Chemical Peels

A chemical peel is a cosmetic treatment that improves the appearance of the skin. It is often performed on the face, but can also be performed on the neck, hands, and certain other areas. Chemical peels vary in strength and intensity. The type of peel that is appropriate for you will depend on the condition of your skin, your complexion and what type of results you’d like to see.

Often, the best candidate for a chemical peel is a person with a fair complexion who have a considerable amount of wrinkles or fine lines on the skin. As part of the resurfacing process, chemical peels can often alter the pigmentation of the skin, causing light spots to develop. The stronger the peel, the more likely it is that some sort of pigmentation change will occur.

Pigmentation changes are usually less noticeable or non-existent in people with fair skin. If your skin is darker or olive, you can still have a chemical peel, but your surgeon or aesthetician might exercise more caution during it.

The strength of a chemical peel determines the setting for it. Mild peels, sometimes called “lunchtime peels,” are often performed in a doctor’s or aesthetician’s office. Since these peels involve a less concentrated form of acid, the aesthetician usually oversees all aspects of the procedure, from consultation through treatment.

Stronger, “surgical” peels are usually performed in a surgical center, although a surgeon might determine that an office is an appropriate setting for one.

Generally speaking, there are three main categories of chemical peel and a range of variety in each category.

1. Mild chemical peels. Mild peels, or “lunchtime peels” only resurface the very top, superficial layer of skin. They typically use a very mild acid, such as salicylic acid or alpha hydroxy acid.
2. Medium strength peels. A medium strength peel can often contain trichloroacetic acid or glycolic acid. It is stronger than the most superficial of peels and will resurface both the outer and middle layer of the skin. The results from a medium peel are usually considerably more dramatic than those from a mild peel.
3. Deep or surgical peels. The stronger types of chemical peels typically use phenol or trichloroacetic acid. They reach a deeper layer of the skin and provide the most noticeable and dramatic results.

How long a chemical peel takes depends on the size of the area treated and the intensity of the peel. Superficial peels or peels that are only applied to a very small area of the face can take around 15 minutes. Often, deeper peels or peels applied to the entire face can take about an hour.

Surgical peels often involve the use of general anesthesia or sedation. Mild, in-office peels might involve a local or topical anesthetic. In some instances, the anesthetic is included in the peel ingredients.

The chemical peel process varies based on your goals and the type of peel being performed. At the start of any peel, though, the skin is first cleansed. The next step is for the surgeon or aesthetician to apply the solution to the skin, using a cotton tip applicator.

What solution is applied, and where, depends on the goal. Certain chemicals used might minimize instances of spotting or hyperpigmentation on the skin, other chemicals can be used to smooth wrinkles and lines. Depending on the patient, a variety of acids and chemicals can be used in different areas during a single treatment.

The recovery process after a chemical peel is based on the strength of the peel. After a mild peel, you’re likely to be able to go back to the work the next day.

After a surgical chemical peel, it’s normal for the skin to be red for several weeks. During the first few days after the procedure, it’s common to see some skin shedding and exfoliation. Within about a week, the new skin cells should have formed, covering the treated area. Once the new skin has formed, you can begin to wear camouflage makeup to cover up any remaining redness. Many patients feel comfortable returning to work about a week after a surgical peel.

The day after any type of peel, you can begin to participate in light exercise, such as walking. Light physical activity is usually recommended to help the healing process.

If you’ve had a deep peel, you’ll want to avoid more vigorous or moderate exercise for about two weeks after the procedure. Keep in mind that you’ll need to wear sunscreen if any of your exercises involves spending any amount of time outdoors.

Complications are usually very rare after the most superficial of peels. One of the risks commonly associated with deeper, surgical peels is a loss or decrease in pigmentation of the skin, but even that only occurs in about 4 percent of patients.

One of the more common issues with a chemical peel is that the procedure didn’t do enough to treat a person’s wrinkles or other skin concerns. If that is the case, it’s possible to repeat the peel after a few months or to try a different skin resurfacing procedure.

• After the initial application of the peel solution, you will feel a stinging pain for several seconds.
• Within several hours, expect the pain to recur and it will last approximately 4 to 6 hours. In addition, you may develop
  swelling, and depending on the area being treated, it is occasionally severe.
• The pain is usually relieved or lessened by taking one or two of the prescribed pain tablets every 3 hours (as needed). Ice
  packs may also be applied to the peeled area(s) for relief.
• Try not to move the peeled area(s) excessively. Keep your lips stiff and avoid grimacing.
• The day following surgery any absorbent dressings can be removed and the following cleansing program should begin.
• Using gauze squares or a washcloth, soak the treated area(s) with a solution of one (1) tablespoon of white vinegar and one (1) cup of cool water. This should be done at least 6 to 8 times per day until the skin is completely healed (usually within 7 to 10 days). Any bluish-gray coating should be gently soaked off. Pat the skin dry, and apply a heavy layer of Aquaphor or A&D ointment. Dilute the vinegar by half if it is too strong. You should keep the treated area(s) moist with ointments at ALL TIMES. Do not pick or remove crusted areas. Do not allow areas to try out or scab over.
• Never pick at crusts or pieces of skin that do not loosen easily. They will come off with time.
• The hair follicles and sweat glands in your face contain skin elements that begin to grow after the peel. Within 5 to 10
  days the peeled areas are covered with a very fine, thin layer of new skin, which must be protected against drying by using
  mild moisturizing creams.
• No make-up should be applied until all the areas are completely covered with new skin. This usually takes 10 to 14 days. ? After an office visit to check the condition of the skin, you may start using a hypoallergenic make-up base (i.e. Clinique
  or Almay).
• The initial redness of the peeled areas will fade rapidly, but will remain pink as the skin thickens for a period of 6 to 8
  weeks. The skin will remain tense and smooth as the finer wrinkles and deep grooves become less evident. Occasionally
  small “whiteheads” may appear in the treated areas, but usually disappear within 2 to 3 weeks without any specific
  treatment. If you are prone to develop fever blisters or cold sores, you may experience a flare-up of these lesions. If you
  have had shingles, especially in the facial area, you are at risk for recurrence.
• AVOID DIRECT SUNLIGHT OR SUNLAMPS FOR 6 - 8 WEEKS. If the new, delicate skin is exposed too early, then blotching may occur. After this initial period you must still protect the peeled areas for at least 6 months. Wear a wide-brimmed heat and use protective sunscreen with maximum sun blockage (i.e. PreSunl5). Do not restart hormone pills (birth control, etc) before discussion with the doctor.