Chemical Peel

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 those individuals 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. This brochure provides basic information about certain types of chemical peel treatments and the results you might expect. It won't answer all your questions, since a lot depends on your individual circumstances. Once you and your plastic surgeon have decided on a specific peel program, be sure to ask about any details that you do not understand.

Deciding if chemical peel is right for you Chemical peel is most commonly performed for cosmetic reasons -- to enhance your appearance and your self-confidence. Chemical peel may also remove pre-cancerous skin growths, soften acne facial scars and even control acne. In certain cases, health insurance may cover the peel procedure. Be sure to check your policy and contact your insurance company before the procedure is performed.

Alphahydroxy acids (AHAs), such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels. 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. AHA peels may be used to treat fine wrinkling, areas of dryness, uneven pigmentation and acne. Various concentrations of an AHA may be applied weekly or at longer intervals to obtain the best result. Your doctor will make this decision during your consultation and as the treatment proceeds. 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 to improve the skin's texture.

Trichloroacetic acid (TCA) can be used in many concentrations, but it is most commonly used for medium-depth peeling. Fine surface wrinkles, superficial blemishes and pigment problems are commonly treated with TCA. The results of TCA peel are usually less dramatic than and not as long lasting as those of a phenol peel. In fact, more than one TCA peel may be needed to achieve the desired result. The recovery from a TCA peel is usually shorter than with a phenol peel.

Risk

All chemical peels carry some uncertainty and risk Chemical peel is normally a safe procedure when it is performed by a qualified, experienced plastic surgeon. However, some unpredictability and risks such as infection and scarring, while infrequent, are possible.

AHA peels may cause stinging, redness, irritation and crusting. However, as the skin adjusts to the treatment regimen, these problems will subside.

With a TCA peel, your healed skin will be able to produce pigment as always; the peel will not bleach the skin. However, TCA-peel patients are advised to avoid sun exposure for several months after treatment to protect the newly formed layers of skin. Even though TCA is milder than phenol, it may also produce some unintended color changes in the skin.

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 also 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.

It is also possible that phenol will cause some undesired cosmetic results, such as uneven pigment changes. Certain modified phenol peels are gentler and may be preferred in some circumstances.

Peel formulas at a glance
Alphahydroxy acids (AHAs)

Uses:
Smoothes rough, dry skin
Improves texture of sun-damaged skin Aids in control of acne
Can be mixed with bleaching agent to correct pigment problems
Can be used as TCA pre-treatment
Considerations:
A series of peels may be needed
As with most peel treatments, sunblock use is recommended
Trichloroacetic acid (TCA)

Uses:
Smoothes out fine surface wrinkles
Removes superficial blemishes
Corrects pigment problems
Considerations:
Can be used on neck or other body areas
May require pre-treatment with Retin-A or AHA creams
Treatment takes only 10-15 minutes
Preferred for darker-skinned patients
Peel depth can be adjusted
Repeat treatment may be needed to maintain results
Sunblock must be used for several months
Healing is usually quick, much quicker than with a phenol peel
Phenol

Uses:
Corrects blotches caused by: sun exposure, birth-control pills, aging
Smoothes out coarse wrinkles
Removes pre-cancerous growths
Considerations:
Used on the face only
Not recommended for dark-skinned individuals
Procedure may pose risk for patients with heart problems
Full-face treatment may take one hour or more
Recovery may be slow - Complete healing may take several months
May permanently remove facial freckles
Sun protection, including sunblock, must always be used
Results are dramatic and long-lasting
Permanent skin lightening and lines of demarcation may occur