Chemical Peels

Chemical Peel Treatments

Chemical peels are a technique used to improve the appearance of the skin. In this treatment, a chemical solution is applied to the skin, which causes it to exfoliate off. The new, regenerated skin is usually smoother and less wrinkled than the old skin. The new skin also is temporarily more sensitive to the sun.

What Conditions Do a Chemical Peel Treat?

Chemical peels are performed on the face, neck, chest, or hands. They can be used to:

	Reduce fine lines under the eyes and around the mouth
	Treat wrinkles caused by sun damage, aging and hereditary factors
	Improve the appearance of mild scarring
	Treat certain types of acne
	Reduce age spots, freckles and dark patches due to pregnancy or taking birth control pills (melasma)
	Improve the look and feel of skin that is dull in texture and color

However, sags, bulges and more severe wrinkles do not respond well to chemical peels. They may require other kinds of cosmetic surgical procedures, such as carbon dioxide laser resurfacing, a facelift, brow lift, eyelid lift or soft tissue filler.  A dermatologic surgeon can help determine the most appropriate type of treatment for each individual case.

Who Is a Good Candidate For a Chemical Peel?

Generally, fair-skinned and light-haired patients are ideal candidates for chemical peels. Darker skin types may also have good results, depending upon the type of problem being treated.

How Are Chemical Peels Performed?

A chemical peel can be performed in a doctor's office or in a surgery center as an outpatient procedure.
The skin is thoroughly cleansed with an agent that removes excess oils and the eyes and hair are protected. One or more chemical solutions, such as glycolic acid, trichloroacetic acid, salicylic acid, or resorcinol), are applied to small areas on the skin. These applications produce a controlled wound, enabling new, regenerated skin to appear.

Preparing for a Chemical Peel

Prior to the chemical peel, your doctor may ask you to stop taking certain drugs and prepare your skin with topical preconditioning medications such as Retin-A, Renova, glycolic acid or hydroquinoine. After the chemical peel, it's important to use a broad-spectrum sunscreen every day.

If you have been prescribed oral antibiotics or an oral antiviral medicine, you should begin taking those as directed. Typically, the oral antibiotics are prescribed depending on the depth of the chemical peel.

What to Expect During the Procedure

During the procedure, most patients experience a warm to somewhat hot sensation that lasts about five to ten minutes, followed by a stinging sensation. Cool compresses may be applied to help alleviate this stinging. A deeper peel may require pain medication during or after the procedure.

What to Expect After the Chemical Peel

The Refinity and the Vitalize peels are superficial or mild peels and have little visible effect and minimal downtime.  The Jessner’s/TCA peels cause a reaction similar to a sunburn (but without the cancer inducing aspect). Peeling usually involves redness, followed by scaling that ends within three to seven days.  Mild peels may be repeated at one to four-week intervals until the desired clinical effect is achieved.

Medium-depth peeling may result in swelling, as well as the presence of water blisters that may break, crust, turn brown and peel off over a period of seven days. Medium-depth peels may be repeated in six to twelve months, if necessary.

You will work with your dermatologist to determine the depth of your peel. This joint decision can vary, depending upon the condition of your skin and the objectives of treatment.

It is important to avoid over-exposure to the sun after a chemical peel since the new skin is fragile and more susceptible to complications. The dermatologic surgeon will prescribe the proper follow-up care to reduce the tendency to develop abnormal skin color after peeling.

What Are the Possible Complications of Chemical Peels?

In certain skin types, there is a risk of developing a temporary or permanent color change in the skin. Taking birth control pills, subsequent pregnancy or family history of brownish discoloration on the face may increase the possibility of developing abnormal pigmentation.

Although low, there is a risk of scarring in certain areas of the face, and certain individuals may be more prone to scarring. If scarring does occur, it can usually be treated with good results.

There is a small risk of reactivation of cold sores in patients with a history of herpes outbreaks. This problem is treated with medication as prescribed by the dermatologic surgeon. Your doctor may also choose to give you medication before or immediately after the peel in order to prevent a herpes outbreak.

Prior to treatment, it is important for a patient to inform the physician of any past history of keloids (scar tissue overgrowth created at the site of a skin injury) or unusual scarring tendencies, as well as any history of x-rays treatments to the face or recurring cold sores.

Microdermabrasion

Microdermabrasion is effective in reducing fine lines, "crow's feet," age spots and acne scars. It stimulates the production of skin cells and collagen. It has proven to be a very popular non-surgical cosmetic procedure.

Technique:

The hand piece emits crystals onto the surface of the skin, resulting in a gentle abrasion or "polishing" process. Each treatment takes from 20 - 30 minutes. The number of treatments recommended for maximal results can range between 5 and 12, spaced from 2 to 3 weeks apart. Maintenance of results requires periodic repeat treatments after the initial regimen is completed.

Benefits:

	Virtually no side effects.
	Gives the skin an overall fresh, healthy-looking glow.
	Non-surgical, safe, effective "lunch hour" procedure.
	No anesthetic required.
	Normal activities can be resumed immediately.

Other Considerations:

	Requires multiple sessions and maintenance treatments.
	Patients with good skin tone will show best results.
	An individualized skin care program may be recommended to maximize results.
	Not ideal for patients with rosacea as the mechanical force can stimulate new telangiectasias (spider veins) on the face.