Protocol
Hyperpigmentation
Hyperpigmentation
Before the 1st Session: PrePeel Preparation
Prepeel preparation is essential to optimize the results of a peel and minimize potential risks. Here's a general outline for preparing the skin before a peeling session:
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Cleansing with ASEPTISKIN: Begin with a thorough cleanse to remove any makeup, oils, and impurities from the skin. This ensures that the peeling agents can penetrate effectively. Use a gentle, non-exfoliating cleanser to avoid stripping the skin.
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Prepeel Application with PREPEEL CREAM: Prepeels are formulated to prepare the skin for the active ingredients in the peel. They usually contain ingredients like citric acid, cetrinamide which help:
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Remove surface oil and debris.
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Balance the pH of the skin (peels work best on slightly acidic skin).
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Enhance the effectiveness of the main peeling product.
Apply the prepeel cream EACH DAY for 7-10 days across the treatment area, avoiding sensitive areas like the eyes and lips. Allow it to dry for a few minutes, and don’t rinse it off at least for 3 hours
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Avoid Sun Exposure: Ideally, avoid direct sun exposure and tanning beds in the days leading up to the treatment. Sunburned or overly sensitive skin can increase the risk of adverse reactions.
- Discontinue Certain Products: For a few days before the peel, avoid using active ingredients like retinoids, strong exfoliating acids (AHA, BHA), or products with alcohol. These can make the skin more sensitive and increase the risk of irritation.
Attack Treatment 1st Session
Step 1 :Cleansing with ASEPTISKIN:
Begin with a thorough cleanse to remove any makeup, oils, and impurities from the skin.
This ensures that the peeling agents can penetrate effectively.
Use a gentle, non-exfoliating cleanser to avoid stripping the skin.
Step 2 :TCA
- The 1st secret of Dr. Alain Tenenbaum in treating hyperpigmentation is that the acid frosting, such as TCA, must completely cover the color of the hyperpigmentation.( lesion)
- The 2nd secret is to use the same acid at decreasing concentrations to prevent demarcations from forming in a gradient pattern, extending from the lesion towards the periphery, which would not result in frosting.
- Our experience shows that only TCAs>15 can cause frosting.
- In cases where the hyperchromia is not adequately covered by the frosting or if the frosting is not white, it will be necessary to increase the acid concentration.
Step 3 : Peeling de Luxe Plus (Frosting Stopper)
The following key points should be observed:
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Frosting Appearance for the Lesion Area:
The frosting must appear white and should completely cover the lesion area.
To achieve this, a highly concentrated TCA solution is required.
Do not use our frosting stopper on the Lesion Area during Frosting !
Wait the Defrosting to apply it on the Lesion Area . -
Frosting Control for the Narrow Peri-Wound Area:
If the frosting turns white in the narrow peri-wound area adjacent to the lesion, it should be stopped using our frosting stopper.
This can be managed with a less concentrated TCA solution, although it will still induce frosting. -
No Frosting for the Larger Area Surrounding the peri-wound area:
For the larger surrounding area around the peri-wound, a low-concentration TCA should be applied.
This concentration should be sufficient to avoid frosting in the area.
There is mostly no need to use the frosting stopper in the larger area surrounding the narrow peri wound area
Step 4 : Stretchpeel (Depigmentant Cream)
Apply it
- on The Lesion Area , above Peeling de Luxe Plus after defrosting
- Apply it to the narrow peri-wound area immediately after using Peeling de Plus, and again over it once the gray frosting appears.
Step 5 : Les Félins (Moisturizing Cream)
Apply it on the Larger Area Surrounding the peri-wound area.
Apply Les Félins non-greasy, fast-absorbing moisturizing cream to the untreated areas of the face to ensure consistent hydration across both treated and untreated zones.
Timeline & Management of Crusts
Please repeat each session, following all steps, once a week for 4 consecutive weeks.
Ideally, schedule the session 3 days prior to a non-working day.
The 2nd, 3rd, and 4th sessions must strictly follow the treatment schedule, even if crusts are present.
These crusts must never be picked or removed, as they should always be regarded as hyperpigmented lesion areas.
In fact, the presence of a white or gray frosting on the crusts is desirable when applying TCA at concentrations greater than 15% w/w.
Between the Sessions
It is completely normal to experience a socially noticeable appearance for about three days following the initial session, known as the attack phase of the treatment. It is especially important not to panic during this period.
This temporary appearance often seems worse than before, particularly around the third day after both the first and second sessions. However, by the third day following the third session, any remaining discoloration (dyschromia) typically does not warrant social withdrawal. By the third day after the fourth session—usually the final one—the skin generally appears almost entirely free of visible discoloration.
It is crucial that the patient continues with the full course of treatment, regardless of temporary setbacks.
Interrupting the treatment or switching physicians mid-process can result in outcomes that are worse than the initial condition and may persist for a significantly longer period. At this stage, patient responsibility is key.
Additionally, it is essential that the patient refrains from using any personal cosmetic creams during the treatment period.
Lipoic Acid Cream offers significant benefits in clinical and aesthetic applications. Lipoic acid is known for its ability to enhance the transdermal penetration of active ingredients, facilitating their delivery into the deeper layers of the epidermis and dermis.
Recommended Combinations:
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For deeper hyperpigmentation: Combine with StretchPeel (Depigmenting Cream) to optimize depigmenting effects beyond the superficial layers.
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For dehydration of the deeper skin layers or in mature skin: Combine with Les Félins (Moisturizing Cream) to restore hydration and improve skin resilience.
This targeted approach allows for more effective and personalized treatment protocols based on individual skin conditions.
Stretchpeel is the ultimate depigmenting cream, thanks to its carefully selected ingredients and its alcohol-free formulation. It does not contain hydroquinone—a drug often associated with complications such as hypochromia.
As stated by Dr. Alain Tenenbaum and Mr. Mauro Tiziani, the goal is not to erase color variations, but to transform the mosaic of skin tones (hyperpigmentation) into a harmonious balance of facial complexion.
Les Félins Moisturizing Cream truly deserves its name, as it is designed to help prevent your dyschromia from turning into feline-like spots. This product has the advantage of being non-greasy and absorbing much faster than other moisturizing creams. It is alcohol-free and contains no ingredients that could cause complications.
Les Félins cosmetic cream also helps to soften and reduce the hardness of the scabs that may form between sessions, making it less likely for you to pick at them—something that could lead to small, permanent scars.
You can apply this cream as often as you like, with no limitations.
HomeCare & SunCare
HomeCare
Why Les Félins as moisturizer is necessary after a peel (as part of homecare):
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To rehydrate the skin:
A peel removes part of the stratum corneum (the skin’s outermost layer), which temporarily reduces the skin’s ability to retain moisture. This leads to dryness and sensitivity. A moisturizer helps restore lost hydration. -
To strengthen the skin barrier:
Hydrating ingredients help rebuild the skin’s protective lipid barrier, reducing irritation, redness, and tightness. -
To minimize excessive flaking:
While some flaking is normal after a peel, moisturizing the skin helps reduce discomfort and makes the process more tolerable and discreet. -
To support cellular regeneration:
Well-hydrated skin heals faster and supports more efficient cell turnover, optimizing the benefits of the peel.
PostPeel
Why a post-peel cream is often recommended:
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Specially formulated:
Post-peel cream typically contains soothing and restorative ingredients (like panthenol). They are free from irritants such as alcohol, fragrance, or harsh preservatives. -
To prevent complications:
Using appropriate post-peel care helps reduce the risk of irritation, inflammation, or post-inflammatory hyperpigmentation—especially important for sensitive or darker skin tones. -
To enhance results:
Proper post-treatment care maintains and prolongs the benefits of the peel, including improved radiance, smoother skin texture, and a more even tone.
SunCare
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Why an alcohol free sunscreen is essential :
Daily sun protection (broad-spectrum like Stretchpeel) is essential for several weeks to months following a peel.
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Avoid harsh products such as retinoids, acids, or exfoliants during the skin’s recovery phase.
Maintenance Treatment
Prevention Treatment
How to Prevent Hyperpigmentation and Melasma
Hyperpigmentation and melasma are common skin concerns caused by excess melanin production, often triggered by sun exposure, hormones, or inflammation. The best way to manage these conditions is through consistent prevention. Here's how to protect your skin and reduce the risk of dark spots and uneven tone:
1. Prioritize Sun Protection
Sun exposure is the leading cause of hyperpigmentation and melasma. Protect your skin every day—rain or shine.
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Apply an Alcohol Free Broad-Spectrum Sunscreen like Stretchpeel daily.
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Wear Protective Clothing: Use wide-brimmed hats, sunglasses, and sun-protective (UPF-rated) clothing.
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Avoid Peak Sun Hours: Stay out of direct sunlight when UV rays are strongest.
2. Use Gentle, Skin-Friendly Products
Harsh or irritating products can worsen pigmentation and damage your skin barrier.
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Cleanse Gently: Use a mild, non-stripping cleanser like Aseptiskin
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Avoid Irritants: Stay away from products with alcohol, fragrance, or abrasive exfoliants. (more than 98.9% of cosmetics an sunscreens are damaging your skin)
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Moisturize Daily: Keep your skin hydrated with Les Félins that support barrier health.
3. Be Mindful of Hormonal Triggers
Melasma is often linked to hormonal changes such as pregnancy, birth control use, or hormone therapy.
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Talk to Your Healthcare Provider If you're noticing skin changes related to medications or hormones
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Postpartum Care: Melasma often fades after pregnancy, but ongoing sun protection is essential to prevent it from returning.
4. Incorporate Preventative Skincare Ingredients ( Les Félins)
Certain ingredients can help regulate melanin production and prevent discoloration.
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Niacinamide (Vitamin B3) – Helps reduce pigment transfer and inflammation.
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Vitamin C – A powerful antioxidant that brightens and protects the skin.
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Azelaic Acid – Calms inflammation and helps fade dark spots.
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Tranexamic Acid – Especially effective for melasma.
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Arbutin and Licorice Extract – Natural brighteners that support an even skin tone.
5. Support Skin Health Through Lifestyle
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Don’t Pick at Skin: Picking, scratching, or over-exfoliating can lead to post-inflammatory hyperpigmentation.
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Manage Stress: Chronic stress can affect hormone levels and skin health.
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Eat a Balanced Diet: A diet rich in antioxidants supports overall skin resilience.
What to Avoid
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Tanning beds and prolonged sun exposure
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Unsupervised use of strong medical treatments like hydroquinone or topical steroids
Results
