Institut Dermed Advanced Peel+ Guide

Institut’ DERMed Clinical Skincare

by

Lyn Ross, L.M.E.

Peels Have the Power to Create Complexion Perfection This informative peel safety guide will show you proper peel selection for each skin type and skin condition as well as help you understand what peels can do, what to expect, and how to care for the skin after a peel. Client safety and satisfaction are very important to us which is why we offer hands-on advanced training at the Institut’ DERMed College of Advanced Aesthetics for skin care specialists desiring to administer high performance chemical peels. This basic peel instruction guide is not intended as a replacement for hands on certification but rather a checklist of what to do and what NOT to do concerning the application of peels.

For your support we have licensed aestheticians available by phone to assist you during our business hours in order to answer any questions you may have about our peels. We encourage you to use their expertise!

IT IS IMPORTANT TO REMEMBER THAT RESULTS WILL VARY AND YOU SHOULD READ THIS GUIDE THOROUGHLY BEFORE ATTEMPTING TO APPLY ANY OF OUR PEELS.

What’s the Deal with Peels A peel involves the application of an enzyme or acid to the skin to remove and exfoliate the outer layers of dead cells so that a clearer, more evenly pigmented, glowing layer of skin can appear. The new, regenerated skin is usually smoother and less wrinkled than the old skin. Peels are also instrumental in the stimulation of fibroblasts and creating new collagen. The new skin will be temporarily more sensitive to the sun, so daily use of sunscreen is a must. Depending on the type of peel application is often repeated with varying degrees of frequency to achieve the desired results.

It is important to remember that applying any kind of a peel solution is in essence creating a controlled injury to the skin. You are intentionally causing “superficial skin damage” which prompts the body to:

1.

Rev-up the rate of cell renewal

2.

Stimulate the production of collagen and elastin to strengthen the support system for the epidermis

3.

Cause the outermost layers of the epidermis to slough off, revealing the new fresh skin underneath.

There are a variety of peel solutions used to resurface the skin at different levels or depths. The appropriate peel solution is selected based on the degree of rejuvenation required to meet each individuals need.

Institut’ DERMed Cosmeceutical skin peels are formulated in different concentrations using proven combinations of natural exfoliating agents for optimal penetration and results for problematic skin conditions in all skin types. Unfortunately real skin rejuvenation results in a wide percentage of the population are not as simple as most claims.

This is why only licensed skincare professionals certified through the Institut’DERMed College of Advanced Aesthetics administer our extensive range of peel solutions, guaranteeing complexion perfection.

The Benefits of a Skin Peel: QQ

Improves skin tone, texture, and overall appearance

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Minimizes fine line lip wrinkles

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Brightens dull, blotchy, uneven complexion with brown spots and freckles

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Dissolves blackheads, kills bacteria, controls acne and refines large pores

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Plans the edges of acne scars and pitted skin for a smoother look

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Improves stretch marks

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Stimulates collagen and elastin production for firmer skin

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Softens fines lines and smoothes deep wrinkles

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Fades discoloration due to sun damage, hormones and scarring

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Peels can be used on other areas of the body for similar benefits

The Limitations of a Skin Peel: QQ

A peel cannot change pore size

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A peel cannot remove a deep wrinkle

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A peel cannot remove deep scarring

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A peel cannot remove hyperpigmentation

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A peel cannot remove broken capillaries

What are the Different Types of Peels?

Light Epidermal Peels Often called “lunch-time peels”, Alpha-hydroxy (Glycolic 30% and Lactic Acids 20%), Betahydroxy (Salicylic Acid) in 10%-30% formulas and Enzymes Peels (Papaya, Pineapple, Bromelaine) are intended to provide a brighter-looking skin for people who can’t spare the time to recover from deeper peels. The skin may turn pink, and usually only minimal peeling or flaking occurs. You can use makeup to hide any redness until it fades. These peels do not require down-time, since they are considered safe for most skin types as they offer minimal side effects. You can have light peels performed as often as every two weeks. They are also commonly used in conjunction with a facial.

Indications: dull, dehydrated, oily congested, uneven skin tone and texture.

Medium Epidermal Peels Often called “weekend peels”, the Classic Lifting Peel and Perfect Lifting Peel are (a blended Jessner’s Solution) used to provide a slightly deeper exfoliation and more aggressive peeling.

The skin can turn reddish brown in 2 to 3 days, become crusty, and then flake and peel over the next 5 -7 days. There may be some swelling, especially around the eye area. Most people will not need to take any time away from work to let the skin heal.

Indications: excessively oily, large pores, acne breakouts, moderate sun damage

Deep Epidermal Peels The Supreme Lifting Peel (a blended Trichloroacetic Acid,TCA) is the strongest of our chemical solutions and is selected for aggressive peeling. The skin can turn reddish brown in 1 to 2 days, become crusty, and then flake and peel over the next 3 to 10 days. There is usually swelling, especially around the eye area. Some people will need to take a few days off from work to let the skin heal.

Indications: acne, scars, skin laxity, fine lines, wrinkles, severe sun damage and melasma

*Special Note: Chronic irritation can cause the skin to age faster. There have been a lot of studies indicating that chronic inflammation, caused from sunburns, too many chemical peels, strong detergent based products, “glycolic and retinoid overload” all break down the skins lipid barrier leaving it exposed and vulnerable to irritation and may increase the production of free radicals. If the skin is irritated all of the time, it is an indication of free radical damage which can change the DNA of the cells and age your skin even faster.

Chemical peels are in high demand now, but you don’t want to be administering deep exfoliating peels all the time. Exfoliation is important to stimulate fibroblasts and create new collagen, as well as stimulate cellular turnover to fool the skin into behaving young. The goal is to exfoliate as much as possible, with minimal irritation.

The skin likes little boosts of exfoliation on a regular basis.

We believe in gentle peels are to be performed weekly and medium depth or deeper peels are to be performed either quarterly or annually depending on your skin condition. It’s similar to exercise and weight loss. Small changes in your eating habits and exercise every day can lead to long term success, rather than one “crash” diet that can stress your system.

Getting the Skin Ready for a Peel Level 101 Peels may be performed on all skin types without pre-skin conditioning.

To achieve the best result from a Level 101 Peel we recommend applying a corrective serum and mask to infuse specialized treatment ingredients while the skin is open following exfoliation when the skin can best receive the nutrients.

Level 201 Peels are to be performed on clients that have had at least one or two Level 101 Peels and are using the Enhancing Micro Crystal Polish followed by a Level 101 peel at home. To achieve the best result from a Level 201 peel we recommend applying either the Bio-Derm Nutri Oil or Gel post peel for deep cell hydration and faster recovery from the peel. Applying a mask after a Level 201 Peel will depend on the peel, number of layers and general sensitivity of the client’s skin.

Level 301 Peels require a 30 day pre-conditioning phase that includes weekly peels to rev-up the skin’s cell renewal engine melanin suppressing agents and sun block. We recommend pre-treating the skin with an AHA /BHA daily exfoliating cleanser and serum to prepare the skin and produce enhanced results. The prepeel conditioning phase may also alert you to the possibility of complications or a potential negative skin reaction. Additionally, a weekly topical exfoliation product such as the Enhancing Micro Crystal Polish is recommended pre and post peel to maintain your results and keep the skin cells multiplying and turning over in between peels.

Pre-Peel Skin Conditioning Properly preparing the skin for a chemical peel is important for an optimal outcome. It is not recommended to perform chemical peeling on first time clients. Clients must commit to a series of skin conditioning treatments and be compliant to the home care regime and sun protection before receiving the peel. When the skin has been conditioned and the client is ready for the peel procedure you have several pre-peel treatment options to consider before applying the chemical peel solution to help create an even penetration and predictable outcome.

Serum RecommendationsGlycolic 30 - 90 Days Pre Peel:

Gain control of your skin with the Institut’ DERMed Glycolic Serum. This potent serum formulated with Glycolic Acid and Sodium PCA decongests and detoxifies clogged pores reducing and clearing blemishes for a clean, clear complexion.

Key Ingredient Benefits

Glycolic Serum • Glycolic Acid 10%

an alpha hydroxy acid (AHA) derived from fermented rhubarb

used acids, to reduce corneocyte a thickening oflactic the skin and salicylic acids, are Natural such cohesion as glycolic, where excess dead skin cells build up. It is also known to help recommended for collagen bothand in-clinic and stimulate and strengthen elastin production for home care treatments to increase smoother, younger looking skin. penetration of a peel solution for greater results. They work to break down • Sodium PCA oils (lipids) in thenatural skinhumectant allowing for moistureaccelerated cell shedding that may a non-comedogenic and effective binding agent that preserves the natural moisturizing factor (NMF) causeof the surface dehydration temporarily until new cells holding fluids move skin up to provide a renewed plump look and feel to the skin. Long term use of Key Selling Points low AHA concentrations have shown in clinical testing to boost collagen • Dissolves and controls oil remodeling • Decongests and pores when used along with sun protection are considered to be Refines textureanti-aging treatment protocols for all ages. one •of theskinbest

• Prevents acne breakout

Personalized Prescription

Ingredients: Aloe VerA Gel , Glycolic Acid And S odium GlycolAte, l AVen der e xtrAct, A rnicA B loSSomS e xtrAct, cAlendulA B loSSomS extrAct, cArBomer, GuAr Gum, S odium HyAluronAte, S odium PcA, S odium Hydroxide, PHenoxyetHAnol , S odium B enzoAte

Presentation: • 0.51 oz/15 mL pump bottle

• Use 3x weekly and gradually increase as tolerance indicates • May be used as a moisturizer for oily skin

• Alternate with another treatment to adjust intensity Vital A Serum

Directions for Use begins with an application of Retinol. Patients are Initial pre-treatment Smooth onto with finger until absorbed.

For best instructed toface apply a tips small amount of serum to the entire face at bedtime. results, use two to three times a week in the evening. Follow Begin an application every other withwith your prescribed Institut’ DERMed moisturizer.

You may night to avoid irritation. Frequency experience mild tingling or redness. This is normal and of use may be gradually increased as the application can be tolerated. should be temporary until your skin adjusts.

Patient compliance to uniform application is stressed to enhance uniform absorption of the peeling solution, leading to uniform healing and consistent results.

Intensive Brightening Serum Affects melanocytic metabolism by decreasing melanin formation and increasing the degradation of melanocyte pigment; it inhibits tyrosinase, the hormone responsible for increasing the proliferation of melanocytes.

Depigmentation does not occur immediately following hydroquinone application because this chemical interferes only with the formation of new melanin. The effectiveness of hydroquinone is enhanced by simultaneous use of Retinol, which appears to increase the penetration of hydroquinone and works synergistically to suppress melanocytic metabolism.

If post inflammatory pigmentation is a concern. In patients who have disorders of hyperpigmentation or who have a dark complexion, the hydroquinone or chromabright and ascorbic acid are recommended.

Skin Peel Preparation

Recommendations the Day of the Peel Clarifying Cleanser

Purify and prevent clogged pores with the Institut’ DERMed Clarifying Cleanser formulated with Salicylic Acid and Tea Tree Oil to decongest and detoxify skin for a clear, clean complexion.

Clarifying Cleanser

Key Ingredient Benefits • Salicylic Dissolves Acid 3%

oil to help degrease the skin and remove traces of makeup stuck inside the hair follicles.

a beta hydroxy acid (BHA) derived from wintergreen tree bark used to help clear and prevent acne breakout. Topical salicylic acid is also a keratolytic agent used to treat skin conditions that involve scaling or overgrowth of skin cells such as psoriasis, ichthyoses, dandruff, corns, calluses, and warts on the hands or feet. It is also a gentle alternative to benzoyl peroxide for reducing redness and decongesting the skin.

• Tea Tree Oil

Peel Prep Solution

anti-inflammatory, antibacterial shown to be effective in controlling the edema often associated with acne, supporting cellular regeneration and wound healing.

The combination of cleanser and Peel Prep Solution create a keratolytic

Key Selling Points effect in the skin like a mini peel for degreasing or defatting the hair

follicles to increase penetration and peel depth.

• Antiseptic, decongesting

• Controls inflammatory acne without dehydrating the skin • Helps to prevent scarring Ingredients: AquA (WAter), CoCAmidopropyl B etAine, d isodium l Aureth s ulfosuCCinAte, s odium CoCoyl i sethionAte, GlyColiC ACid, GlyCerin , peG-18 GlyCeryl o leAte/C oCoAte, d eCyl Glu Coside , h ydrolyzed s oy p rotein , sAliCyliC ACid, l ACtiC ACid, hAmAmelis VirGiniAnA (WitCh hAzel) e xtrACt, rosmArinus o ffiCinAlis (rosemAry) l eAf e xtrACt, CAmelliA s inensis (G reen teA) l eAf e xtrACt, sACChArum o ffiCinArum (s uGArCAne) e xtrACt, Citrus m ediCA l imonum (l emon) fruit e xtrACt, Citrus AurAntium d ulCis (o rAnGe) fruit e xtrACt, p yrus mAlus (A pple) fruit e xtrACt, toCopheryl ACetAte, pAnthenol , peG-150 pentAerythrityl tetrAsteArAte, Citrus AurAntium d ulCis (o rAnGe) peel o il , Citrus G rAndis (G rApefruit) peel o il , euCAlyptus GloBulus l eAf o il , m elAleuCA AlternifoliA (teA tree) l eAf o il , s odium B enzoAte, CitriC ACid

Personalized Prescription • For corrective treatment, apply like a mask and leave on

Dermaplaningthe skin for 60 seconds

• Alternate with another cleanser to adjust intensity of

treatment Helps to remove superfluous hair and the top layer of dead skin cells using a surgeons scalpel blade. This controlled method of scrapping the skin’s surface has been used for many years to Directions for Use “resurface” small Wet areas face.to Dermaplaning may be performed as an individual hands or andthe applyentire a small amount finger tips.

Massage onto face and neck in upward circular motions treatment or in conjunction with other procedures such as a chemical peel, microdermabrasion, Presentation: for thirty to sixty seconds avoiding direct contact with • 2light oz/59.15 mLtherapies bottle or the facials forthoroughly. enhanced absorption eyes. Rinse For best results, use twice of topical treatments. Dermaplaning requires • 4 oz/118.29 mL bottle daily, morning and evening. Follow with your • 8 approximately oz/236.59 mL bottle 20prescribed to 30 minutes to perform and offers immediate improvement for fine lines, Institut’ DERMed toner. wrinkles, skin discoloration and acnenic conditions. Because it is a dry peel, dermaplaning is relatively safe except for a small risk of irritation or nick from the blade.

Microdermabrasion Pre-treating the skin with microdermabrasion opens the skin up for greater penetration and absorption of the peel solution resulting in a much deeper peel. Individuals with very dry skin may benefit from pre treatment with micro prior to the peel application as the dryer the skin the harder it is for the solution to penetrate. Remember if the client has a Fitzpatrick lll or lV that means they have a potential for hyperpigmentation and microdermabrasion may exacerbate the chance of a complication.

Peel Layering Layering peels works to prep the skin for greater penetration and absorption of the peeling solution. As an example, think about using the Pumpkin Peel prior to the Classic Lifting Peel. Using the Glycolic+ Peel prior to the Perfect Lifting Peel will degrease the skin and increase penetration of the solution for greater results.

Each individual’s skin must be carefully scrutinized to determine which peeling modality or agent will give the greatest improvement with the least side effect based on the client’s skin type, condition to be corrected and lifestyle. Before selecting the peel evaluate the following factors:

Peel Procedure Supplies Checklist QQ

Enhancing Eye Makeup Remover

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Enhancing Creamy Cleanser

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Clarifying Cleanser

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Micro Crystal Polish

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Peel Prep Solution

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Selected Peel Solution

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Dermaplaning blade

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Chemical peel solution

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Sterile Glass Bowl

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Rayon tipped applicator

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Bowl of ice water

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Gauze or cotton strips

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Gloves

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Protective Cream

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Hydro-Cort Complex

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Eye wash

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Motorized fan

*Special Note: If your client is currently performing home peels, exfoliates daily, uses a Clarisonic Brush, facial scrub, uses products containing AHA/ BHA, Retioids, Retinols, etc.), you may expect a deep peel from increased penetration as the skin is considered prepped for a peel. We also stress the importance of using Sun Protective Moisturizer containing an SPF of 28 daily.

Do Not Apply Level 301 Skin Peels If: QQ

You are currently taking Accutane or have done so within the past 12 months

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You are pregnant or nursing

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You have a tendency to form Keloid Scars

You have a sexually transmitted disease such as Herpes, HIV/AIDS or a similar condition

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You are undergoing cancer treatments, including chemotherapy and/or radiation

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You do not understand the process of a peel, are not willing to follow the pre and post peel regime, or do not take the time to properly educate yourself about which solution should be used

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You have unrealistic expectations. Most chemical peels are designed to be a progressive treatment and need multiple applications to achieve a goal

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The client has recently been treated with a hair removal system

Immediately discontinue the peel if the client is in pain, or is reacting negatively

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The client has abnormal skin conditions: QQ

Skin Allergies

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Skin Grafts

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Sunburn

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Open Wounds/Lesions

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Red Colored Skin

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Recent Surgery

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Broken Skin

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Inflamed Skin

Special Precautions: QQ

For Men: Do not shave the area being treated 24 hours prior to the peel

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For Men: Do not resume shaving until shedding has started

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Stop using Retinoids/ Retinols or acid based exfoliators 48 hours prior to a peel

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Never pick at or pull the flaking skin if it is still firmly attached

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Do not scratch at your skin after the peel or during the shedding process

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Do not apply the peel to any area where the skin is broken, scratched or open

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Do not indoor tan while performing a series of peel

Do not get peel solution in your eyes, mouth, on the vermillion of the lip, in your nose or any other sensitive tissue

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Store peel solution in a cool, dark place and make sure to seal tightly

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Do not use metal or plastic containers, instruments or applicators with skin peels

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Make sure you have selected the correct peel prior to applying

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It is not always necessary but is recommended to perform a patch test

Check with your doctor or pharmacist before performing a peel if you are taking any medications

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See your doctor if you are experiencing severe swelling or any extreme reaction

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Do not mix anything with the peel solution prior to application

Skin Assessment Checklist o

Client medical history intake

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Obtain a signed informed chemical peel consent form

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Skin assessment SOAP format S Subjective (what they see) O Objective (what you see) A Assessment P Plan

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Evaluate type and depth of pathology a. Area of skin affected b. Skin type and conditions c. Skin texture and thickness d. Skin color e. Skin sensitivity f. Epidermal g. Light/medium hyperpigmentation, fine lines, acne grades I, II, III h. Dermal i. Deep/dark, hyperpigmentation, deep wrinkles

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Discuss realistic goals a. Percentage of expected goals b. Set time frame for achieving realistic results c. Identify contraindications

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Discuss risks associated with the peel a. Change of skin texture b. Dryness & invisible peeling c. Herpes Simplex breakout (recommend anti-viral 48 hours prior to peel) d. Pigment changes: hyper & hypo-pigmentation e. Side effects of sun exposure

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Explain the peel procedure, benefits, expectations & post peel instructions

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Document all discussions and treatment progress a. Patient/client complies to post peel treatments and home care b. Observations c. Benefits/results

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Photo documentation/before and after photographs

Additional Topics to Discuss QQ

Full skin assessment

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Current medications

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Lifestyle limitations

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Pregnancy

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Hours of daily sun exposure

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History of herpes simplex

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Present retinoid use

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History of hypertrophic scarring

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Prior cosmetic surgery

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General physical and mental health

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Cigarette smoking

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Realistic expectation

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Alcohol or drug use

Step-by-Step Peel Application Step 1

Cleanse the eye area with the Enhancing Eye Makeup Remover applied to a damp cotton pad. Hold pad on the eye area to dissolve makeup and gently wipe inward to remove.

Step 2

To remove facial makeup, apply the Enhancing Creamy Cleanser to the skin and massage in upward circular motions. Remove with damp cotton or micro fiber mitts.

Step 3

Apply the corrective Clarifying Cleanser to the entire face and massage in upward circular motions with wet palms to deep cleanse the skin. Remove with damp cotton or micro fiber mitts.

Step 4

De-grease the skin with Peel Prep Solution on a dry cotton pad buffing the skin using light pressure, a section at a time, counting the number of passes for preparation. Six passes over an area is usually enough abrasion to sufficiently remove all superficial oil that may prevent penetration.

Optional: Micro Crystal Polish for greater exfoliation and peel penetration.

Step 5

Optional: Dermaplane to remove superfluous hair and exfoliate layers of dead skin cells increasing penetration and absorption of the peel solution.

Clean skin with a damp cotton pad.

Step 6

Pour approximately 1 tablespoon of the selected peel solution into a glass bowl. Apply the solution beginning with the forehead in vertical and horizontal strokes from the eyebrow to the hairline making sure the solution is evenly distributed. Methodically move around the face, as shown in the diagram below.

Step 7

For acid and chemical peels cool the skin with a motorized fan. TCA solution may be cooled with either a fan or ice water compresses. Cooling the skin creates client comfort while the peel activates and processes. After approximately 10 minutes, the chemical solution will begin to self neutralize.

Step 8

Apply the Bio-Derm Nutri Gel for oily skin and Bio-Derm Nutri Oil for dry skin.

Layer a generous amount of Protective Cream and Brightening Moisturizer post peel.

Avoid Complications Checklist 1. Individual sensitivity and tolerance will vary.

2. A tingling or stinging sensation is normal.

3. A fan may be used to reduce the feeling of activity.

4. Discomfort should resolve in 30 to 60 minutes.

5. Moderate frosting should resolve in 30 to 60 minutes.

6. Ice may be used if extreme discomfort occurs.

7. Hydrocortisone will reduce abnormal inflammation.

8. Extreme discomfort may be an allergic reaction and should be addressed immediately.

9. Persistent erythema (redness) may be an allergic reaction or warning signs

of a developing scar.

10. Allergic reaction will require physician care.

11. Care may include topical and intralesional steroid medication.

12. Visible peeling may or may not be seen.

13. Inflammatory reactions are an accepted risk.

14. Reactions may include hyperpigmentation, hypopigmentation, or acne breakout.

15. Hyperpigmentation may be treated with lightening agents and will usually

resolve in approximately four weeks.

16. Acne may be treated with a combination of glycolic acid, salicylic acid

and benzoyl peroxide and will usually improve quickly.

17. History of herpes simplex must be pretreated with an oral antiviral three

days prior to peel.

18. In case of herpes breakout treat immediately with an oral and topical

antiviral medication.

19. During menses, women will have higher sensitivity and may want to

reschedule the peel.

20. Use of retinoid and glycolic will increase peel depth.

21. Discontinue use of manual exfoliating products and any irritating agents

48 hours prior to the peel and slowly resume after day ten.

22. Patient should not pick or peel shedding skin.

23. Avoid strenuous exercise 48 hours after peel.

24. Advil or Tylenol may be taken for patient comfort.

25. Avoid all hair removal procedures one week prior to the peel and three

weeks post-peel.

26. No guarantee should be made or implied as to the result of the peel.

27. Pregnant or lactating women should not have a chemical peel.

28. Peels should not be administered on an empty stomach.

Burn Protocol to Accelerate Healing QQ QQ QQ

Apply ice water compresses, ice reduces inflammation & heat in the skin Apply Hydrocortisone to reduce inflammation Apply Protective Cream to create a skin dressing or bandage for rapid skin healing

Post Peel Skincare Instructions Depending on the type of chemical peel administered, a reaction similar to a sunburn occurs following the procedure.

Visible peeling usually involves redness, brown discoloration and scaling that begins in about three days and may last for seven to ten days. Chemical peels may be repeated in four to eight week intervals depending on the degree of correction desired. Milder superficial peels may be performed weekly or every other week and are not associated with healing and downtime.

After the Peel Treatment Initially you may develop a fever or feel slightly faint. This may last a few hours until the body temperature returns to normal.

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To avoid premature cracking due to tightness, cut food into small pieces and avoid foods that require a lot of chewing and eat yogurts, soups, mashed vegetables and pasta.

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Wound Care Use a mild cleanser to wash your face gently for 20 to 30 seconds twice a day. Lather the cleanser on your hands and gently pat the cleanser on your face, rather than rub.

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Splash lukewarm water onto your face to rinse off the cleanser.

Dry your face by gently patting it with a clean towel.

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Apply Brightening Moisturizer during the day and Enhancing Protective Cream at night to keep your skin from getting dry and cracked.

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Do not let your skin dry out. It will pull on the new tissue underneath and may cause red irritated areas. You can apply Enhancing Protective Cream several times a day, if you feel the need too. This will reduce the tightness and will make the skin more comfortable.

Some mild itching and burning is normal and may last seven to ten days. You may also develop an occasional whitehead due to an inflammatory response, this is normal, do not be alarmed. You will be able to treat the breakouts for complete healing after the peel has healed.

Swelling You may have some swelling during the first two to three days of your peel, particularly, if it is a deeper peel. In extreme cases, your eyes may swell almost closed during the first few mornings. This is a normal response and it will resolve on its own. However, sleeping with an extra pillow to elevate your head will help to decrease your swelling.

Redness Your skin heals by initially being inflamed i.e., pinkish red. This will fade in three to six weeks. A steroid cream like the Hydro-Cort Complex may be recommended if the redness is persistent is only recommended in extreme cases where discomfort is a concern.

Sunscreen After the peel, sunscreen must be used to protect the skin from the rays of the sun. You need to use it even if you are wearing a hat or in the shade, as the reflective rays may cause damage also. If you see any signs of persistent brown discoloration after 14 days, you could be developing post inflammatory hyperpigmentation and may require a lightening agent like the Intensive Brightening Serum.

Exercise If you feel you have to do some exercise, you may go out for a walk in the early morning or evening when the sun is not out. Building up a sweat will cause stinging and swelling in the first two weeks. Avoid strenuous exercise for 48-72 hours post peel.

What Not To Do QQ

DO NOT pick or rub your skin at all.

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If you must wash your hair, wash it with your head tilted backwards in the shower.

DO NOT wet your face in the shower, too much water will cause you to peel prematurely and leave you with red, sore areas that may need to be treated again.

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DO NOT sit in a Sauna or Jacuzzi for four weeks, or do strenuous exercise. Sweating will make your face sting and it will cause you to peel too soon.

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DO NOT expose your face to sunlight at all during this time.

DO NOT use the cleaning or moisturizer routines as excuses to speed up peeling of your skin, it will only increase your risk of complications.

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DO NOT be alarmed if you bend over and feel warm or flushed.

Post Peel Warnings QQ

Avoid sun exposure immediately after a peel and always wear sun block with SPF15

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Avoid strenuous exercise 48 hours after a peeling treatment.

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Do not use any irritating products the same day after a professional peel

Avoid procedures which irritate the skin such as waxing, electrolysis or deep extractions on the same day you receive a professional peel.

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Sleeping It is important that you try to sleep on your back with your head elevated on pillows, if possible. This is so you don’t rub the skin off the chin or cheek area prematurely.

Makeup You probably will not want to apply makeup during the peel. Makeup may be used after finishing the peel usually in approximately seven to ten days. It is important to use hypoallergenic make up preferably with sun protection factor.

Contact the Clinic Immediately If...

You have unexpected irritation, pustules or persistent yellowness of the skin. This is especially important if you feel you may have been developing a cold sore. You may require an anti-viral prescription from your physician.

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You have any signs of acne or persistent abnormal darkness in the skin after the peeling has completed in about fourteen days, you may require treatment for these side effects.

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Sun Protection Broad spectrum sunscreen applied daily along with the use of melanin suppressing agents is crucial pre-peel to prevent an over production of pigment cells that can occur from the peel solution. The potential for a post inflammatory hyperpigmentation must be taken seriously and discussed in depth with the client. The sunscreen and brightening agents regime should begin at least 30 days prior to the peel and continued as a lifestyle habit.

The purpose of integrating sun protection as part of your skin care regime is to protect the skin from future photo-damage and aging. Client education on proper use of sun protection is one of the most important conversations to have with your clients.

B Brightenin

The Sun Protection Factor (SPF) = Minimal Erythemal Dose (MED) MED, is the amount of radiation (or time) required for the skin to start reddening. In other words, the SPF is a number that says how much longer you can stay in the sun with the sunscreen on, than you could without it. So, if you pinken in 15 minutes without sunscreen, with an SPF10 product, it would take you about 150 minutes to get the same degree of pinkening (i.e., damage).

A sunscreen cannot prevent skin damage, if it is merely used as a means of staying in the sun longer. Staying 100 minutes in the sun with an SPF10 causes the same damage as 10 minutes with no sunscreen.

Even your skin De ton the Moisturizer SPF15 hy and Oxybenzone to (UVA/UVB) of sun vib for a healthy, vib

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101

FUNDAMENTAL PEELS are light peel solutions formulated with a combination of enzymes and natural acids ranging in concentration from 2 –10% to provide superficial exfoliation and removal of the dry dead surface skin cells that dull the skin’s appearance. These peels are ideal for new clients seeking a peel and are recommended for home treatments to maintain healthy skin results.

Brightening Peel This intensive Lactic Acid, Lemon Peel Extract and Japanese Pearl Powder peel dramatically lightens your skin. Clinically proven active ingredients remove dark pigmented, dead skin cells to reveal radiant, luminous skin.

Clarifying Peel This potent Pumpkin and Lactic Acid peeling mask dramatically renews your skin by exfoliating dead skin cells helping to heal blemishes and prevent future breakouts for an improved clarity.

Renewing Peel This potent Lactic Acid, Retinol and Goji Berry peeling mask dramatically rejuvenates your skin by exfoliating damaged cells while helping to stimulate collagen production for a smoother, firmer complexion.

Soothing Peel Formulated for sensitive skin, this non-irritating Papain and Lactic Acid peeling mask remarkably rejuvenates sensitive skin with an unique blend of gentle smoothers for a healthy, refined look and feel.

201

ADVANCED PEELS are medium peel solutions formulated with higher concentrations of enzymes and natural acids to provide moderate exfoliation that assists with the removal of dead skin cells, deep pore congestion and skin discoloration. These professional only peels are ideal for progressing your rejuvenation results to the next level of skin health.

Herbal Peel This soothing, all natural Herbal Enzyme peel smoothes and hydrates your skin. It works by hydrolyzing hard, dry, dead skin cells and nourishing new, healthy cells for a renewed and deeply hydrated, soft, radiant glow.

Pumpkin Peel This stimulating all natural Pumpkin Enzyme peel clarifies your skin. It works by dissolving and removing dead cells to clear clogged pores, reduce oil and heal acne breakouts for a clean, clear, healthy look and feel.

Retinol+ Peel This potent L - Retinol peel is perfect for strengthening the integrity of your skin. It works to accelerate new cell growth, regulate collagen synthesis and improve the skin’s moisture barrier for rejuvenating dry, devitalized skin.

Lactic+ Peel This gentle, all natural Alpha Hydroxy Acid peel rejuvenates sensitive skin. It works as an excellent alternative to Glycolic Peels to remove dead skin cells without disrupting the natural moisturizing factor of the skin for a healthy, hydrated, renewed surface.

Glycolic+ Peel This intensive all natural ALpha Hydroxy Acid (AHA) peel refines your skin’s texture. It works to accelerate exfoliation and stimulate the cell renewal process lightening age spots, clearing congested pores and stimulating collagen for a tight, firm, youthful look.

301 INTENSIVE PEELS

are deep peel solutions formulated with highly concentrated natural acids for deeper penetration. Excellent for targeting more serious skin abnormalities such as; fine lines, moderate hyperpigmentation and acne. These professional only peels are ideal for challenging skin conditions where accelerated skin rejuvenation is desired.

Supreme Lifting Peel This intensive Trichloroacetic Acid (TCA) peel re-texturizes and tones your skin. It works by lfting layers of skin cells, stimulating fibroblast activity, re-organizing collagen/elastin networks, and repairing deep wrinkles with dramatic rejuvenating resuls for the face, neck, hands and body.

Perfect Lifting Peel This intensive Non-Resorcinol, Lactic, Glycolic and Salicylic Acid peel blend restores your skin. It works by combining three unique peeling solutions to lift dead skin cells for increased penetration to reduce oil, heal acne breakouts, and lightens the skin for a clean, fresh, clear complexion.

Classic Lifting Peel This intensive Salicylic, Lactic, Resorcinol and Pomegranate Extract peel blend decongests and clears your skin. It works by lifting the top layer of damaged skin cells for lighter, brighter, fresh, clean skin.

Level 101-201 Expectations Day - by - Day:

Day 1

Your skin may appear pink and feel tight from a slight swelling of the tissues. This is tempoary and should not last more than 24 to 72 hours.

Day 2

By now, you should notice a clearer, smoother looking complexion with little to no flaking. If you are still bothered by dehydration perform a gentle Micro Crystal Polish to remove any dead skin cells. You will immediately notice a fresh renewed complexion.

You can resume your full skin care regime.

Day 3

You may notice slight flaking as dead skin cells start to slough away. This is temporary dehydration that can occur post peel. Visible flaking or peeling can be easily managed by applying your recommended serum and moisturizer to maintain skin hydration.

Level 301 Expectations Day - by - Day:

Day 1

Your skin will appear pink and feel tight. You may also experience mild redness and swelling of the tissues.

This is normal and will resolve in the next couple of days.

Day 2

The skin turns a brown sun tanned color and is still very tight any swelling usually starts to subside by now.

Day 3

Your skin will start to crack and peel especially around the mouth as dead skin cells start to lift and slough away

Day 4

You should experience less tightening and more flaking and peeling as the dead skin continues to slough off. This can potentially be the heaviest peeling day. You may be tempted to pick your skin. This a big NO, NO. Picking may result in a complicated wound.

So do not pick peeling skin!!

Day 5

Most of the heavy peeling and flaking should be over by now and your skin will be returning to normal but it is not fully recovered yet so keep it moist and use your sunscreen to prevent any complications.

Day 6

It is recommended to remove any remaining dead skin cells with a professional Herbal Peel application. If you cannot get into the spa for the enzyme treatment you may use the Micro Crystal Polish very lightly as not to irritate the new skin.

Day 7

By now, you should notice a clearer, smoother looking skin with little to no flaking. Enjoy your renewed complexion. You can resume your full skin care regime.

Try Our Other Peel Support Skin Rejuvenating Products Renewing Line Anti-Aging Key ingredients: Apple Stem Cells, Rosehip, Pomegranate, Hyaluronic Acid, Argireline QQ

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Optimal treatment for those exibiting the first signs of aging through mature skin

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Perfectly matched for post peel care, to maintain peel results and for daily use

Complimentary professional peels include: Renewing Peel, Supreme Lifting Peel, Retinol+ Peel QQ

Clarifying Line Acne & Blemish Control QQ

Key ingredients: Salicylic Acid, Willowherb, Tea Tree, Hyaluronic Acid

Controls oil, prevents breakouts, restores dermal water content and helps heal lesions QQ

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Utilizes ingredients from nature to gently sooth inflammation and irritation

Complimentary peels include: Clarifying Peel, Classic Lifting Peel, Pumpkin Peel QQ

Brightening Line Discoloration & Uneven Skin Tone QQ

Key ingredients: Licorice, Mallow, Yarrow, Arbutin, Peppermint, Hyaluronic Acid

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A natural, safe, wholistic approach to achieving an even, bright skin tone

Corrects dark spots, age spots, and discoloration while hydrating and nourishing QQ

Complimentary professional peels include: Brightening Peel, Perfect Lifting Peel, Glycolic+ Peel QQ

Soothing Line Diffuse Redness Key ingredients: , Goji, Acai, Mangosteen, Coffee, Berry Pomegranate, Hyaluronic Acid QQ

Powerful age and damage prevention derived from anti-oxidant rich exotic fruits QQ

Supports skin function, hydration, healing and vitality so you look younger longer QQ

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Retinol rejuvinates and refines the epidermis

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Complimentary peels include: Sothing Peel, Lactic+ Peel, Herbal Peel

Offered by Institut’ DERMed Certified Professional Skin Therapists in the finest MedSpas nationwide PRODUCT QUESTIONS? Contact Alli Kim: 770-454-7788, akim@idermed.com

PRODUCT QUESTIONS? Contact Alli Kim: 770-454-7788, akim@idermed.com LIKE THE PRODUCTS? Share with your friends!

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