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Chemical Peel

The affects of this rejuvenating procedure are long lasting and give the face a much more youthful appearance.

About Chemical Peels

Chemical peels use various chemical solutions to improve and smooth the texture of the facial skin by removing its damaged outer layers. It is helpful for those individuals with combinations of uneven skin pigmentation, facial blemishes, and even wrinkles. Phenol, trichloroacetic acid (TCA) and alphahydroxy acids (AHA's) are used for this purpose. The precise formula used may be adjusted to meet each patient's needs. Peels will not prevent or slow the aging process, but can adjust the presentation and more youthful appearance to the skin. Although chemical peel may be performed in conjunction with a facelift, it is not a substitute for such surgery.

Who’s a Candidate?

When deciding if chemical peel is right for you, understand that a  Chemical peel is most commonly performed for cosmetic reasons. This is done to enhance your appearance and your self confidence. Chemical peel may potentially remove pre-cancerous skin growths, soften acne facial scars and even control acne. In certain cases, health insurance may cover your peel procedure. Be sure to check your policy and contact your insurance company before the procedure is performed.

What Are the Risks of Chemical Peels?

All chemical peels carry some uncertainty and risk. Chemical peel is normally a safe procedure when it is performed by a qualified, experienced plastic surgeon. However, some unpredictability and risks such as infection and scarring, while infrequent, are possible.

Phenol peels carry slightly higher risks and will be discussed with you by your surgeon if you are an appropriate candidate for the procedure.  Alphahydroxy acid (AHA) peels may cause stinging, redness, irritation and crusting during the healing process. As the skin adjusts to the treatment regimen, however, these problems will subside.

With a Trichloroacetic acid (TCA) peel, your healed skin will be able to produce pigment as always; the peel will not generally bleach the skin. However, TCA-peel patients are advised to avoid sun exposure for several months after treatment utilizing various methods such as hats, and sunscreen to protect the newly formed layers of skin. Even though TCA is milder than phenol, it may also produce some unintended color changes in the skin.

Preparing for Your Peel

Your plastic surgeon will instruct you on how to prepare your skin and yourself for your peel treatment.

Occasionally Retin A, a prescription medication derived from Vitamin A, is used to pre-treat the skin. This improves and thins out the skin's surface layer, allowing the TCA solution to penetrate more deeply and evenly. Occasionally your skin won't tolerate Retin-A pre-treatment, and an AHA cream may be used instead. Hydroquinone, a bleaching agent, is sometimes used in conjunction with Retin-A or AHA pre-treatment plan.  This is generally the case if you have irregularly pigmented or “blotchy” skin areas. You may have to spend a month or more in the skin pre-treatment phase before the doctor will schedule your actual peel.

You are instructed to arrange for someone to drive you home and help you out for a day or two if you are having a phenol or deeper TCA peel. You generally won't require any extra assistance if you're having an AHA peel or superficial TCA peel.

Your surgeon will examine your face and neck in order to maintain the harmony between the two regions. He or she will discuss some variables that may affect the procedure such as your age, the size, and shape of your neck, the amount of fat noted and the quality of your skin.

The Procedure

AHA Peels/Treatments

Your doctor will apply the AHA solution to your cleansed facial skin.  This process usually takes no more than 10 minutes. No "post-peel" ointment or covering is required, but one may be recommended. Depending on the strength of the peel, periodic treatments may be necessary or recommended  until the desired effects are achieved.

For some patients, the application of an AHA-based face wash or cream once or twice a day at home will be sufficient to accomplish the desired goal and potentially reduce the need for repeat procedures with stronger peels. Your plastic surgeon may add Retin-A or a bleaching agent such as Hydroquinone to your at-home treatment schedule. After several weeks of at-home use, your doctor will re-examine your skin to determine if your regimen needs adjustment.

Phenol and TCA Peels

Typically, the skin is first thoroughly cleansed. Next, the surgeon will carefully apply the phenol or TCA solution. You may feel some stinging sensations as the peel solution is applied, but understand that this feeling will quickly pass.

A full-face TCA peel usually takes about 15 minutes. Two or more TCA peels may be needed to obtain the desired result.  These are generally spaced out over several months. Mild TCA peels may be repeated as often as every month and will be discussed by your physician.

If phenol solution has been used, your plastic surgeon may coat the treated area after the treatment.  This is generally done with petroleum jelly or a waterproof adhesive tape. Often with lighter peels, no covering is necessary.

After Your Treatment

After an AHA peel, it is very common to experience some temporary flaking or scaling, redness and even dryness of the skin. However, these conditions are expected to disappear as the skin adjusts to treatment and the healthier skin comes through. With an AHA peel, the temporary redness, flaking and dryness that you experience should not prevent you from working or engaging in your normal activities. An  improved skin texture will result with continued AHA treatments.

Remember, protecting your skin from the sun is very  important following these mild acid peels. Ask your doctor to recommend a sun block with adequate UVA and UVB protection and use it every day.

After a phenol or TCA peel, your doctor may prescribe a mild pain medication to assist in relieving any tingling or throbbing you may feel. A crust or scab may form on some of the treated areas. To help your face heal properly, it is essential that you follow your doctor's specific post-operative instructions including not removing any crusts on your own.

A TCA peel may also cause moderate or even significant swelling, depending on the strength of the peel used. With a TCA peel, the moderate discomfort and mild swelling you may experience will subside within the first week. In about a week to ten days, your new skin will be apparent and you should be healed sufficiently to return to your normal activities. It is best to avoid sun exposure unless you are adequately protected.

If you've had a phenol peel, your face may become quite swollen potentially even affecting your eyelids. You may need someone to help care for you for a day or two. You may also be limited to a liquid diet and advised not to talk too much during the first few days of recovery to minimize premature crust removal.

About two weeks after treatment, you may return to work and resume some of your normal activities. Your skin will be healed enough for you to wear makeup if you desire.