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Chemical Peels

The Chemical peel is used to improve the skin’s appearance by applying a chemical solution which causes the damaged outer layers of skin to “blister” and eventually peel off. The new skin will be smoother, less wrinkled and may be more even in color. Chemical peels reduce fine lines, especially under the eyes and around the mouth. They can treat mild scarring and certain types of acne. They can diminish skin discoloration, such as sun spots, age spots, liver spots, freckles, or blotchiness.

Initial Visit

During a patient's first visit, a full medical history will be taken. Physical examination will focus on age, genetics, skin type and elasticity. It is important to discuss any pre-existing conditions, allergies, and surgeries. The dermatologic surgeon will ask what you like and dislike about your skin.

Types of Peels

Glycolic acid peels(GA):  Glycolic acid is a naturally occurring organic acid formulated from sugar cane, and creates a mild exfoliating action. These peels are the mildest and result in smoother, brighter-looking skin and can also treat fine wrinkling, areas of dryness, uneven pigmentation and certain types of acne. Multiple peels may be needed to achieve desired results.

Since GA peels cause minimal discomfort, they do not usually require an anesthetic because the patient feels only a slight stinging when the solution is applied. If a patient were to request something for pain, an oral pain pill like Tylenol with codeine would be appropriate.

Trichloroacetic acid peels (TCA): TCA peels are used for medium to deep peeling and primarily address fine surface wrinkles, superficial blemishes and pigment problems. More than one TCA peel may be needed to achieve the desired result.

Deeper peels like the TCA peel are a bit more painful but usually do not require anesthesia because the TCA solution has a numbing effect on the skin. Frequently, the combination of a tranquilizer like Valium and a pain pill will suffice to relax patients and keep them comfortable.

Chemical Peel Procedure

The skin is cleansed with an agent that removes excess oils. The acid solution is then carefully applied, which takes about 10 minutes.

During a chemical peel, most patients experience a brief warm to hot sensation that may last 5 to 10 minutes and may be followed by some stinging. Deep peels may be more painful.

Pre-Operative Instructions

Prior to treatment, you may be instructed to stop certain medications and prepare the skin with pre-conditioning creams, which would be applied at home for a certain period of time. These thin out the skin's surface layer, allowing the peel to penetrate more deeply and evenly.

Post-Operative Instructions

Depending on the type of peel, there may be a mild to severe sunburn-like sensation. The GA peel usually produces redness, which is followed by scaling that lasts three to five days. The deeper TCA peel can result in swelling and blisters that may peel off in a week or two, or it may take longer.

All peel patients are advised to avoid sun exposure (with SPF 15 or higher) for several months after treatment to protect the newly formed layers of skin.

Risks

People with certain skin types have a risk of developing a temporary or permanent skin color change. Persistent redness may also occur after a chemical peel. If scarring does occur, it can usually be treated with good results. There is also a possibility of infection.

Improvements may be very subtle a few weeks after treatment. There may be improvement in the texture of your skin which may have a healthier appearance.

Chemical peels are one of the most popular treatments for an aging face, with more than one million performed annually.