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LASER 2012 > peels revision > Flashcards

peels revision Flashcards

1
Q

why does barrier function need to be considered when doing CP

A

we want the CP to evenly penetrate

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2
Q

why would you use a superficial light peel?

A

no down time, increases permeability for actives, removes damaged corneocytes, increases mitotic rate via chemical messengers.

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3
Q

why would you use a superficial peel?

A

basement membrane is still intact, good for shallow scarring, texture, removes keratotic build up, actinic damage and fine rhytides.

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4
Q

why would you use a medium depth peel?

A

acne scaring, fine rhytides.

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5
Q

what depth does a medium depth peel reach to?

A

The paplilary dermis

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6
Q

Can a fitz 4 have a medium depth peel?

A

yes, but with prepping

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7
Q

what depth peels do you need a sterile environment for?

A

medium

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8
Q

when would you refer a client to have a deep peel?

A

deep scarring, skin laxity, deep rhytides.

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9
Q

what fitz can have a deep peel?

A

only 1 & 2

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10
Q

what depth does a micro usually reach?

A

superficial light - superficial

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11
Q

what results can a client expect following a micro?

A

smoother skin, increased hydration, reduction in break outs, finer rhytides.

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12
Q

what is kPa?

A

Measurement of pressure, kilo-pascals

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13
Q

what are some control variables that effect depth of wounding in micro?

A

crystal type, velocity of crystals, kPa, rate of movement, number of passes.

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14
Q

when would you turn the kPa down?

A

around the eyes and mouth & skin conditions that you don’t want to create heat.

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15
Q

what kPa would you have it on around the eyes?

A

5-15

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16
Q

what is an end point?

A

either immediate, delayed, desired or un desired.

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17
Q

what are some common topical ingredients applied post micro or peels?

A

hyalauronic acid, soothing botanical s, azelaic acid, pigment inhibitors, retinol and l-ascorbic.

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18
Q

is some one had mild acne (mostly comedones) what would the micro do?

A

it would be superficial light and would reduce sebum and corneocytes.

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19
Q

A client with Glogau 4 with concerns of photo aging, what would you advise them?

A

consult with a doctor in regards to deeper peels.

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20
Q

why can it be hard to see erythema in aged skin?

A

due to the reduction in blood vessels.

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21
Q

why do older people tend to show a higher pain thresh hold in their skin?

A

due to the decrease in their sensory function.

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22
Q

what are the main differences in keloid scars and hypertrophic scars?

A

hypertrophic scars develop soon after injury, keloid scars can be delayed. H can be self resolved, K can’t. H are limited to the wound margins, K aren’t, H are most common in the tension areas, K can occur anywhere.

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23
Q

what type of scars are best suited for treatment with micro?

A

shallow, non atrophic

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24
Q

what scars will not show much improvement ‘or could worsen with micro?

A

keloid, hypertrophic, ice pick scars.

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25
Q

what stage are striae most responsive to micro in?

A

2nd stage (light pink/mauve color)

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26
Q

how can the concentration of a peel affect the treatment?

A

it can determine the depth

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27
Q

how can the length of time affect the depth?

A

some peels don’t self neutralize and will keep activated.

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28
Q

how does the site affect the healing time following peels?

A

the face has more sebaceous follicles and will reepithelialize faster.

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29
Q

client in her 50’s with actinic damage, what depth peel would you recommend?

A

medium, prepped on an inhibitor for 4 weeks. prep on AHA’s and Niacinamide also to help even out the barrier.

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30
Q

How often can you have a deep peel?

A

only one per lifetime

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31
Q

what depth does a deep peel reach?

A

the Reticular dermis

32
Q

A client with milia, comedones, but no pustules or papules. What grade acne is this? & what kPa would you use with micro?

A

Grade 1, 20-34 kPa

33
Q

why are you more likely to turn down the kPa and do more passes on a client with hyper-pigmentation?

A

so we can exfoliate the epidermis, allowing for deeper penetration of inhibitors

34
Q

list 3 ‘mechanisms of actions’ of chemical peeling agents. with an example.

A

metabolic - causes increased slothing of cells (AHA’s and retinoids)
caustic & toxic - causes necrosis and inflammation. (phenol, salicylic & resorcinol)

35
Q

if a client has excessive sebum with no acne, what active cosmeseutical would you prescribe?

A

Niacinamide

36
Q

client concerned with photo aging & she enjoys the outdoors, what products would you recommend for her?

A

sunblock & vitamins E & C to help aid in collagen production.

37
Q

adult acne, dull skin, soap base cleanser, no moisturizer. why is her skin dull & why does she think moisturizer makes her break out? how could we improve her skin?

A

higher fitz can look dull, due to build up of cells, AHA’s would improve this, Niacinamide will help improve her acne & act as a moisturizer.

38
Q

rosacea client what would you recommend?

A

vitamin B to help promote a good barrier and helps improves TEWL.

39
Q

what are the main differences with AHA’s and BHA’s

A

AHA’s have a smaller molecule compared to BHA’s which limit their depth. AHA’s are considered to be hydrating (metabolic) where as BHA’s are caustic.

40
Q

what peeling agents have hydrating properties?

A

Lactic acid and Mandelic acid

41
Q

why do you ask clients to cease use of retinoids before a peel?

A

to avoid uneven penetration of peel.

42
Q

which of the following can be both caustic and metabolic, depending on the percentage used? Salicylic, Glycolic, Lactic or TCA

A

Glycolic

43
Q

what peeling agents did Unna pioneer?

A

Salicylic. resorcinol & TCA

44
Q

What is the minimum time frame between superficial light peels?

A

1 Week

45
Q

what can you apply after UV exposure, that will provide photo protection?

A

Vitamin E & C

46
Q

What are 5 main variables with the skin (general)

A

oil flow, hydration level, vascularity, skin thickness, pigmentation.

47
Q

what Glogau has visible actinic keratosis, wrinkles all the time, skin discoloration & telangiectasia?

A

type 3

48
Q

what Glogau has no lines, and little to no discoloration.

A

type 1

49
Q

what Glogau has skin cancers & actinic keratosis?

A

type 4

50
Q

what Glogau has early actinic keratosis, wrinkles with motion?

A

type 2

51
Q

what is the barrier of the skin comprised of?

A

acid mantle & stratum corneum

52
Q

what are the 3 phases of wound healing?

A

inflammatory, proliferation and maturation

53
Q

what is an example of superficial light peels?

A

BHA’s (salicylic acid), TCA 10% Glycolic 30-50% (1-2 mins), Jessner’s 1-3 coats

54
Q

what is an example of superficial peels?

A

Glycolic 50-70% 2-10 mins, Jessner’s 4-10 coats, Resorcinol 40-50% (30-60 mins), TCA 20-30% - full epidermis

55
Q

What is an example of medium peels?

A

Glycolic 70% 3-30 mins, TCA 35-50%

56
Q

What is an example of deep peels?

A

Phenol 88% Baker Gordon Phenol, >50% TCA

57
Q

what is considered to be low kPa?

A

15-20

58
Q

what is considered to be medium kPa

A

20-35

59
Q

what is considered to be high kPa

A

35-40

60
Q

when would you use high kPa?

A

spot planning, scar margins, stretch marks

61
Q

when would you use low kPa?

A

neck, reactive skin, acne prone skin, telangiectasia.

62
Q

What is a mixture?

A

a combination of compounds or elements that are physically blended but not bound by chemical bonds

63
Q

what peels are considered to be toxic?

A

phenol, salicylic & resorcinol

64
Q

how often can you do a medium depth peel?

A

3-6 monthly

65
Q

how often can you do superficial peels?

A

2-4 weekly

66
Q

what is the retinoid conversion?

A

retinyl palmitate, retinol, retinaldehyde, all-trans retinoic acid, retinoic acid.

67
Q

does vitamin C reduce pigment?

A

yes, it inhibits tyrosinase

68
Q

what is the least stable form of vitamin C?

A

L-Ascorbic acid

69
Q

what is the most stable form of vitamin c?

A

magnesium ascorbyl Phosphate

70
Q

how does Niacinamide reduce pigment?

A

prevents the transfer to k.cyte from m.cyte

71
Q

what is considered to be a strong acid? pKa of -2 or pKa of 5

A

pKa of -2 is considered a strong acid

72
Q

what % of TCA is light superficial, superficial, medium & deep?

A

10-20, 25-35, 35-50, 50 +

73
Q

what peel would you use on an acne client with moderate sebum flow?

A

glycolic

74
Q

what peel would you use on a acne client with seborrhea skin?

A

Jessner’s Salicylic or pyruvic

75
Q

what peel would you use on an acne client with dehydrated skin?

A

lactic or mandelic (larger molecule)

76
Q

what are the best peels for PIHP?

A

Jessner’s, Salicylic, Glycolic & Tretinoin

77
Q

what percentage of TCA do you use for Cross?

A

50-100%

LASER 2012 (10 decks)

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