Chemical Peels

Chemical Peeling is a technique used to improve the appearance of the skin.  In this treatment, a chemical solution is applied to the skin, which causes it to separate and eventually peel off.  The new regenerated skin is usually smoother and less wrinkled than the older skin.  The new skin is also more even in color.

With the public’s increasing interest in rejuvenating skin and slowing the effects of the aging process, chemical peeling has emerged as an exciting supplement to a total skin care program.  A thorough evaluation by your dermatologist is imperative before performing a chemical peel.

What Can a Chemical Peel Do?

Chemical peeling if often used to treat fine lines under the eyes and around the mouth.  Wrinkles caused by sun damage, aging and hereditary factors can often be reduced or even eliminated with this procedure.  However, sags, bulges and more severe wrinkles do not respond well to peeling and may require other kinds of cosmetic surgical procedures, such as eyelid lift or soft tissue filler.  A dermatologist can help determine the most appropriate type of treatment for each individual case.

Mild scarring and certain types of acne can be treated with chemical peels.  In addition, pigmentation of the skin in the form of sun spots, age spots, liver spots, freckles, blotchiness due to taking birth control pills, and skin that is dull in texture and color may be improved with chemical peeling.  Areas of sun damaged skin, spots of precancerous keratoses and scaling patches may improve after chemical peeling.  Following treatment, new lesions or patches are less likely to appear.

How are Chemical Peels Performed?

The procedure can be performed on the face, neck, chest, hands, arms, and legs.  Superficial, medium, or deep chemical peels may be used to improve damaged skin.  As a rule, the deeper the peel, the longer the recovery time.  Your dermatologist will recommend the best peel for your skin problems.

Prior to treatment, instructions may include stopping certain medications and preparing the skin with preconditioning creams.

When a chemical peel is performed, the skin is thoroughly cleansed with an agent that removes excess oils, and the eyes and hair are protected.  One or more chemical solutions – such a glycolic acid, trichloracetic acid, salicylic acid, or lactic acid – are used.  Your dermatologist will select the proper peeling agent based upon the type of skin damage present.

During the procedure, patients may experience a somewhat hot sensation which lasts about 5-10 minutes, followed by a stinging sensation.  A deeper peel may require pain medication during or after the procedure.

What Should Be Expected After Treatment?

Depending upon the type of peel, a reaction similar to a mild to severe sunburn occurs following a chemical peel.  Superficial peeling usually involves redness, followed by scaling that ends within 3-5 days.

Medium-depth and deep peeling can sometimes result in swelling and plasters that may break, crust, turn brown, and peel off over a period of 7-14 days.  Some peels may require surgical tape to be placed on part or all of the skin that is treated.

It is important to avoid overexposure to the sun immediately after a chemical peel since the new skin is fragile and more susceptible to injury.  Your dermatologist will prescribe proper follow-up care to help the skin through the healing stages.

What are the Limitations of Chemical Peels?

Chemical peels cannot remove loose or sagging skin and do not eliminate the gravitational forces that produce loose skin.

Chemical peeling will not remove deep scars.  Dermabrasion, punch grafting, punch elevation, scar excision, or soft tissue fillers may be much more effective for scars and should be discussed with your dermatologist.

Chemical peels cannot change pore size, nor can they predictably remove broken blood vessels on the face.  However, chemical peels may improve the appearance of these conditions.

Types of Peels

Glycolic Acid: (35%-70%)

Glycolic Acid works by stimulating new growth of the epidermis (outer layer of the skin) and also results in the production of new collagen and elastic tissue.  This allows dead cells to be regenerated, gradually leaving behind a layer of smoother and softer skin, improving discoloration.

Jessners Peel: (Salicylic Acid 14%, Lactic Acid 14%, and Resoreinol 14% in Alcohol)

A Jessners Peel is particularly beneficial for clogged pores, thickened, aging skin, severe acne, environmentally damaged skin, and dyschromia (blotchy skin).  It is suitable for all skin types.  Jessners Peel penetrates more deeply into the epidermal layers of the skin.  It is gentler than TCA peels.  There is little or no downtime and most patients are able to return to their normal activities soon after receiving treatment.

Trichloroacetic Acid: (TCA 20%-30%)

This is a deeper class of peeling used for acne scaring, lines above the lips, around the eyes, and superficial wrinkles and hyperpigmentation.  The acid penetrates through the epidermis into the top of the dermis.  You can expect to peel for 5-7 days and 7 days of healing with a 30% or greater TCA peel.

What are Possible Complications?

In certain skin types, there is a risk of developing a temporary or permanent color change in the skin.  Taking birth control pills, pregnancy, or a family history of brownish discoloration on the face may increase the possibility of developing abnormal pigmentation.

Although low, there is a risk of scarring after chemical peels.  If scarring does occur, it can usually be treated.

There is a small incidence of the reactivation of cold sores or herpes simplex infection in patients with a history of fever blisters.

Prior to a chemical peel, it is important for a patient to inform the physician of any past history of keloids, unusual scarring tendencies, extensive X-rays or radiation to the face, or recurring cold sores.