What are some of the most common benefits of a chemical peel?

A chemical peel can restore a more youthful appearance to wrinkled, unevenly pigmented, sun-damaged, or blotchy skin. However, a peel cannot reverse the aging process or completely remove deep scars. Wrinkled skin that is loose and sagging may also require a face-lift, laser resurfacing treatment, or combination of procedures for best results.

How is a chemical peel performed?

All chemical peels involve applying a chemical solution to remove the outer layers of skin so that a smoother, more evenly pigmented, glowing layer of skin can appear. There are three basic categories of chemical peels. Each type works differently, and produces different results.

Light peels: Alphahydroxy acids (AHAs), Betahydroxy acids (BHAs) Light or “lunch hour” peels are the mildest of the chemical peels. These peels include glycolic, lactic, and fruit acid peels (AHA) or Salicylic Acid (BHA). They burn off only the outer layers of the skin to smooth out fine wrinkles and/or rough, dry skin. AHA and Beta lift peels may also be used to improve the texture of sun-damaged skin, balance out skin pigmentation, or diminish some types of acne scars. These peels are often repeated to achieve the desired results.

The application of AHA and Beta lift peels are relatively fast and simple. These peels are generally performed in the doctor’s office. No sedation or anesthesia is required, since the patient only experiences a slight stinging when the solution is applied. The treatment usually takes about 10 to 15 minutes, but the nurse may vary the concentration of the chemical solution or the length of time of the treatment.

The nurse will begin by thoroughly cleansing the area to be treated. Next, he/she will apply the AHA solution, wait up to 15 minutes, and then remove it. After the procedure, no ointments or salves will be necessary to cover the treated area. Monthly or weekly repetition is common.

Medium peels: Trichloroacetic acids (TCA) A TCA solution is used for medium depth peels. This is generally used to treat skin with moderate sun damage, surface wrinkles, and/or uneven tone or pigment abnormalities. Full-face TCA peels take approximately 15 minutes.

Before applying the chemical solution, the nurse will thoroughly cleanse the area to be treated. At first, the patient may feel a warm or burning sensation, followed by stinging. Sometimes two or more TCA peel treatments, at intervals of one to two months, are necessary to achieve the desired results. The TCA peels can be used in varying concentrations, the higher concentrations may require oral or liquid anesthesia medication.

How long does it take?

AHA and TCA peels for the full face generally take 10 - 15 minutes. Full-face Phenol peels may take between one and two hours. Phenol peels for small portions of the face, such as the upper lip, may take only 10 to 15 minutes.

What can I expect after a chemical peel?

After a chemical peel, most people experience some facial swelling and reddening. Your doctor may advise you to keep your head elevated.

The recovery period is different for each type of peel.

Light peels: Alphahydroxy acids (AHAs) AHA peels generally cause some flaking, redness and dryness, or skin irritation. These side effects diminish over time. Once the body heals itself naturally, the outer layer of skin will fall away. Patients are usually able to engage in normal public activities the day after an AHA peel.

Medium peels: Trichloroacetic acids (TCA) TCA peels may cause significant swelling, depending on the potency of the chemical solution that was used. Swelling should diminish after the first week. The skin will heal sufficiently to resume normal activities in approximately 7-10 days.

After TCA peels, some patients also have outbreaks of small whiteheads, called milia, which are formed in obstructed facial glands. Generally, these disappear with washing, but your nurse will consult with you if this occurs.

After any peel, it is critically important that the skin be protected from the sun. Ask your nurse to recommend a sun block with both UVA and UVB protection, and apply it daily.

How much pain is there?

During the procedure, most people feel a brief burning sensation, followed by a feeling of numbness or stinging. The sensation will vary depending on the type of peel as well as the possible of pain medications in the case of deep peels. The AHA, BHA and TCA peeks are uncomfortable only during treatment.

Who should consider a chemical peel?

In general, the best candidates for chemical peels are people:

• In good physical health.
• Psychologically stable.
• Who understand the procedure.
• Who do not smoke.
• Wanting to look younger and more refreshed.
• Unhappy with the appearance of wrinkles or brown spots, especially around mouth or eyes.
• Free of active skin infections, including most kinds of acne.
• Informed about the appropriate skin tone for the type of peel used.
• Not taking Accutane, nor have taken it for the previous 18 months
• Free from large or unusual scar formations, such as keloids.
• Realistic in their expectations.
• Willing to accept the limitations involved in the healing process.

Risks and limitations:

Significant complications with chemical peels are infrequent, but potential complications include:

• Scarring
• Infection
• Temporary or permanent changes in skin tone or uneven tone (especially with Phenol peels). These include
• Hyperpigmentation (a darkening of the skin, treatable in most cases with current bleaching techniques)
• Hypopigmentation (a lightening of the skin, more difficult to treat)
• Cold sore breakouts in patients who have a history of recurring blisters and cold sores, like herpes and shingles. (An anti-viral medication before the procedure can help prevent this.)
• Risks for those with a family history of heart disease (Phenol peel only)

You can help minimize certain risks by following the advice and instructions of your nurse, both before and after the chemical peel. Pre-existing conditions may also put you at risk. If you have a history of heart disease or herpes, or you have a tendency to form large or unusual scars, be sure to discuss this with your treatment consultant and nurse before you have a chemical peel.