Skin layers

Our skin has two layers with a third layer directly below. The top two layers each have several sub-layers.

1.The top layer, the epidermis. This layer has pigment cells that define our skin color. It is continually discarding old skin cells and accepting new ones that rise from deeper down. Lotions and creams add moisture to this layer, which helps to keep our skin soft and supple. Some lotions and creams contain ingredients like collagen or elastin, two substances which do help skin to stay youthful, but not when applied to the epidermis in a lotion. The collagen and elastin are found in the next layer down, and cannot penetrate to that layer when applied to the epidermis.

2.The middle layer, the dermis. Here the skin is supported by a collagen-and-elastin framework, or matrix. As we age, the body produces less of these substances, making that support matrix weaker and leading to wrinkle formation. There are facial fillers such as Restylane, Sculptra and Radiesse which can be injected into the dermis to reinforce the skin's support. Also in the dermis are other structures such as nerves, blood vessels and hair follicles.

3.The lower layer, the subcutaneous layer, meaning 'below the skin'. It stores fat which helps keep our skin smooth and helps to insulate us.

Chemical peels work by removing the epidermis to a greater or lesser depth, depending on the strength of the peel. This stimulates the dermis to produce new replacement cells. Peels are usually done in a series because repetition of the peel 'teaches' the dermis to create tighter cells, giving the skin a tighter, smoother look. The new cells replace old damaged cells which may have been giving you irregularities of texture or color.

Mild chemical peels

•The mildest chemical peels can be bought in stores, and may have slight temporary results.

•Stronger peels that are still considered 'mild', such as glycolic peels, can be done at non-medical salons and spas.

•A cosmetic surgeon can give you a stronger peel yet, though it can still be relatively 'mild', such as TCA peels. It requires no anesthetic. It helps with age spots and other minor blemishes, but not with wrinkles.

Stronger chemical peels

Stronger peels penetrate more deeply, even into the dermis. An example is a Phenol-Croton oil peel. They require an anesthetic and longer healing time. What makes them more effective is that they give injury to the dermis, which causes it to refresh and realign the collagen and elastin fibers of the support matrix. New collagen regenerates the skin.

The skin looks red for about six to twelve weeks afterwards, but the results are worth it. A deep peel reduces crows feet and the wrinkles around the mouth and across the forehead. It removes sun damage too. However, it is best done on people with fair skin, as it may injure the skin's pigment cells and cause some skin whitening. The skin will not tan again.