Skin Peeling can be performed through acids, laser or can be mechanical . Peeling of the superficial layers of the skin (epidermis and / or superficial dermis) will renew the skin giving it a glowing aspect. With this peeling, the skin is renewed from the deeper layers, showing a rejuvenated aspect – with less spots and wrinkles.

The depth of peeling depends on the type of acid or technique used. The more aggressive the acid, the deeper will the peeling be, with subsequent better results but higher risk of complications.

Superficial peeling (eg. Glycolic acid or retinoic) provide a light peeling, removing only the most superficial lesions of the skin. Being less aggressive, the patient does not need rest or recovery, and can return to his activities the same day.

Average peeling (eg. Trichloroacetic acid) lead to an intense desquamation, requiring 7 to 14 days of recovery. They are more aggressive and effective than superficial peels, removing spots and average depth of wrinkles.

Deep peeling (eg. Phenol or CO2 laser) lead to crusting, which take up to 21 days to fall. They are the most aggressive peels requiring anesthesia for achievement. By reaching the deeper layers of the skin, they provide the best results, but also the greater chance of complications.

In the case of dermabrasion (skin sanding), Dr. El Hachem will control the depth of the peel, which may range from superficial to deep.

Frequently asked questions to Dr. Charbel El Hachem
Chemical Peel or mechanic Peel

1) Can peeling have complications?
Every medical procedure can have complications. These are minimized by proper evaluation of the skin and by the type of peel option. The deeper the peel, the greater risk of complications such as hyperpigmentation (dark spots), hypopigmentation (light spots), scarring and infection. Dark skin are at higher risk of complications than clear skin.

2) What can be done to avoid complications?
Careful assessment of skin type and the choice of peeling by Dr. El Hachem are fundamental to avoid complications. Protecting the skin for 14 to 30 days with specific creams and avoiding the sun before and after are also essential.

3) Are there contraindications for peeling?
Yes. Patients who have some skin disease or active infection should not be subject to peeling. If patients have herpes, they must first be treated with an antiviral drug (fanvir, acyclovir). Patients who used drugs based on isotretinoin (Accutane, Ro-acutane) in the last year are also contraindicated.




With time, changes of the structure of the skin will cause aging which will be accelerated by external factors such as sun, cigarette, diseases, stress, etc.

Among the most significant changes are the loss of hydration, the thinning of the dermis (the deepest layer), thickening of the epidermis (surface layer), loss of elasticity and of the amount of collagen. All these factors will collaborate for wrinkles formation, skin sagging.

The aim of peeling is thinning out the skin layers, providing a controlled regeneration, revitalizing it. The peelings can be classified according to the depth reaching the skin, or the number of layers that will be damage and subsequently regenerated.

The superficial peels reach only the epidermis first layer. Because they are less aggressive, they provide a slight peeling and quick recovery. They are appropriate to treat very superficial spots and improve skin texture. However, because they do not reach the dermis (deep layer where there is increased collagen accumulation), they do not provide improvement of sagging or of deeper marks such as wrinkles or imperfections.

The medium and deep peelings, reach the dermis, causing greater remodeling of the skin, increased collagen production, re-orientation of collagen fibers, skin tightening and improvement of deeper stains.

The deeper the peel, the greater the damage to the skin and consequently greater remodeling and retraction. However, greater damage also brings an increased risk of complications such as marks and scarring – especially in darker skins. Therefore, medium to deep peelings are safer in patients with fair skin (types I to III Fitzpatrick – see Box below).

The peeling Laser CO2 Fractional is a deep peel, an improved from of the old peeling known as Resurfacing. The great evolution of the method of the CO2 laser is that today it has an interrupted way (like a light through a filter) and was previously still (reached all the skin, such as a scanner). By not burning the entire skin surface and leaving small fragments of intact skin, the recovery is much more rapid and complications infrequent, while providing very satisfactory results.
It is indicated for sagging, spots, superficial wrinkles, acne scars, stretch marks.

The application is painful and can be performed with topical anesthesia (creams). Lasts about 20 minutes.

Immediately after application the skin is slightly red and shows no pain. It is unusual to have pain at any stage of the recovery, however slight burning may occur sporadically.

On the second day post-peeling, reactions caused by fractionated CO2 laser are more evident: the redness increases, and the swelling is common. It’s the worst day of recovery. To minimize these changes, cold compresses on the area of the peeling are indicating during the first 2 days. Fortunately it does not usually hurt.

The skin gradually becomes dry and small crusts appear on the laser penetration sites. Special moisturizers are very important to reduce the feeling of dryness, burning sensation and promote regeneration. After 3 to 4 days, desquamation of the crusts will show a regenerated skin with gradual reduction of the redness.

Peeling Laser

With peeling, the skin begins to show a softer smoother texture, with less spots. The production and reorganization of collagen (which lasts for a few months), retract the skin and reduce sagging. A new application can be performed after 30 to 60 days, if indicated to further improve the results already obtained.

Avoid continuous exposure to the sun after the application. Bleaching creams can be used as needed. Patients who have herpes labialis should use before and after drug to prevent the appearance of lesions.

Like any medical procedure, the application of fractionated CO2 laser should be performed by an expert and qualified doctor, to maximize results and minimize risk.

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