III collagen, a process clinically known as Neocollagenesis.
A physical peel (like crystal or diamond) promotes mechanical abrasion, sanding the superficial layer (stratum corneum). A chemical peel acts chemically, denaturing proteins and penetrating much deeper, allowing the treatment of deep dark spots and wrinkles.
Turnover is the speed at which the skin produces a new cell, pushes it to the surface, and sheds the old one. With aging, this cycle slows down, leaving the skin dull. A chemical peel drastically accelerates this turnover, bringing young cells to the surface quickly.
Melasma is a chronic disease of the melanocyte. A peel doesn't "cure" it, but it is the most powerful clinical tool for its control. Specific acids act by inhibiting the tyrosinase enzyme and expelling the melanin already deposited, lightening spots safely and severely.
Salicylic Acid (a BHA) is lipophilic (has an affinity for fat/oil). It penetrates deep into the clogged pilosebaceous follicle, dissolving blackheads, reducing sebum overproduction, and sterilizing the environment against the Cutibacterium acnes bacteria, halting active inflammation.
Yes. For depressed scars ("holes"), we use medium-depth peels, such as Trichloroacetic Acid (TCA). It reaches the papillary dermis, promoting intense tissue remodeling that "raises" the floor of the scar over several sessions.
Yes. When dark circles are melanin-based (excess brown pigment, not vascular), we use specific formulations, such as Thioglycolic or Mandelic Acid in low concentrations, to depigment the delicate periorbital region with total ophthalmological safety.
Glycolic is the smallest of the Alpha-Hydroxy Acids (AHAs). Because it is so small, it penetrates quickly and deeply. It is the gold standard for mature and fair skin, providing an immediate "glow" and treating severe photoaging.
Mandelic has a much larger molecule than glycolic. This means it penetrates the skin slowly and evenly, without startling the melanocytes. It is the perfect medical choice for sensitive skin, rosacea, or for darker phototypes.
Absolutely yes, but with extreme medical rigor. Skin with high Fitzpatrick phototypes has hyper-reactive melanocytes. The use of wrong acids causes the "Rebound Effect" (PIH). We use safe molecules and require absolute pre-peel prep to put the pigment to sleep.
No. Phenol is the deepest peel in dermatology, reaching the mid-reticular dermis. It requires strict monitoring, absolute rest, and causes severe peeling. It is indicated only for extreme aging and deep laxity (solar elastosis).
Applying a strong peel to unprepared skin is dangerous. "Priming" involves the use of depigmenting formulas at home for 15 to 30 days before the session. This thins the stratum corneum and blocks melanin synthesis, preventing post-procedure defensive dark spots.
In peels that reach the papillary dermis (like TCA), the acid causes coagulation necrosis of the proteins. Visually, the affected area turns white (frosting). This is a fundamental clinical sign for the dermatologist, indicating the exact therapeutic depth has been reached.
In very superficial peels (AHAs), only a slight tingling or heat is felt. In medium peels (TCA), the burning is more intense for about 3 to 5 minutes, which is controlled in the office with the use of cold air jets and chemical neutralizers.
Yes. Pregnant and breastfeeding women should not undergo peels with certain acids (like Salicylic and Retinoic). Patients with active infections (Herpes simplex), severe keloid scarring history, or who have recently used oral isotretinoin must undergo restricted medical evaluation.
After the peel, the skin's natural hydrolipidic barrier is removed. This causes TEWL, where the skin quickly loses hydration to the environment, generating dryness and tightness. Replenishment with ointments rich in ceramides and panthenol is vital in the first week.
It is the worst possible mistake. The peeling acts as a biological dressing for the new tissue forming below (reepithelialization). Prematurely picking the scabs tears the immature epithelium, generating permanent atrophic scars and Post-Inflammatory Hyperpigmentation.
It varies according to the acid's aggressiveness. Superficial peels flake softly (like bran) from the 3rd to the 5th day. Medium peels form thicker brownish crusts, which take 7 to 14 days to fall off completely. During this time, physical sunscreen is mandatory.
We recommend pausing intense exercises that generate a lot of sweat in the first 48 to 72 hours. Sweat is saline and can severely irritate the sensitized skin, exacerbating the inflammatory condition and prolonging the downtime.
The glow and improvement in superficial texture are noticed in the very first week after the peeling phase. However, true collagen (neocollagenesis) physiologically takes 28 to 90 days to organize in the dermis. The improvement is progressive each month.
No, they are synergistic. Botox paralyzes the muscle, preventing the skin from folding and creasing. Peels treat the "canvas" itself (texture, spots, pores, and dermal thickness). The gold standard protocol combines muscle paralysis with chemical tissue renewal.
Also no. A peel acts from the "outside in", focusing more on epidermal quality and superficial dermis. Injectable biostimulators (like Sculptra or Radiesse) act in the deep dermis, treating structural laxity and repositioning the fat pads of the face.
Yes. There is a myth that peels are only done in winter. For residents of hot cities, we formulate "summer" peels (like Mandelic or Lactic) that are highly stable and photo-safe, provided the patient commits to rigorous use of high PPD sunscreen.