Am I a Candidate for Chemical Peels?
If you have aging and sun-damaged skin, you may be a candidate for chemical peeling.
Chemical peels are quick, office-based procedures that help create a more youthful facial appearance. These treatments diminish wrinkles and lighten pigmented spots by removing the skin’s top layers.
Chemical peels are a popular non-surgical cosmetic procedure and can be a potential alternative to laser therapy. Dr. Minoli and his staff can help guide you toward the peels that are right for you.
Some facial skin disorders do not respond to chemical peeling.
How Are Chemical Peels Performed?
Chemical peels vary according to their specific ingredients, strengths, application times, and vigor of penetration.
A chemical peeling solution is typically applied with a gauze sponge, cotton pad, cotton swab, or brush.
- Alpha-hydroxy acids (α-hydroxy acids or AHAs) are the most superficial chemical peels and include glycolic acid, lactic acid, and fruit acid. Various concentrations of alpha-hydroxy acids may be applied weekly (or at longer intervals) for best results.
- Trichloroacetic acid (TCA) peels are stronger and have a greater penetration depth than light alpha-hydroxy acid peels.
- Phenol peels usually represent the strongest chemical peels, providing deep levels of skin penetration (similar to skin penetration levels achieved with certain ablative lasers).
- The VI Peel™ uses specific compounds of chemical peeling ingredients.
Alpha-hydroxy Acid Peels (AHAs or α-hydroxy Acids)
Alpha-hydroxy acids are a class of weak acids that penetrate the skin when topically applied. They refresh and smooth the skin by exfoliation (shedding of skin), collagen synthesis, and a slight thickening of the skin itself.
The alpha-hydroxy acids are often naturally occurring fermentation products of certain foods and fruits, including citric acid (from citrus fruits), glycolic acid (from sugar), lactic acid (from sour milk), malic acid (from apples), mandelic acid (from almond extract), and tartaric acid (from grape wine).
Lower concentrations of these acids are found in many over-the-counter skin care products; higher concentrations are usually reserved for clinical treatments.
A chemical peel with alpha-hydroxy acid is a short, safe procedure that does not require anesthesia or sedation. The solution only produces a mild tingling or stinging sensation when applied.
Sometimes a single treatment will convey a healthier, more radiant look to the skin; however, this chemical peel can be repeated for optimal, ongoing results. Certain skin conditions will require multiple treatments.
Alpha-hydroxy peels require no downtime, covering, or after-peel ointment. Normal activities may be resumed immediately.
Mild concentrations of alpha-hydroxy acids can be mixed with facial creams or body washes as part of a daily skin care regimen.
TCA Peels (Trichloroacetic Acid)
TCA peels use medium (intermediate) to deep peeling agents, usually ranging from 15 to 50% in concentration. The skin penetration depth increases as the TCA peel concentration increases, with 50% TCA penetrating deeply into the skin. For some patients, concentrations higher than 35% are not recommended due to their higher risk of scarring.
As opposed to phenol peels, TCA peels are especially effective in treating darker-skinned patients and are typically short, safe procedures. These peels may require pre-treatment with alpha-hydroxy acid products or Retin-A (vitamin A derivative) creams.
TCA peeling may cause changes that require several days of healing (including restricted activity), depending on the depth of skin penetration; however, they typically require a shorter recovery time than a deep phenol peel. No covering or after-peel ointment is necessary.
Repeat treatments may be helpful.
Phenol Peels (Phenolic Acid)
A deep chemical skin peel, or phenol peel, is the strongest chemical peel available and is reserved for individuals with deep wrinkles from sun exposure or deep dynamic wrinkles around the lips and chin. This procedure diminishes imperfections in sun-damaged, unevenly pigmented, and coarsely wrinkled facial areas by peeling away the skin’s top layers.
A full-face phenol peel takes 1 to 2 hours and is done in a monitored setting. A more limited procedure (such as treating a wrinkled upper lip) will generally take less than 30 minutes.
A solution is applied to a given treatment area (with much care around the eyes and lips). There is a slight burning sensation, but it is minimal since the solution also acts as an anesthetic. After the peel solution has worked on the skin, it is neutralized with water. A thick coating of petroleum jelly is layered over the face within an hour of treatment to cover the protective crust that develops rapidly over the area. This jelly stays in place for 1 to 2 days.
Some patients experience discomfort after a deep chemical peel, but this can be controlled with medication. The protective crust flakes off a few days after the procedure, and new skin (with a bright pink color akin to sunburn) will emerge.
Post-operative puffiness will subside in a few days, and the pinkness will fade within a few weeks, but the skin will remain sensitive.
A normal work schedule and other activities can be resumed after 1 to 2 weeks. Variants in the phenol peel formula can create a milder solution for broader use.
The effects of phenol chemical peel are long lasting and, in some cases, are still readily apparent up to 20 years following the procedure. Improvement in the patient’s skin can be quite dramatic.
Before a deep phenol peel, patients should be aware of the following:
- Possible post-operative complications include scarring, infection, abnormal pigmentation, or bleaching. Patients may need to wear make-up to match treated and untreated areas.
- EKG monitoring is advised during the procedure.
- Phenol peels cannot be used on the neck or other parts of the body.
- Phenol peels are less effective in treating individuals with dark, oily complexions.
Is There Downtime After Chemical Peels?
Some peels can be done in an office setting with little-or-no downtime, but others require healing time for several days. Please see the above requirements based on peel type.
Gently washing the face with cool water will help in the early stages after peels. Topical applications of petroleum-based agents, such as Aquaphor or Vaseline, will also help during the first few days after chemical peeling.
When Will I See My Chemical Peel Results, and How Long Will They Last?
Peels diminish wrinkles and lighten pigmented spots by removing the skin’s top layers while preserving deeper layers which replenish fresh skin. Results will develop gradually as the damaged skin flakes off, and the new, healthier skin emerges.
Sunblock is strongly recommended, and skin may not tan evenly following a chemical peel.
Contact Dr. Minoli to Start Your Non-surgical Facial Rejuvenation Process
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