REFINITY™ Glycolic Peel

CLIENT SELECTION
The REFINITY™ Skin Refining System may be used for clients just beginning their AHA treatments, clients who have received previous in-office peel treatments and clients with sensitive skin. Clients with dry, oily or combination skin types may be candidates for this treatment.

PEEL TREATMENT PROTOCOL
For the most effective results, we recommend a series of six peels performed every two weeks. The treatment time can be increased based on the client's reaction to the peel. The maximum treatment time that has been clinically observed is 12 minutes. Following the initial 12-week program, we recommend a maintenance program once a month for an in-office 70% Glycolic Acid Peel treatment. A series of six peel treatments can be scheduled annually depending on the client's skin type, age, photo damage and other cosmetic factors.

The REFINITY™ Skin Refining System contains:

• One 2 oz. bottle of Pre-Peel Conditioner with Cosmederm-7. (Purified Water, Alcohol, Strontium Nitrate, Polysorbate-20, Gluconic Acid Lactone, Methylparaben, Diazolidinyl Urea, Disodium EDTA, Sodium Hydroxide and Propylene Glycol).
• Refining Peel Formula with Cosmederm-7. (Glycolic Acid, Purified Water and Strontium Nitrate).
• Peel Neutralizer. (Purified Water, Sodium Bicarbonate, Propylene Glycol, Benzyl Alcohol, Methylparaben,
  Propylparaben, Diazolidinly Urea and Disodium EDTA.)
• Eighteen .33 oz tubes of Post-Peel Moisturizer with Cosmederm-7.
• Eighteen double-tipped rayon applicators.

PRE/POST TREATMENT INSTRUCTIONS:
The following products and procedures should not be used prior to/after the 70% Glycolic Acid Peel System:

• 48-72 hours: products containing alpha-hydroxy acid, bleaching or skin lightening agents, waxing or any products that contain ascorbic acid.
• Two weeks: Retin-A, Renova, any chemical peel or other prescription skin care products.
• One month: any surgical or laser procedure.

It is important to know if the client has a skin disorder or is taking any prescription medication for the treatment of a skin disorder, or if they have a history of allergic reactions to any of the peel ingredients in the REFINITY™ Skin Refining products.

• NO TREATMENT SHOULD BE PERFORMED IF ANY OF THE FOLLOWING CONDITIONS EXIST AT THE PEEL SITE:
  • Infection, disease, cut or broken skin, sunburn, history of "cold sores" and herpes.
• Clients should understand that the peel treatment may be part of a comprehensive skin care program recommended by the physician to include:
  • Regular use of REFINITY™ skin solutions homecare products (product use can be resumed 48 hours after peel treatment. REFINITY™ Cleanser and Toner are safe to use at all times.)
  • Sun protection
• Women who are pregnant or nursing should consult their physician before a treatment.
• MICRODERMABRASION: We have anecdotal data of various doctors combining the REFINITY™ Skin Refining System and microdermabrasion on the same day. However, the safest recommendation we suggest is to perform a microdermabrasion and the REFINITY™ Skin Refining System one week apart.

INSTRUCTIONS FOR IN-OFFICE PROCEDURE:

Be sure to have the following items before beginning:

• REFINITY™ Purifying Cleanser or other mild soap-free cleanser
• Timer
• REFINITY™ Skin Refining System
• Bowl of clean, tepid water
• Cotton pads/small measuring cup
• Band for hair control

PROCEDURE:

1. Cleanse the skin with the REFINITY™ Purifying Cleanser, or other mild, soap-free cleanser.
2. (Step 1) Pre-Peel Conditioner - SHAKE WELL BEFORE USING. Prepare skin by applying Pre-Peel Conditioner to cotton pad and gently rubbing evenly over the entire area to be treated (face, hands, neck, décolleté, etc).
3. ALLOW AREAS TO DRY.
4. (Step 2) Refining Peel Formula - SHAKE WELL BEFORE USING. Pour a small amount into a small measuring cup (Face & Neck ½ Tsp. Or Face, Neck, Hands & Décolleté 1 Tsp). Using the supplied rayon applicator, dip end into the Refining Peel Formula until saturated. Prevent
   dripping by rolling applicator against side of cup to reduce excess solution.
5. Apply Refining Peel Formula evenly to all areas that were treated with Pre-Peel Conditioner, beginning with the forehead and the outer areas of the face and working toward the central portion of the face. If the neck, hands or chest are to be treated, they can be addressed after the
   facial application is completed.
6. NOTE AND RECORD TIME DO NOT LEAVE CLIENT UNATTENDED DURING THIS STEP.
7. Observe treated areas for erythema. If erythema occurs, apply Peel Neutralizer (Step 3) with cotton pad immediately.
8. In the absence of erythema. Use time as an indicator of when to apply Peel Neutralizer (Step 3).
   • The client's first treatment is usually timed at 2-6 minutes. Timing may vary depending on client's skin type and their history of use with AHA products and treatments. Subsequent treatments may increase in duration.
9. (Step 3) Peel Neutralizer - SHAKE WELL BEFORE USING. Apply Peel Neutralizer with cotton to all areas which were treated with the Skin Refining Peel Formula.
10. To Ensure the Skin Refining Peel Formula has neutralized, apply another layer to all treated areas with water.
11. (Step 4) Apply Post-Peel Moisturizer to all treated areas. Please note: Post-peel Moisturizer does not contain sunscreen.
12. Give client REFINITY™ Post-peel Moisturizer for home use during the 1-2 days following this treatment, prior to resuming the use of REFINITY™ Skin Solutions home products.
    
13. Clients may schedule next treatment as advised by the physician. Safety of treatment with the REFINITY™ Skin Refining System more frequently than within two weeks has not been established.

The REFINITY™ homecare products may be used to complement the REFINITY™ Skin Refining System as part of a comprehensive skin care program for your clients. Physicians have reported the best results from their clients when they use the homecare maintenance program two weeks prior to their scheduled 70% Glycolic Acid Peel treatment.

COMPLICATIONS:
Complications with glycolic peeling are rare. Potential complications which have been observed with glycolic acid peels include persistent erythema, superficial crusting, post-inflammatory hyperpigmentation, infection, scarring and facial herpes simplex1 virus. Care must be taken to ensure complete neutralization of the REFINITY™ Skin Refining System. Additionally, clients must be instructed to contact their esthetician immediately if they experience any complications.

Cosmederm Glycolic Peel

CLIENT SELECTION:
COSMEDERM SKIN SCIENCE™ may be used for clients just beginning their AHA treatments, clients who have received previous in-office peel treatments and clients with sensitive skin. Clients with dry, oily or combination skin types may be candidates for this treatment.

PEEL TREATMENT PROTOCOL:
For the most effective results, we recommend a series of six peels performed every two weeks. The treatment time can be increased based on the client's reaction to the peel. The maximum treatment time that has been clinically observed is 12 minutes. Following the initial 12-week program, we recommend a maintenance program once a month for an in-office 50% Glycolic Acid Peel treatment. A series of six peel treatments can be scheduled annually depending on the client's skin type, age, photo damage and other cosmetic factors.

The COSMEDERM SKIN SCIENCE™ Peel contains:

• One 6 oz. bottle of Pre-Peel Conditioner with Cosmederm-7™. (Purified Water, Alcohol, Strontium Nitrate, Polysorbate-20, Gluconic Acid Lactone, Methylparaben, Diazolidinyl Urea, Disodium EDTA, Sodium Hydroxide and Porpylene Glycol).
• One 4 oz. 50% Glycolic Peel Formula with Cosmederm-7™. (Glycolic Acid, Purified Water and Strontium Nitrate).
• One 6 oz. Peel Neutralizer. (Purified Water, Sodium Bicarbonate, Propylene Glycol, Benzyl Alcohol, Methylparaben, Propylparaben, Diazolidinyl Urea, Disodium EDTA).
• Eighteen double-tipped rayon applicators.

PRE/POST TREATMENT INSTRUCTIONS:

• The following products and procedures should not be used prior to/after the 50% Glycolic Acid Peel System:
  • 48-72 hours: products containing alpha-hydroxy acid, bleaching or skin lightening agents, waxing or any products that contain ascorbic acid.
  • Two weeks: Retin-A, Renova, any chemical peel or other prescription skin care products.
  • One month: any surgical or laser procedure.

It is important to know if the client has a skin disorder or is taking any prescription medication for the treatment of a skin disorder, or if they have a history of allergic reactions to any of the peel ingredients in the COSMEDERM SKIN SCIENCE™ products.

• NO TREATMENT SHOULD BE PERFORMED IF ANY OF THE FOLLOWING CONDITIONS EXIST AT THE PEEL SITE:
  • Infection, disease, cut or broken skin, sunburn, history of "cold sores" and herpes.
• Clients should understand that the peel treatment may be part of a comprehensive skin care program recommended by the esthetician to include:
  • Regular use of COSMEDERM SKIN SCIENCE™ homecare products (product use can be resumed 48 hours after peel treatment. COSMEDERM SKIN SCIENCE™ Cleanser and Toner are safe to use at all times.)
  • Sun protection
• Women who are pregnant or nursing should consult their esthetician before a treatment.
• MICRODERMABRASION: We have anecdotal data of various doctors combining the COSMEDERM SKIN SCIENCE™ Peel and microdermabrasion on the same day. However, the safest recommendation we suggest is to perform a microdermabrasion and the COSMEDERM SKIN SCIENCE™ Peel one week apart.

INSTRUCTIONS FOR IN-OFFICE PROCEDURE:

Be sure to have the following items before beginning:

• COSMEDERM SKIN SCIENCE™ Moisturizing Cleanser or other mild, soap-free cleanser
• 50% Glycolic Acid Peel SystemCotton pads
• Timer
• Bowl of clean, tepid water
• Small measuring cup
• Band for hair control

PROCEDURE:

1. Cleanse the skin with the COSMEDERM SKIN SCIENCE™ Moisturizing Cleanser or other mild, soap-free cleanser.
2. (Step 1) Pre-Peel Conditioner - SHAKE WELL BEFORE USING. Prepare skin by applying the Pre-Peel Conditioner to cotton pad and gently rubbing evenly over the entire area to be treated (face, hands, neck, décolleté, etc.).
3. ALLOW AREAS TO DRY.
4. (Step 2) 50% Glycolic Peel Formula - SHAKE WELL BEFORE USING. Pour a small amount into a cup (face & neck ½ tsp. or face, neck, hands and décolleté 1 tsp.). Using the supplied rayon applicator, dip the cotton end into the Peel Formula until saturated. Prevent dripping by rolling the applicator against the side of cup to reduce excess solution.
5. Apply 50% Glycolic Peel Formula evenly to all areas that were treated with Pre-Peel Conditioner, beginning with the forehead and the outer areas of the face and working towards the central portion of the face. If the neck, hands or chest are to be treated, they can be addressed after the facial application is completed.
6. NOTE AND RECORD TIME. DO NOT LEAVE CLIENT UNATTENDED DURING THIS STEP.
7. Observe treated areas for erythema. If erythema occurs, apply Peel Neutralizer (Step 3) with cotton pad immediately. SHAKE WELL BEFORE USING. In the absence of erythema, use time as an indicator of when to apply (Step 3) Peel Neutralizer.
• The client's first treatment is usually timed at 2-6 minutes. Timing may vary depending on client's skin type and their history of use with AHA products and treatments. Subsequent treatments may increase in duration.
8. (Step 3) Peel Neutralizer - SHAKE WELL BEFORE USING. Apply Peel Neutralizer with cotton pad to all areas which were treated with the Peel Formula.
9. To ensure the Peel Formula has neutralized, apply another layer of water to all treated areas.
10. (Step 4) Apply Post-Peel Moisturizer to all treated areas. Please note: Post-Peel Moisturizer does not contain sunscreen.
11. Clients may schedule their next treatment as advised by the esthetician. A clinical study of safety to perform the COSMEDERM SKIN SCIENCE™ 50% Glycolic Acid Peel System more frequently than the suggested two week waiting period has not been established.

The COSMEDERM SKIN SCIENCE™ homecare products may be used to complement the COSMEDERM SCIENCE™ 50% Glycolic Acid Peel System as part of a comprehensive skin care program for your clients. Estheticians have reported the best results from their clients when they use the homecare maintenance program two weeks prior to their scheduled 50% Glycolic Acid Peel treatment.

COMPLICATIONS:
Complications with glycolic peeling are rare. Potential complications which have been observed with glycolic acid peels include persistent erythema, superficial crusting, post-inflammatory hyperpigmentation, infection, scarring and facial herpes simplex1 virus. Care must be taken to ensure complete neutralization of the COSMEDERM SKIN SCIENCE™ Peel. Additionally, clients must be instructed to contact their esthetician immediately if they experience any complications.