Advanced Esthetics (Chemical Peels, Microdermabrasion, Devices)
Chemical peels
- Superficial: AHAs (glycolic, lactic), BHA (salicylic), enzymes, low-percentage TCA - typically within an esthetician's scope.
- Medium and deep: higher TCA, Jessner's, phenol - medical, referred out.
Prep the client by stopping retinoids and strong actives several days ahead, patch test, degrease the skin, time the application precisely, and neutralize acids that require it. Post-care means gentle cleansing, barrier repair, and strict sun protection, with no heat, waxing, or actives for several days. Frosting (white blanching) means stop.
Microdermabrasion
Mechanical exfoliation through crystal (aluminum oxide, vacuumed away) or diamond-tip handpieces. Use light, even pressure and limited passes. Avoid on active acne, rosacea with telangiectasia, thin or fragile skin, recent waxing, peels, or laser, and on clients using retinoids or isotretinoin.
Devices
- LED: blue for acne bacteria, red for aging and healing.
- Ultrasound, microcurrent, high frequency: each has specific indications, protocols, and contraindications.
- IPL and lasers are often restricted to medical settings.
Scope and safety
Pregnancy, photosensitivity, keloid history, active infection, and compromised skin are contraindications. Always patch test, obtain informed consent, document settings, and follow your state's scope of practice.
Traps
Estheticians do not perform medium or deep peels. More passes or longer timing is not better. "Frosting is a good result" is false.
Rule of thumb: "If it frosts, it's medical - stop and refer."