SUMMARY

This article will explain the standard operating procedure for the Lactic Peel 20%. 

Indications:  To reduce appearance of acne and PIH. To be used during the Acne Program.

Contraindications: 

1. Do not peel if client has a sunburn. Cannot treat clients with frequent unprotected sun exposure or tanning bed usage. 
2. Do not peel if client has a Herpes Simplex Virus (HSV) outbreak.  If client has a susceptibility to HSV, avoid common outbreak area with solution.  Can take prescription Valtrex or Zovirax prior to treatment, or immediately after treatment if beginning signs occur.  If client needs a prescription, notify Overseeing Medical Director.
3. Do not peel if client has significant product irritation or history of cosmetic related irritant/allergic reaction without a test patch.
4. Do not peel if client is sensitive or allergic to specific chemical peeling agents.  If client is allergic to aspirin, do not use Salicylic Acid solution.
5. Do not peel if client has recurrent contact dermatitis.
6. DO NOT use on open lesions, rashes, burns, or suspicious lesions.
7. If client is pregnant, written authorization is required from her medical provider approving chemical peels during pregnancy. 
8. Cannot treat skin if client has been on Accutane (Isotretinoin) within the past 6 months.

10.  Use caution on skin that has been treated with Tretinoin (Retin A, Renova) or other   photosensitizing oral medications. 

Procedure:        

1. All clients treated will have a skin history consultation, signed a chemical peel consent form during which time questions are answered, as well as discussing potential risks, complications, and anticipated results.  These completed forms will be present in the chart.
2. Any drug allergies will be noted on the front cover of the chart.
3. Photographs must be taken.
4. Clinician to perform service in latex or non-latex gloves.
5. Client is placed in treatment chair, supine and in a reclined position.
6. The client is properly draped, using linens that are laundered after each use.
7. The skin will be cleansed, with appropriate cleanser and soft gauze, removing all make-up except eye make-up.
8. If client is on the Acne Program, review current regimen by having them recite to you the products they are using, in the order they use them. Review diet changes and make sure they are taking their herbs and supplements.
9. Analyze the skin and determine the appropriate products to use during the treatment.
10. Degrease the skin with the Glycolic/Lactic Toner.  REMEMEBER:  the dryer the skin, the more intense the peel will be.
11. The client is given a motorized fan to be placed comfortably on the chest area.
12. Apply 1 layer of the Lactic Peel using a fan brush.  (Do not go over an area more than once or apply more that 1 layer.)
13. Allow peel to sit on the skin for 5-10  minutes.
14. Remove peel with wet esthetic wipes with clean room temperature/cool water. This is not a self-neutralizing peel and must be completely removed from the skin.
15. Cover the clients eyes with goggles.
16. Perform extractions.
17. Apply moisturizer and SPF.

Post Treatment:

1. No active products for 24 hours then return to normal regimen.
2. Schedule follow-up in 2 weeks.