Chemical Peels
Most patients display fear when their doctor mention the word ‘chemical peel’. They think blistering, desquamation, scabs and a long recovery period. With all the more media coverage, people are staring to realize that there are different levels of chemical peels. Even ‘lunch time peels’ where you can go back to work and still look radiant.
If you are considering a chemical peel, the following information will provide you with a good introduction to the procedure. For more detailed information about how the procedure may help you, we recommend that you consult a registered physician who has completed a training program that includes instruction in this procedure.
So, what exactly is a chemical peel?
Chemical peel uses a chemical solution to improve and smooth the texture of the facial skin by removing its damaged outer layers. A peel removes several layers of sun damaged skin cells, leaving fresh skin which has a more even surface and colour. It may stimulate new collagen to be formed improving skin texture. Peels may result in superficial, moderate depth or deep skin injury.
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. It is helpful for those individuals with facial blemishes, wrinkles and uneven skin pigmentation.
As we age, the accumulated effects of sun exposure, pollutants, acne, and scarring can damage our skin and cause us to look older than we are. Such skin damage can be treated with a chemical peel, a non-invasive procedure designed to promote cell growth and produce smoother, clearer skin.
Chemical peels are also used to treat melasma (a skin condition characterized by irregularly shaped patches of brown skin commonly found on the face and neck), and pre-cancerous changes in the skin. Chemical peels can be performed on the face, neck, chest, arms, hands, and legs.
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.
Chemical peels are sometimes applied to other sites such as the hands. They may be used to treat damage caused by exposure to the sun (photo ageing), to remove pigmentation such as freckles and melasma and fine lines and wrinkles.
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.
The risks
All chemical peels carry some uncertainty and risk. Chemical peel is normally a safe procedure when it is performed by a qualified, experienced doctor. A nurse or aesthetician (beauty therapist) may perform superficial peels. A trained doctor usually performs deeper peels. However, some unpredictability and risks such as infection and scarring, while infrequent, are possible.
AHA peels and the Glycopeel 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.
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.Planning For A Chemical Peel
It is very important that you find a Doctor who has adequate training and experience in skin resurfacing. Your Doctor may offer you a choice of peel techniques or suggest a combination of peels to obtain the best result for you. During your initial consultation, it is important that you discuss your expectations with your Doctor. Don’t hesitate to ask any questions or express any concerns that you may have. Expect your Doctor to 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 your Doctor prior to the procedure. Remember, chemical peel treatments are usually not covered by medical insurance unless they are performed for medically related problems.
Preparing For Your Chemical Peel
You may have to spend a month or more in the pre-treatment phase before the doctor will schedule your actual peel. Pre-treatment creams may be applied to the face at night for several weeks prior to the peel. By exfoliating the skin and reducing pigmentation themselves, they improve the results seen from chemical peeling. They may also reduce the time needed for healing. Broad spectrum SPF 20+ sunscreen should be used during the day.
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.
Where Your Peel Will Be Performed
Most chemical peels may be safely performed in a doctor’s office.
Types Of Anesthesia
Anesthesia isn’t required for TCA peels because 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.
The Peel
Superficial chemical peels are a minor procedure and no special arrangements are needed. But you may need painkillers, sedation or local anaesthetic.
First the face is thoroughly washed to remove surface oil. The peeling agent is then applied for several minutes. It stings – how badly and for how long depends on the chemical, its concentration, whether you’ve had pre-treatment with aspirin, and individual factors. A fan can help. The peel is then neutralised, and the burning sensation lessens. Individual treatments may include peels with several agents on the same occasion, with the aim of improving results and reducing risks. Antibiotics and oral antiviral agents may be recommended after deeper peels.
AHA peels/treatments: Your doctor will apply the AHA solution to your cleansed facial skin, a process that usually takes no more than 10 minutes. No ‘after-peel’ ointment or covering is required. Depending on the strength of the peel, periodic treatments may be necessary until the desired effects are achieved.
Glykopeel by Filorga: Also called the lunchtime peel! This superficial peel is very popular. At last – a peel which brightens dull winter skin improves skin tone and evens out areas of redness, brown patches or freckles whilst at the same time being gentle on the skin! Glycolic acid peeling enriched with pigment lightening agents and Vitamins A, C and E. Revives the radiance of the skin, refine texture, smoothes and reduces fine lines and wrinkles, improves the elasticity of dehydrated skin, softens pigmentation and evens the skin tone.
TCA peels: Typically, the skin is first thoroughly cleansed. Then, the physician will carefully apply the TCA solution. You may feel a stinging sensation as the peel solution is applied, but this feeling will quickly pass. A full-face TCA peel usually takes no more than 15 minutes. Two or more TCA peels may be needed to obtain the desired result, and those may be spaced out over several months.
After Your Treatment
After an AHA peel, it is common to experience some temporary flaking or scaling, redness and dryness of the skin. However, these conditions will disappear as the skin adjusts to treatment.
After a TCA peel, your doctor may prescribe a mild pain medication to relieve any tingling or throbbing you may feel. If tape was used to cover your face, it will be removed after a day or two. A crust or scab will form on the treated area. To help your face heal properly, it is essential that you follow your doctor’s specific post-operative instructions. A TCA peel may also cause significant swelling, depending on the strength of the peel used.
Getting Back To Normal
Superficial peels result in mild facial redness and occasional swelling which usually resolve within 48 hours. The peeling is similar to sunburn. Most people can continue their normal activities. Make-up can be applied a few hours after the procedure. 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. A fresher and improved skin texture will result with continued AHA treatments. Remember, protecting your skin from the sun is also important following these mild acid peels. Ask your doctor to recommend a sunblock with adequate UVA and UVB protection and use it every day.
Moderate depth peels result in intense inflammation and swelling, which resolve within a week. The peeling is more marked. Mild redness can persist for several weeks. Most people take a week off from work after a moderate depth peel. With a TCA peel, the moderate discomfort and mild swelling you may experience will subside within the first week. In about a week to ten days, your new skin will be apparent and you should be healed sufficiently to return to your normal activities. It is best to avoid sun exposure unless you are adequately protected.
Looking after the skin after the peel
- Keep treated areas cool (use a water spray)
- Do not pick! Picking delays healing and causes scarring
- Moisturise – use light preparations after a superficial peel, thicker moisturisers after a deeper peel
- Protect from the sun – especially for the first 6 months
Your New Look
Improvements from AHA peels may be very subtle at first. You may detect a healthier glow to your skin. With continued treatments, you will notice a general improvement in the texture of your skin.
Peels can be repeated as necessary; some people have superficial peels every few weeks. It is wise to wait 3 to 6 months before repeating a moderate depth peel.
General advice
- Ensure your doctor’s instructions are carefully followed
- If you don’t understand, ask!
