We recently received a question from a reader: This is a new one on me. One of my regular microderm clients wants to come in for a chemical peel...on her butt. She has some acne scars and wants to remove them by using a lactic acid peel. Any advice?
First, as with any service, you need to make sure it’s safe for the client. Let’s look at what chemical peels do and then look at options for treating this delicate area.
How Chemical Exfoliation Works
Chemical exfoliation is a process where acids of varying pH strengths are applied to the skin. The pH is lower than the pH of the skin. When it is applied, the skin is “superficially shocked” and the bonds between the cells of the stratum corneum are weakened. Their action depends on whether the acid is lipid soluble or water soluble. Water-soluble chemical peel solutions such as glycolic acid work by dissolving the desmosomes, those glue-like bonds that hold the keratinized cells of the stratum corneum in place. Lipid soluble solutions dissolve the oil on the surface which also reduces sebaceous follicle. Enzymes, like papaya, digest the protein bonds breaking up the dead cells. These methods of action allow a uniform shedding of the dead skin cells over a period of several days.
Particular actions can influence the results of a chemical peel. Things like friction, degreasing, ingredient concentration, length of time left on the skin, pH, and skin thickness are all factors that affect a peel’s effectiveness.
Is A Chemical Peel the Best Option?
Before you consider the application process, take a good look at your client’s keister and recommend a medical evaluation before you treat the cheeks. Is it really acne? Could it be perifollicular dermatitis, from an irritation to the hair follicles on her derriere? Is it a heat rash? Has she shaved the area and now has some razor burn?
If you did apply some type of acid or enzyme to your client’s bum, will her anatomy allow you to uniformly apply the solution? You also need to discuss the side effects of the treatment with your client: a chemical peel side effect is dryness, microscopic cracking that can advance to infection if the area is exposed to bacteria. Can she tolerate the itchy, uncomfortable heat to the area while the peel does its magic? How will the friction of wearing clothing affect the peel’s result?
If neither you nor the client believes a chemical peel will work, consider having your client add a salicylic acid cleanser and light manual exfoliation when showering. A series of LED light treatments could also help the area. Make sure the clothing that is in contact with her backside is clean and advise her not to put on the same pair of jeans day after day, if she’s going commando.
It’s great that your client trusts you enough to bring up what could be an embarrassing issue. You owe it to them and yourself to fully assess the situation and make sure you’re implementing the best treatment plan possible.
Photo: Shutterstock | ginger_polina_bublik
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Mary Nielsen grew up in Minnesota but calls Portland, Oregon home for the past 30 years. She is the Executive Director of Spectrum Advanced Aesthetics Institute and serves on the board of Certified Advanced Estheticians for the state of Oregon. She is a happily married grandmother who has been thrilled to be working in the never dull field of advanced esthetics for over 17 years. She spends her free time outdoors or at her sewing machine.
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