Karen Pittar and Tara Jenkins
Today, there are more bewildering choices than ever for those who want youthful-looking, blemish-free skin, and beauty technology continues to develop at a rapid rate. Chemical peels have been around for years, but the trend, according to Dr Gavin Chan, a specialist in dermatology at Skincentral, is towards the superficial as medium to deep peels have been all but replaced by laser resurfacing.
Traditionally, chemical peels improve the appearance of skin through the application of a chemical that exfoliates the top layers, stimulating collagen production and new skin growth. According to experts, this helps improve skin texture and reduces skin discolouration, such as sun spots, age spots and mottled pigmentation. It is also supposed to reduce the clogging of pores that contributes to acne.
'The results of chemical peels depend on the depth of the peel,' says Chan. 'Medium and deep peels penetrate the dermis [the deeper layer of skin], while the more common, superficial alpha-hydroxyl acid [AHA] peels work on the epidermis [the topmost skin layer] and typically use glycolic or salicyclic acid. Superficial peels are safe with minimal risks or disruption to a person's lifestyle.'
Marketing consultant Sue Leung had a series of seven AHA peels earlier this year.
'I wanted to improve the network of fine lines and sun spots on my forehead and my dermatologist recommended a course of AHA peels,' she says. 'You need to have several sessions to see the benefits, but the actual process is over within 20 minutes. By the end of the course I really felt I looked younger, and people were commenting on my glowing skin.'
Chan says that unlike superficial peels, deep chemical peels can cause damage within the skin, resulting in increased redness and swelling, and can also expose the skin to infections during the raw healing stage.
'There is a higher risk of prolonged redness and problems of pigmentation. If pigment cells within the skin are damaged, there may also be long-lasting hypopigmentation. Permanent scarring is also a concern,' he says. 'Nowadays we have many advanced technologies and procedures to choose from to deal with specific problems in the skin without having to take such high risks. For example, radio frequency for skin tightening, botulinum toxin [Botox] for wrinkles and lasers specifically targeted at pigmentation.'
Resurfacing lasers are available for full-face rejuvenation, and most experts favour them over deep chemical peels because the thickness of tissue being removed is more easily controlled using a laser. The two most common resurfacing lasers are the carbon dioxide and the erbium. According to Chan, the carbon dioxide laser goes deeper than the erbium, but also carries a risk of scarring and pigmentary changes, and a long recovery time.
Interior designer Jennifer Wyatt was advised to try a carbon dioxide laser to treat her acne scarring and large pores.
'I'd been having glycolic peels but with minimal results, so I decided to give laser resurfacing a go,' she says. 'The procedure took about an hour and I had numbing cream beforehand, but it still hurt like hell - it felt like a pneumatic drill with very rough sandpaper was boring into my face.
'The actual laser is about 7mm squared, and it's held on your face for a few seconds each time. They treat the whole of your face like this, in squares. Within a few hours red squares started to appear all over my face and got steadily worse until the next day, when they started to turn into sores with pus-like scabs - I couldn't leave my house for nine days,' Wyatt says.
'Essentially, the top layers of my skin had been burned off, so it was a long healing process. I was told I may get some acne following the treatment, so I went on antibiotics for three months. A few months later people started to say my skin looked better, but to be honest, I couldn't see much difference. I would never do it again.'
As with any medical procedure, there are always risks, but experts say these are being gradually minimised by the latest technology.
Dr Henry Chan, a dermatologist in private practice, says: 'Fractional resurfacing was developed in 2004 at the Harvard Medical School, and generally allows the epidermis to heal within 24 hours as there are no open wounds.'
Gavin Chan says: 'Rather than taking the whole layer of skin off, as with conventional resurfacing laser or deep chemical peel, micro 'punch-outs' are made. As each of the resurfaced spots is surrounded by non-traumatised tissue, healing is much faster and the risk of side effects is hugely reduced. However, several treatments are usually required for best results.'
Clare Parker, 46, grew up in Hong Kong and was a committed sun worshipper. 'I spent my weekends on a junk and never wore sunscreen,' she says. 'Baby oil was my sun protection. I hated my skin, so I jumped at the chance to try [fractional resurfacing]. It was incredibly painful.
'After the treatment my face was covered with ice packs for around 30 minutes, but I still left the clinic with a red and swollen face. Over the next few months I had four treatments and six months after my last one, people started to comment on my skin. I saw a big improvement - most of my sun spots and pigmentation had gone. My skin looked much smoother.'