Chemical peels are used to smooth the texture of the skin on the face, neck or hands by removing its damaged outer layers. By applying a chemical solution to the skin, this technique exfoliates dead skin cells to reveal new, regenerated skin that is usually smoother and less wrinkled than the old skin.
How is the chemical peel procedure performed?
The procedure is done in an operating room under sedation. First, the skin is cleaned to remove normal oils and greases generated by the skin. Next, the peel solution (a diluted acid) is applied to the skin with cotton swabs. There is usually a mild burning sensation during this part of the procedure, but that feeling will disappear after a short time. The treated area is then covered with strips of tape or an ointment.
Will the chemical peel surgery result in permanent scarring?
Skin loss or scarring is very rare. Areas that are prone to developing scarring, such as the neck, are never peeled.
How long does the chemical peel procedure take?
Depending on the type of chemical used and the coverage area, a typical peel can take anywhere from 15 minutes to two hours to perform.
How long is the recovery time for a chemical peel?
With an AHA peel, the temporary redness, flaking and dryness that you experience will not prevent you from working or engaging in your normal activities. However, with more-aggressive peel solutions, like TSA and phenol, there may be a longer period of recovery that may require a delay in returning to work.
Will I need anesthesia for a chemical peel?
Anesthesia is not required for phenol or TCA peels since the chemical solution acts as an anesthetic. However, sedation may be used before and during the procedure to relax you and keep you comfortable.
No anesthesia is needed for AHA peels since they cause only a slight stinging sensation during application.
Am I a good candidate for a chemical peel?
A chemical peel is most commonly performed on patients for cosmetic reasons to enhance appearance and self-confidence. A chemical peel also may remove pre-cancerous skin growths, soften acne facial scars and even control acne.
What are the possible risks and complications of a chemical peel?
Problems are infrequent if the postoperative care is carefully outlined and followed. “Fever blisters” (localized herpes infections) infrequently flare up in treated areas, but an antiviral drug can be used to combat this. It is possible to have a peel that will result in skin loss or scarring. This is a drastic complication. It is very rare and, in our experience, it has not happened with the type of treatment we use. Areas that are prone to develop scarring, such as the neck, are never peeled. Precautions are taken to try to keep this complication at a minimum.
Hypopigmentation is a lightening of the skin color. After peel, dermabrasion or laser treatments, it is common for the skin to be a shade lighter in color. Usually, this difference is minimal. In persons with very light skin, freckles, blue eyes and reddish-blond hair, hypopigmentation can be exaggerated and almost chalk white. For persons with this type skin, a peel might be contra-indicated.
Hyperpigmentation is a dark discoloration of the skin that can happen after a chemical peel. This pigmentation is a function of heredity and sunlight exposure. It happens most frequently in people with dark complexions (dark hair, dark eyes and dark skin). Patients are evaluated with this in mind, and if there is a possibility of hyperpigmentation, a small test treatment site may be advised.
Your plastic surgeon will instruct you on how to prepare for your peel treatment.
Sometimes, Retin A – a prescription medication derived from vitamin A – is used to pretreat the skin. This thins out the skin's surface layer, allowing the TCA solution to penetrate more deeply and evenly. If your skin won't tolerate Retin-A pretreatment, an AHA cream may be used instead.
The bleaching agent hydroquinone is sometimes used in conjunction with Retin-A or AHA pretreatment, especially if you have blotchy skin areas or pigmentation problems. You may have to spend a month or more in the pretreatment phase before the doctor will schedule your actual peel.
You will need 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 probably won't need any extra assistance if you're having an AHA peel or superficial TCA peel.
Hyperpigmentation can happen in women on birth control pills. Patients who are taking this medication should make this known to the physician.
During the first three months post-treatment, it is important that you control sun exposure and use a sunscreen as prescribed. This is done because the tender, new skin is susceptible to hyperpigmentation, or dark discoloration, if exposed to significant sunlight.
The possibility of skin darkening is a possibility in persons who have dark skin coloration. Your particular case will be evaluated and if it appears that you are a high risk for pigmentation, a test may be performed on a small area of skin to determine if the procedure is advisable for you.
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