Chemical Peels

A chemical peel uses a chemical solution to improve and smooth the texture of the facial skin by removing its damaged outer layers. It is helpful for patients with facial blemishes, wrinkles, and uneven skin pigmentation. Phenol, trichloroacetic acid (TCA), and alphahydroxy acids (AHAs) are used for this purpose. The precise formula used may be adjusted to meet each patient's needs. Although chemical peel may be performed in conjunction with a facelift, it is not a substitute for such surgery, nor will it prevent or slow the aging process.

There are three main types of peels. Light peels, or those using Alphahydroxy acids (AHAs) such as glycolic, lactic, or fruit acids, are the mildest of the peel formulas. These are naturally occurring acids found in fruits and other foods. Alphahydroxy acids have proven to be effective in treating dry skin, acne, liver or sun spots, diminishing fine facial wrinkles, decreasing pore size, and improving skin texture. Light peels are usually performed in a series of six to eight peels, two or three weeks apart. These types of peels can provide smoother, brighter-looking skin for people who can't spare the time to recover from a phenol or TCA peel. This type of peel leaves the skin with a red glow that only lasts for a day or so. An alphahydroxy acid, such as glycolic acid, can also be mixed with a facial wash or cream, in lesser concentrations, as part of a daily skin-care regimen. AHA peels may cause stinging, redness, irritation, and crusting. However, as the skin adjusts to the treatment regimen, these problems will subside.

Medium peels are usually performed with trichloroacetic acid (TCA). These peels are only performed once every couple of years. Medium peels have the same benefits as light peels and, in addition, remove larger wrinkles and precancerous skin lesions because of deeper penetration. The drawback is that a medium peel makes the skin on the face look like severe sunburn for one week. If one has multiple precancerous skin lesions this is better than using Efudex, which makes the face look sore for six to eight weeks. A person having a medium peel must stay indoors for one week to recover from the procedure. This type of peel is also better than liquid nitrogen, because it treats small precancers that are too small to be seen with the naked eye. Like a medium peel, liquid nitrogen also takes a week of recovery time, but is only good for treating larger precancerous skin lesions. With a TCA peel, your healed skin will be able to produce pigment as always; the peel will not bleach the skin. Even so, TCA-peel patients are advised to avoid sun exposure for several months after treatment to protect the newly formed layers of skin. Although TCA is milder than phenol, it may still produce unintended color changes in the skin.

Phenol is the strongest of the chemical solutions and causes a deep peel. It is used mainly to treat patients with coarse facial wrinkles, areas of blotchy or damaged skin caused by sun exposure, or pre-cancerous growths. A phenol peel can have results as dramatic as a face-lift. This type of peel has a recovery time of 1-2 months. With a phenol peel, the new skin frequently loses its ability to make pigment (that is, tan). This means that not only will the skin be lighter in color, but you'll always have to protect it from the sun. Phenol may pose a special risk for patients with a history of heart disease. It's important that you make your surgeon aware of any heart problems when your medical history is taken. Skin pigmentation may be a determining factor as to whether or not this is an appropriate treatment for you. This peel is being done less since the introduction of laser resurfacing.

All chemical peels carry some uncertainty and risk. Chemical peel is normally a safe procedure when it is performed by a qualified, experienced dermatological surgeon. However, some unpredictability, and risks such as infection and scarring, while infrequent, are possible. During your initial consultation, Dr Treen will discuss expectations and outcomes. He will explain the planned procedure in detail, including its risks and benefits, the recovery period and the costs. If you have a history of herpes, you should inform Dr. Treen prior to the procedure.

Chemical peel treatments are usually not covered by medical insurance unless they are performed for medically related problems.