The best way to ensure success, speed the healing process and prevent complications such as pigmentary changes is to adequately prepare the skin before the peel. The purpose of this process is to regulate cell function and reduce the risk of postoperative alteration of pigment. This medical prescription strength ointment regimen is developed by the famous dermatologist Dr Obagi as part of a scientifically advanced skin care treatment to achieve a healthy skin.
Skipping or shortening the preparation has resulted in intense and excessively long erythema. This treatment increases the risk of sunburn. Care should be taken (shade, sunblock, etc.) to protect treated skin.
7 weeks before peel—Start preparation with ointments for one skin cycle of 6 weeks
A normal skin renewal cycle of the epidermis takes about 6 weeks (the amount of time it takes for a keratinocyte to mature, reach the stratum corneum, and exfoliate). Start with the preparation 7 weeks before the peel, stop 5 days before the peel. The skin may appear worse before it gets better.
This ointment regimen can result during the first 6 weeks in erythematous, flaky skin that the patient must accept as a normal effect. In about 6 weeks the damaged top layers of skin are replaced by new layers of healthier cells. One or more of the following symptoms can be expected: dryness, peeling, redness, sensitive skin, itching, burning, wrinkles may look worse, acne may look worse. Such reactions indicate that the treatment is being used effectively and that the skin is responding and skin restoration is in progress. This reaction indicates the initial lack of skin tolerance, which the program is meant to build up. If the irritation is too much, you can use the cortison rescue cream, but not for more then one week at a time.
Oily skin requires proper washing to remove sebum.
Mix the ointments in the palm of one hand. Apply evenly with to fingers of the other hand on the entire face, including above the upper eyelids and under the eyes (if supported), extending to the hairline and over the ears. Massage until the cream is completely absorbed (can take a while). End at the jawline with a feathering motion towards the neck.
Morning: hydroquinone + sunblock + glycolic acid
Evening: tretinoine + hydroquinone
- Tretinoin— Apply once daily in the evening (one push of the pump). Tretinoin is the most important ointment of the regimen. Tretinoin has a normalizing effect on epidermal cells (keratinocytes). It also decreases epidermal melanin content and has been shown to facilitate the formation of new collage in the dermis.
- Hydroquinon—Hydroquinone is applied morning and evening (one push of the pump). The action of hydroquinone is short-lived, thus skin should be saturated twice daily. Hydroquinone is a topical depigmenting agent that specifically targets the melanocyte system to interfere with the formation of new melanin. The purpose is to suppress and regulate melanocytes to give a more even skin tone and to prevent postinflammatory hyperpigmentation.
- Glycolic acid—Glycolic acid is applied once daily in the morning (one push of the pump)). Glycolic acid is an exfoliating agent that to helps accelerate exfoliation of the upper layers of the epidermis. This increases the effectiveness and the penetration of the tretinoin and hydroquinone ointment.
- Sunblock—Apply sunblock in the morning under makeup (one push of the pump). Reapply often while in the sun. Avoid prolonged exposure to the sun until 6 months after the procedure.
- Hydrocortisone—If the irritation (redness, itching, extreme dryness) is too much, you can use the cortison rescue cream, but not for more then one week at a time. Hydrocortisone is an anti-inflammatory agent that helps to calm the initial reaction of the skin.
5 days before the peel
The use of the ointments should be stopped 5 days before the peel to allow settling of the epidermis.
3 days before the surgery until one week after the surgery
- Antiviral medication—The possibility of a herpetic outbreak is real and antiviral prophylaxis is routinely used. Valacyclovir hydrochloride 500 mg, one tablet administered 2 times daily is begun 3 days before the procedure and continued for 1 week after peeling.
Morning of the peel
- No ointments or makeup—don’t apply anything to the skin the morning of the peel
FAQ concerning the ointment preparation
One week before the peel avoid waxing, electrolysis, deploritory creams, and laser hair removal. In general you should avoid anything that can irritate the skin, including the medical preparation ointments we prescribed to you (stopping 5 days before is enough).
You can have a laser hair removal session until one week before the peeling. One week is enough time for the skin to recover from this irritation.
You still have another question? Feel free to ask! We will answer your question and if generally applicable add it to the FAQ of this page.