Chemical Peels
Chemical peels are used to remove damaged outer layers of skin to reveal new healthy skin. Most often used on the face, some can also be used on the hands and neck. A chemical solution is applied to the face, or other area, causing the skin to blister and separate before peeling off. The new skin will appear younger and smoother with fewer wrinkles and spots and a more even tone.
Chemical peels are used to reduce fine wrinkles around the eyes and mouth associated with aging and sun damage. Blotchy skin pigmentation, freckles, age spots, and some scarring from acne and injuries can also be improved to varying degrees. Though primarily a cosmetic treatment, chemical peels will also remove or improve scaly pre-cancerous keratoses and render them less likely to reappear.
Peels are available in three levels—mild, moderate, and extreme—varying with the chemical used, the time for recovery, and the results.
The simplest, quickest, and most basic chemical peel is the AHA peel. Alpha hydroxy acids are applied to the target area. AHA peels are appropriate and may be used on any kind, color, or type of skin. The procedure can safely be done in a plastic surgeon’s office or in an outpatient setting at a hospital. The skin is cleansed and oils removed before the surgeon applies the AHA chemicals. After 10 to 15 minutes, the face is rinsed with cold water and the procedure is over. A post-treatment cream may be applied, and the procedure may be repeated every week, two weeks, or monthly as may be needed or recommended. Sunblock use is necessary until the face is completely healed. AHA peels are best for rough, dry skin and acne control, and they can also incorporate bleaching agents to even out pigmentation abnormalities. They are also used as a pre-treatment for more powerful peels.
The next step up is the medium peel, usually using trichloroacetic acid. The TCA peel burns deeper to improve superficial discoloration while it eliminates fine wrinkles. It does not improve acne scarring or heavy wrinkling. The procedure may take 15 to 60 minutes in the doctor’s office, though you are likely to need pain medication to counteract the intense burning sensation when the TCA is applied. When the chemical has reached the required depth, iced saline will be applied to neutralize and inactivate the acid. Ice will be applied and there will be no further pain. Your face will be treated with oil or a steroid cream, and the normal color will return in about half an hour. You’re on your way, and no meds are needed.
In the days after the treatment, your face will first turn red, then the outer layers will turn dark and leathery in appearance. The old skin will crack and peel, coming off in flakes with no scabbing or wounds. This is usually complete in four to seven days. Your new skin will look rather flushed, and you can start using makeup. Though you will be physically fine, you may want to wait a week before returning to work due to the crusting and flaking. The effects of the TCA peel may fade after about six months, but you can use micro peels and skin treatments for long lasting maintenance. You may eventually have to repeat the procedure.
A phenol peel is a very extreme type of chemical peel. It can only be used on people with light colored skin. With phenol peels, there is good news, and there is bad news. They improve wrinkles much better than any other competing method or peel, including laser and dermabrasion. A phenol peel will improve acne scars and even most dark discoloration. And the results last for decades with just a single treatment. There is a flip side. Your skin, though smooth to the eye and to the touch, will become permanently ghostly white. The line where the peel ended will be noticeable. You will never be able to tan where the skin was peeled, and you will always have to wear heavy sunblock to avoid burning. Freckles will be gone forever, so your face may not match your neck and shoulders. The healing process is long and entails swelling, oozing, and crusting. After ten days of flaking, your face will be bright red for two to three months, though you can return to public in two weeks with makeup. Those most satisfied with phenol peels are women with extremely pallid complexions that have experienced severe sun damage or spotting.
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