Policy and Procedure

SkinPath, LLC

Clinical Aesthetic Services

Title:               Deep Peel (Use FR Back Peel)

Policy:            All clinical aesthetic staff rendering client care will adhere to this protocol

Purpose:          To safely and properly administer peel treatments and solutions by exfoliating with chemical peeling agents on the face, neck, hands, chest, arms, legs and back.

Scope:            All licensed aestheticians rendering client care

Definition:      Clinical Protocol

Indications:  To reduce appearance of Melasma, Sun Spots, Rhytids and PIH. A series of treatments is needed.

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. Analyze the skin and determine the appropriate products to use during the treatment.
9. Degrease the skin with the Glycolic/Lactic Toner.  REMEMEBER:  the dryer the skin, the more intense the peel will be.
10. The client is given a motorized fan to be placed comfortably on the chest area.
11. Apply ONE LAYER of Face Reality “Back Peel” solution on a 4 x 4 rough gauze. Hold the skin taunt, and apply gentle, even glide strokes to the skin’s surface ensuring NO overlap and consistency. Start on the forehead, then proceed to the right side of the face with downward strokes, then to the left side applying slight pressure.  Have the client keep their eyes closed during the procedure.
12. Wait 3-4 minutes before applying next layer.
13. Watch for areas that blanch. Once an area blanches, do not apply any more peel solution over this area.
14. Apply a SECOND LAYER of the “Back Peel” solution on a 4 x 4 rough gauze. Hold the skin taunt, and apply gentle, even glide strokes to the skin’s surface ensuring NO overlap and consistency. Start on the forehead, then proceed to the right side of the face with downward strokes, then to the left side applying slight pressure.  Have the client keep their eyes closed during the procedure.
15. Wait 3-4 minutes before applying next layer.
16. Watch for areas that blanch. Once an area blanches, do not apply any more peel solution over this area.
17. A third layer may not be needed. If most of the face has blanched, then “touch up” an areas that have not blanched with the 1 small swatch of the peel on the gauze or with a Q-tip.
18. Leave the peel solution on as it self-neutralizes.
19. The client’s skin will feel very tight and warm.
20. DO NOT apply moisturizer or SPF. The peel self neutralizes and can be left on the skin for up to 24 hours.
21. Instruct the client to wash their skin in the morning with cool water and a very gentle cleanser. Apply Aquafor for 48 hours.
22. Give them post procedure instructions and read through it together.
23. Downtime is 5-10 days.

Post Treatment:

1. Written post treatment instructions to be given and reviewed with the client after the treatment has been administered.