Clinical Aesthetic Services

Title: Microdermabrasion with Jessner’s Peel (MicroPeel)

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

Purpose: To safely and properly exfoliate the skin utilizing the Microdermabrasion machine and to safely and properly administer peel treatments and solutions by exfoliating with chemical peeling agents.

Scope: All licensed clinical personnel rendering client care

Definition: Clinical Aesthetics Protocol

Indications: To help minimize fine lines and wrinkles, rejuvenate skin from discoloration and hyperpigmentation due to solar damage, aging, acne and acne prone skin, and large pores.

Contraindications:

Do not peel if client has a sunburn.Cannot treat clients with frequent unprotected sun exposure or tanning bed usage.
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.
Do not peel if client has significant product irritation or history of cosmetic related irritant/allergic reaction without a test patch.
Do not peel if client is allergic to specific chemical peeling agents. If client is allergic to aspirin, do not use Salicylic Acid solution.
Do not peel if client has recurrent contact dermatitis.
Use caution when treating sensitive areas, thin skin, rosacea, eczema, or areas of telangiectasias.
DO NOT use on open lesions, rashes, burns, or suspicious lesions.
If client is pregnant, written authorization is required from her medical provider approving chemical peels during pregnancy.
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.

11. Contraindications: Clients that present with severe rosacea or chronic use of oral or topical steroids on the face. Tan or sunburned skin cannot be treated. Waxing and Filler injections (Collagen, Restylane, Etc.) should be avoided for 1 week prior to treatment..

Procedure:

All clients treated will have a skin history consultation, sign a Microdermabrasion Consent form and 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.
Any drug allergies will be noted on the front cover of the chart.
Photographs may be taken.
Client is placed in treatment chair, supine and in a reclined position.
The client lays on top of the blankets. Or draped if they care chilled.
Wrap hair with towel or headband.
The skin will be cleansed, with appropriate cleanser and soft gauze, removing all make-up except eye make-up.
Analyze the skin and determine the appropriate Microdermabrasion hand piece and setting to use during the treatment.
Degreasing the skin is optional, depending on the skin type and sensitivity. Glycolic Toner or 70% alcohol may be used. REMEMEBER: the dryer the skin, the more intense the peel will be.
Ensure skin is dry by either allowing it to air dry or using a fan.
Turn on the machine by flipping toggle switch on top of the machine.
Determine vacuum power by occluding the tip. Higher settings may be used on Chest, Back, Arms, Hands.
Test vacuum power on client’s mid forehead. Check for slight redness or excoriation (scratch).
Ask client, “would you like the vacuum higher or lower?”
Re-adjust vacuum to achieve desired result.
Proceed with mircodermabrasion: Hold the patient’s skin taunt, and apply gentle, even glide strokes to the skin’s surface ensuring consistency.
Cover the entire face, making two passes in opposite directions. Adjust vacuum pressure accordingly on various parts of the face. Be sure to turn down the vacuum before working around the eyes.
Do not lift the hand piece off of the skin directly, but rather angle the hand piece off the skin slowly to ensure there is no suction on the skin before removing the hand piece.
Skin will be stimulated and appear pink.
Perform extractions.
Hand client fan.
Apply Jessner’s peel solution on a 4 x 4 gauze. Hold the skin taunt, and apply gentle, even glide strokes to the skin’s surface ensuring overlap and consistency. Have the client keep their eyes closed during the procedure. Applying chemical will increase the redness and flakiness the client experiences. Discuss this prior to procedure and when signing the informed consents.
After each layer, check to see how “tingley” the skin is between 1 and 10. You should be able to do 3-4 layers. But stop once they get to an 8.
Should the skin blanch in any areas, neutralize immediately.
Leave the peel solution on as it self-neutralizes.
The client may experience slight warmth for up to an hour after the treatment is administered.
Do NOT apply moisturizer or SPF unless the face is neutralized.
Sanitize all implements used, loupe, bowls, and work area (As described in the Policy and Procedures - Sanitation/Sterilization).

Post Treatment:

Do not wash the skin for up to 24 hours for full peeling effect.
Do not sweat, workout or expose the area to the sun for 24 hours.
Peeling will not start for 48 hours.
Written post treatment instructions to be given and reviewed with the client after the treatment has been administered.
Clients can expect minimal flaking after the treatment. Occasionally “hot spots” may occur and can be occluded with Aquafor or Anti-biotic Ointment to alleviate discomfort and decrease healing time. These areas may have a “rug burn” like appearance. It is imperative that the area is left to heal and the client does not pick or scratch at it for this could lead to premature healing of the skin and the potential for scarring.
Client is not to apply any irritants, such as Retinols, glycolics, etc. for 5-7 days.
Avoid direct sun and wear sunblock of 30 spf or higher.
Schedule a follow up visit in 3-8 weeks.

Complications:

In case of complications or emergency, clients are advised to contact Natural Skincare Clinic immediately. If clinicians cannot resolve the matter, the physician is to be contacted and available within 30 minutes.

ALL CHARTS MUST BE REVIEWED BY MEDICAL DIRECTOR