Retinol Peels; At A Glance
- Best Results2- 4, maintenance peels
- Treatment Recovery1- 4 days
- Procedure Time3 minutes
- Skin SpecialistTherapist, Nurse
- Duration of Results1-3 months
- AnaestheticNone
- Back to WorkNext day (peeling usually delayed)
- Cost$
Retinol Peels
The VitA peel is Cutis’ signature peel, consisting of specialist strength retinoic acid. This powerful molecule is the most potent collagen stimulant & forms the basis of anti-aging treatments. We tailor a concentration based upon your skin type & concerns. Most patients will peel for a period of 2 to 4 days. As a reference, the concentration of retinol is approximately 100 times that of over-the-counter creams.
FactsMore Facts on Vitamin A Peels
- This peel stands for VITAmin A, hence the term VitA peels
- This peel is classed as a superficial intraepidermal chemical peel
- The active ingredient in this peel is retinoic acid
- VITA peels can treat acne, sun damage, wrinkles, congested skin & enlarged pores
- Retinoic acid peels can also be used to treat pigmentation & melasma
- Expect mild peeling for 2-4 days after the peel
Retinol Peels
Specialist strength retinoic acid chemical peels can address the following skin conditions-
- Acne – oily skin. Retinoids form the cornerstone of acne management as they reduce blackheads, oil production & bacteria.
- Enlarged pores. Vitamin A promotes collagen production & decreases sebum (oil).
- Skin pigmentation, as retinoids suppress pigment cells.
- Wrinkles, sun damage & premature aging. Peels increase collagen & elastin, promoting a healthy dermal layer. Retinoids have a pivotal role in antiaging.
How is this peel performed?
The very first step is finding a concentration for your skin, based upon clinical examination, your goals, as well as your skin care history. We then select a suitable concentration typically ranging from 0.5 to 5% retinoic acid, that’s about 100 to 200 stronger than over the counter retinol.
The steps are as follows-
- Skin is cleansed, makeup & sunscreen are removed. For better results we may elect to prime your skin with a pre-peel preparation.
- We then layer the treated area with retinoic acid in a predetermined make up base.
- This peel mask is left on for 4 to 8 hours (time dependent penetration)
- The retinoic acid peel mask is washed off in the convenience of your home
- A moisturiser is applied before bedtime
- Your skin will peel after 24 to 48 hours for 1-3 days
What is the recovery following retinoic acid peels?
2-4 days depending on your skin sensitivities & the strength of the peel. As a guide, delayed peeling may occur 36-48 hours after application of the peel. Peeling can occur for up to 5 days after application.
For first time users my advice is to start at 1% retinoic acid. This is still 20 times more powerful than prescription retinoids, and at least 100 times stronger than over the counter retinols. Once you have an idea on the duration of peeling, you may step up to a higher concentration.
Why is this peel different compared to beautician peels?
Retinoic acid is the strongest form of vitamin A. These are physician prescription peels. Retinol requires conversion to retinoic acid, hence with 1% retinol formulations, less than 1% gets converted to the active ‘acid’ form. In theory, this gives an ‘active concentration’ of 0.01%. In comparison our retinoic acid peels start at 1 to 4%.
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How often should I get chemical peels?
Retinoic acid peels can be applied up to once a month. My recommended frequency ranges from 4 to 10 weeks, depending on the clinical indications. As a guideline-
- Acne prone skin, enlarged pores: Every 4 weeks
- Fine lines, anti-aging concerns: Every 6-8 weeks
- Skin pigmentation including melasma: Every 4-8 weeks
- General skin care: 6-8 weeks
*Guideline only, peels should be tailored according to your skin as well as your goals.
Can I have chemical peels if I suffer from rosacea & sensitive skin?
High strength retinoic acid peels are not recommended for sensitive skin, including rosacea patients. As a guide, most rosacea patients do not tolerate prescription retinoids (0.05%), the concentration we use is up to 80 times STRONGER than prescriptions, and approximately 1000 X stronger than over the counter retinols. Not a good choice if you have sensitive skin.
A sensible peel for patients with sensitive skin is LOW strength salicylic acid. This can be anti-inflammatory. Other sensible options are mandelic acid, or low strength lactic acid peels.
Ideally for patients with rosacea, the use of low powered vascular, Q Switch, Pico & LLED (Low Level Laser Emission Devices) are advisable. Lasers can reduce BOTH redness & stimulate collagen production. For more information on skin rejuvenation in sensitive skin patients / rosacea patients, book an appointment with my clinical team @cliniccutis
Experimenting with laser assisted delivery of retinoids AKA: LARI or laser assisted retinoid infusion 2.0
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🔬Skin science: approximately 1-2% of topical retinol is absorbed by the skin. It requires conversion to retinoic acid for activity. Stuff that, too many variables, too many steps before it is biochemically active
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👍🏻The Concept: increase absorption by a factor of 20-50. I have been using small spot super dense, low energy CO2 fractional lasers. They work infinitely better than NA lasers. Last week I nearly tripled the spot size to 300 microns. This week it’s 500 microns, super dense with adjusted joules (due to bigger spot size)
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🧪The molecule: I have been playing around with retinoic acid 1-5%, trifarotene, & today #tazarotene (third gen retinoid). I would have continued with #trifarotene, but it is patented, so I can’t increase my concentration. Solution? Tazarotene at 5 mg/ml (5-10x stronger than prescription, when it was available)
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🧬Hopeful outcome: retinoid bomb topically, MOAR - monther of all retinoids, it’s probably 1000X more acitve than topical retinol. Hopefully peel for 4-8 days
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🔎Aiming to improve: skin quality- wrinkles, pores, pigment, etc…
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💯Stay tuned
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😎Davin Lim
Dermatologist
Brisbane🇦🇺
#retinol #retinoids #retinoicacid #retinoltips #retinolskincare #differin #acnetips #co2laser #skincaretips #skincarescience #skinscience
Table based upon intended use, comparisons with other agents and clinical effects
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👌🏻Chemical peels: are great. They are underutilized in the day and age of lasers & devices. Peels, like everything else, are merely tools to get the job done. Clinical scenarios where peels have advantages over lasers include-
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1️⃣Treatment of comedonal acne. Salicylic acid 20-30% is a marvelous agent for blackheads & congestion, as is retinoic acid 1-7%
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2️⃣Freckles & superficial pigmentation: A medium depth peel can beat fractional lasers & BBL or IPL. One session of Jessner TCA or TCA will do the trick
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3️⃣Ice Pick scars, enlarged pores (like pathologically enlarged, not psychologically), TCA or phenol will beat fractional and even ablative devices
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4️⃣Deep rhytids; severe sun damage/elastosis: Phenol croton oil will out gun ablative lasers, albeit long downtime
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5️⃣Accelerated melasma treatment: in superficial > dermal pigment, where time is an issue. Remember, high gain, high risk, higher cost, but in some, but not all cases, faster results
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🔫🍌Combination lasers & peels: LARI or laser assisted retinoid infusion, combines laser & potent retinoids. The former aids in delivery of the latter. It works. Downtime can be tailored from 48 to 96 hours
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🎬Action: Book an appointment with my nursing team @clinic cutis to see whether peels are right for you
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😎Davin Lim
Dermatologist
Brisbane🇦🇺
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Disclaimer: My clinical work deals with medium to deep peels only. For superficial peels including lactic, glycolic, retinoic, mandelic, #cosmelan #dermamelan & salicylic acid peels, please consult our nurses @cliniccutis
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#peels #chemicalpeels #tcapeels #jesserpeels #jessnertca #AHApeels #retinol #BHA #glycolicacid #lacticacidpeels #skincare #mandelicacid #melasmapeels #cosmelan
Retinoids are one of the most widely prescribed drugs for treating skin conditions. Uses include acne & anti aging all the way to genetic disorders of cell turnover
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🔬Skin science: Retinoids exert their power through interactions with retinoid receptors known as RAR or retinoic acid receptors. In the skin, gamma is the most prevalent, hence why I have changed my prescription habits & favor a fourth generation retinoid called trifarotene (gamma specific retinoid)
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👍🏻Tips: start with an OTC formulation. Retinol 0.5-1% is a good starting point. From there understand your skin’s threshold & know how to modulate & optimise topicals 💯
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📖My practice: I prescribe topical retinoids to a small minority of patients (in the context of anti-aging), usually post laser or deep chemical peels. Your dermatologist may have a different algorithm. Prescription retinoids are tricker to use cf OTC, but with a sensible approach, most people will work it out. More on how to use in next week's post
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😎Davin Lim
Dermatologist
Brisbane🇦🇺
#retinoids #retinol #skinscience #skincarecommunity #retinoicacid #skincaretips #drdavinlim #dermatologistbrisbane
Are there any side effects with super strength retinoic acid peels?
Side effects are extremely uncommon following this type of peel. Firstly, we need to define what are the expected effects (by definition these are predictable).
Predicted effects include- redness, mild stinging & peeling for 2-4 days.
Exaggerated side effects include- prolonged redness & peeling (greater than 6 d). Other rare side effects include post-peel skin darkening (especially if you receive lots of UV), viral infections such as cold sores are extremely uncommon.
Who CAN NOT get this type of chemical peel?
If you suffer from sensitive skin, including rosacea, chemical peels may not be the best solution for your skin type. Enzyme peels may decrease any potential post peel side effect, but these peels do not give a meaningful change. Lasers including pulse dye laser, dermal toning & laser genesis are better options to improve skin quality & generate collagen.
Other methods of skin rejuvenation include Tixel as well as HIFU or RF procedures.
How can I incorporate clinical peels with my skin care routine?
Be guided by the clinical team @cliniccutis. Our approach to skin rejuvenation & skin care is simple- make every application count. This philosophy entails finding skin care that suits your skin concerns & end goals. By incorporating specialist strength peels, your anti-aging routine can be boosted.
A simple, yet cost effective peeling routine is to add VITA peels monthly. This will promote increased collagen production, suppress excessive pigmentation as well as providing chemical exfoliation.
How would I know if this peel is the correct peel for my skin?
Discuss skin issues with my clinical team @cliniccutis. My nurses & dermal therapists will guide you through our chemical peels, lasers & EBD (energy-based devices) to find the correct treatment to address your skin concerns & goals.
Davin’s viewpoint on retinoic acid peels
Super strength retinoic acid peels (VITA peels, stands for VITamin A) are of my favourite chemical peels. Why? Because they can address a myriad of skin concerns ranging from wrinkles, pigmentation, acne, congested skin, through to anti-aging concerns. Typically, my formulations range between 1 to 4%. Unlike other peels that primarily act as exfoliating agents, retinoid peels work at a molecular level.
These peels can be incorporated into your home skin care regimen every 4 to 6 weeks. Retinoic acid peels are simple, convenient & cost effective.
