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Facial Chemical Peel

Chemical peels are a safe alternative to surgery in order to minimize the appearance of wrinkles, especially that which is associated with sun damage, acne scars/ blemishes and areas of uneven skin pigmentation that appear over time. The procedure uses a liquid solution to peel away the top layers of your skin, revealing new, smoother skin. Chemical peels can be performed on your face, neck, chest, hands, legs or arms. Every year, an increasing number of people choose chemical peels to resurface their skin creating a fresh, healthy and younger looking appearance.

Chemical peels are categorized as light, medium and deep, depending on the type of chemical agent used.

Light Peels

Alphahydroxy acid (AHA) is used for light peels, which are often called "lunch hour" peels because they can be done quickly and the recovery time is very short. The chemicals used in this procedure lightly peel the skin, which quickly results in skin that is brighter and smoother. Light peels are often done repeatedly over time because the results are not as dramatic and long lasting as deep peels.

Medium Peels

Medium Peels use trichloracetic acid (TCA) for a medium depth peel that is used to treat moderate sun damage, fine lines and weathered skin. To achieve the best results, medium peels are usually performed two or more times over a span of weeks or months.

Deep Peels

Phenol acid is the strongest chemical solution used for this type of procedure and it causes the deepest skin peel. A deep peel is an extreme one-time procedure that can produce dramatic, long lasting results. This procedure is typically performed on women with extensive wrinkling, numerous dark brown age spots, mild scarring or precancerous growths. Phenol peels should be used with caution because they can cause permanent lightening of the skin. For this reason, Phenol peels are not recommended for most patients with very dark skin tones.

• How is a facial chemical peel performed?
• How long does a facial chemical peel take?
• What type of anesthesia is used?
• Where is the procedure performed?
• When can I return home and resume normal activities?
• How do I prepare for a facial chemical peel?
• What precautions are necessary during recovery?
• What are the possible complications after a facial chemical peel?
• What results can I expect after a facial chemical peel?
• Choosing the right surgeon

How is a facial chemical peel performed?

After cleansing your treatment areas, your surgeon will apply a chemical solution. You should feel a slight burning sensation as it is applied, however, this will quickly pass because the solution also acts as a mild anesthetic. The chemical solution "peels" away your top layers of skin, which reveals new, fresher and smoother skin. Depending on the results your desire and the condition of your skin, your surgeon will perform a light, medium or deep peel.

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How long does a facial chemical peel take?

A light peel usually only takes about 10 minutes to complete. To achieve your desired results, further peels may need to be scheduled at regular intervals. Medium peels normally take about 15 minutes to treat the entire face. Two or more peels spaced over several months may be required to achieve your goal. Full-face Phenol peels take approximately one to two hours, but small-area phenol peels (such as on the upper lip) may take about 10 - 15 minutes.

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What type of anesthesia is used?

Anesthesia is not required for medium and deep peels because the chemical solution used also acts as an anesthetic. No anesthesia is used for light peels because the chemical used results in only a light stinging sensation. For all chemical peels a light sedative can be used to help relax you prior to and during your procedure.

Where is the procedure performed?

Generally, AHA peels are performed in the doctor's office. TCA peels may be performed in the doctor's office or in an outpatient surgery center. Phenol peels are typically performed in an outpatient surgical center.

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When can I return home and resume normal activities?

Chemical peels are performed on an outpatient basis so you may return home the same day.

After a light peel you will experience temporary dryness, redness and flaking. However, this will not prevent you from getting back to your normal routines almost immediately. After two weeks you should be able to wear makeup, which will help masque some of the redness. With a medium peel you will experience some minor discomfort and swelling that will subside after the first week. After about ten days your new skin will be more evident and you should be ready to resume you daily activities. A deep peel will normally require that you wait about two weeks to get back to most of your normal activities. At first your face will be very red, gradually fading to a lighter pink over the following weeks to months. You will experience greater swelling than with a medium peel, and it will take about ten days for your new skin to start emerging.

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How do I prepare for a facial chemical peel?

During your initial consultation, your surgeon will discuss the changes that you would like to make to your appearance. Your surgeon will evaluate your skin type, skin condition and the severity of any discolorations, wrinkling, scarring, or age spots. This will allow the surgeon to select the type of chemical peel that is most appropriate for you. Since the appearance of your face is a matter of personal perception and preference, you will need to discuss your concerns in detail so your surgeon can determine the appropriate alternatives.

Your surgeon may recommend a pretreatment routine for you to follow. A common pretreatment routine may include taking Retin A, which is a prescription medication derived from Vitamin A. Retin A thins your skin's surface layer, which allows chemical peel solutions to penetrate more evenly. If you have blotchy skin, your surgeon may prescribe a bleaching agent that is used in combination with Retin A. On occasion, patients may spend a month in pretreatment before their chemical peel procedure.

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What precautions are necessary during recovery?

The recovery period for chemical peels varies depending on whether you have a light, medium or deep peel. Keep in mind that the deeper the peel procedure the more intense each aspect of your recovery will be. For deep peels, you may have to wear bandages over your treated area for a day or two. This normally isn't necessary for light or medium peels. About a day after your procedure, small flakes or scabs may form to protect your new skin. It's important not to pick at these flakes because it could result in scarring. In many cases they can be removed with soap and water. Your surgeon also may advise you to apply a skin ointment, cream or moisturizer after cleaning your skin. After these skin flakes have fallen off, your new skin will begin to appear. It will most likely be bright red (similar to a bad sunburn), dimming to a lighter pink over time.

After your new skin has grown in it will be lighter in color than before your procedure. Because of this, you will need to protect your skin from sun exposure by applying sun block lotions of at least SPF 15 before going outside. While your new skin is healing, you may experience abnormal itching, swelling or tingling. Your surgeon will provide you with medications or directions on how to use cold compresses to minimize this condition. With medium and deep peels, you should refrain from strenuous activities for two to three weeks. You also should wait this same length of time before applying makeup. Your usual makeup could possibly cause skin irritation, so your surgeon may recommend non-allergenic makeup.

What are the possible complications after a facial chemical peel?

Chemical peels are normally a safe procedure when performed by an experienced, board-certified plastic surgeon. However, as with any medical procedure, chemical peels have some potential risks and complications that you should be aware of. Though the occurrence is rare, any peel can lead to uneven skin pigmentation, infection or scarring. The greatest risk involves over exposure to the sun. Failure to follow your surgeon's directions for protecting your skin from the sun can result in uneven skin pigmentation and blotching. Deep peels may pose special risks for patients with a history of heart disease. It's very important to notify your surgeon of any previous occurrence of heart ailments when he or she takes your medical history.
Although chemical peels may be performed in conjunction with a facelift, they are not intended to serve as a replacement for such procedures. Chemical peels can provide you with younger, fresher and smoother skin; however they cannot slow the aging process or the ultimate long-term effects old age can have on the skin. It is always important to be informed about the possible complications before any procedure. Be sure to discuss any concerns you may have with your surgeon.

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What results can I expect after a facial chemical peel?

The results you obtain from a light peel will initially be very subtle. At first you may detect a healthier glow to your skin. After several treatments you should notice a smoother texture as well. Medium peels will produce results that are more obvious and pronounced than a light peel; however, they will not be as dramatic as a deep peel. Overall, you should notice that your skin has become much smoother and fresher looking. In most cases, maintaining these results will require that you repeat your treatments over a long period of time.

Deep peels will provide you the most dramatic and long lasting results. Following an extended recovery period you should have fewer wrinkles, scars and blemishes and much improved skin tone. Keep in mind that even extensive chemical peel treatments cannot overcome the natural effects of routine sun exposure and aging. Every woman's body chemistry is different and the long-term results you can achieve with chemical peels will depend on your skin type and individual circumstances. Make sure you speak openly with your surgeon about your long-term goals and the chemical procedure that is appropriate for your individual situation.

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