Chemical peeling is
a process whereby a chemical solution is applied to
the surface of the skin to peel away the top cell
layers which will be replaced during the healing
process with a fresh, new skin surface.
The following
description will give you a basic idea of chemical
peeling including peel types, who are the best
candidates, what to expect, what each type of peel
entails and what results you can expect. Chemical
peels are not a substitute for facelifts, but can
improve the texture of the skin. Your cosmetic
surgeon can discuss your individual circumstances
and review the procedure and the peel he or she
plans to use with you. It is important that you
understand the procedure, so be sure to ask Dr.
Vincent any questions you may still have.
Chemical peels can enhance the appearance of facial and other skin
on men and women of all ages. While chemical peeling is available
to almost everyone, skin type and coloring are important considerations.
The best candidates are usually those with fair, thin skin that
has a tendency toward fine wrinkling or scarring on the face. Deeper
chemical peels are usually not recommended for highly pigmented
skin, such as Asian, Black and Mediterranean, or oily complexions.
This procedure will not prevent aging, however, chemical peels
can erase, fade or reduce fine facial wrinkles and remove other
surface imperfections. Before your surgery, think carefully about
your expectations and discuss them with your cosmetic surgeon. Remember,
improvement, not perfection, is the goal.
There are now several different types of chemical peels depending
upon your particular condition. For certain types of scars and pits,
dermabrasion, which uses a tool to "sand" the surface
of the skin, may be suggested. Dr. Vincent will discuss your condition
to see if and what type of chemical peel is right for you.
Chemical peels use 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 peels 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.
A chemical peel is most
commonly performed for cosmetic reasons -- to enhance your appearance
and your self confidence. Chemical peels 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. Dr. Vincent 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 peels 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.
Phenol is the
strongest of the chemical solutions and produces 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. Since phenol sometimes lightens the treated
areas, your skin pigmentation may be a determining
factor as to whether or not this is an appropriate
treatment for you. Phenol is primarily used on the
face; scarring may result if it's applied to the
neck or other body areas.
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 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 Dr. Vincent 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.
During your initial consultation, it is important that you discuss
your expectations with Dr. Vincent. Don't hesitate to ask any questions
or express any concerns that you may have. The procedure will be
explained in detail, including its risks and benefits, the recovery
period and the costs. If you have a history of herpes, you should
inform your physician prior to the procedure. Remember, chemical
peel treatments are usually not covered by medical insurance unless
they are performed for medically-related problems.
Sometimes Retin A - a prescription medication derived from Vitamin
A - is used to pre-treat the skin. This thins out the skin's surface
layer, allowing the TCA solution to penetrate more deeply and evenly.
If your skin won't tolerate Retin-A pre-treatment, an AHA cream
may be used instead. Hydroquinone, a bleaching agent, is sometimes
used in conjunction with Retin-A or AHA pre-treatment, especially
if you have blotchy skin areas or pigmentation problems. You may
have to spend a month or more in the pre-treatment phase before
the doctor will schedule your actual peel.
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.
Most patients are given a prescription for an antiviral and antifungal
medication to help prevent herpes and fungal infections.
AHA
peels/treatments: AHA solution will be applied to your cleansed
facial skin, a process that usually takes no more than ten 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.
For some patients, the application of an AHA-based face wash or
cream once or twice a day at home will be sufficient to accomplish
the desired goal. Your plastic surgeon may add Retin-A or a bleaching
agent to your at-home treatment schedule. After several weeks of
at-home use, Dr. Vincent
will examine your skin to determine if
your regimen needs adjustment.
Phenol and TCA peels: Typically, the skin is first thoroughly cleansed.
Then, the surgeon will carefully apply the phenol or 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. Mild TCA peels may
be repeated as often as every month.
If phenol solution has been used, your plastic surgeon may coat
the treated area with petroleum jelly or a waterproof adhesive tape.
With lighter peels, no covering is necessary.
A full-face phenol peel generally takes one or two hours to perform,
while a phenol peel to a smaller facial region (perhaps the skin
above the upper lip) may take only 10 or 15 minutes. A single treatment
usually suffices.
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 phenol or TCA peel, Dr.
Vincent 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 Dr. Vincent's
specific post-operative instructions.
A TCA peel may also cause significant swelling, depending on the
strength of the peel used.
If you've had a phenol peel, your face may become quite swollen.
Your eyes may even be swollen shut temporarily. You will need someone
to help care for you for a day or two. You may also be limited to
a liquid diet and advised not to talk very much during the first
few days of recovery.
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 Dr. Vincent to recommend a sun block with adequate UVA and UVB
protection and use it every day.
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.
With a phenol peel, new skin will begin to form in about seven
to ten days. Your face will be very red at first, gradually fading
to a pinkish color over the following weeks to months. During this
time, it is especially important that you use a sun block or blotchy,
irregular skin coloring may result.
About two weeks after treatment, you may return to work and resume
some of your normal activities. Your skin will be healed enough
for you to wear makeup. (For makeup tips, ask your plastic surgeon
for the ASPS brochure on camouflage cosmetics.)
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.
The results of a TCA peel are usually not as long-lasting as those
of phenol peels, however, your skin will be noticeably smoother and
fresher-looking. If you're planning a phenol peel, you can expect
dramatic improvement in the surface of your skin - fewer fine wrinkles,
fewer blemishes and more even-toned skin. Your results will be long-lasting,
although not immune to the effects of aging and sun exposure.
Like all surgery, chemical peels involve some level of risk. Chemical
peels are a normally safe and popular way to treat facial wrinkling
and fine scarring. To help ensure a successful outcome, the patient
should be a good candidate, the surgeon should be well-trained in
chemical peeling techniques, the surgical facility should be properly
equipped and the patient should follow the doctor's instructions
and advice.
While complications are extremely unusual, you should discuss the
risks and possible side effects with Dr. Vincent. Patients with
liver, kidney or heart ailments need to make their cosmetic surgeon
aware of this.
You should have realistic expectations and realize that the true
results may not be apparent for up to a year. Chemical peels can
offer softer, smoother skin to those who never thought it was possible.
Discuss the benefits and risks with Dr. Vincent given your particular
circumstances.
Click here for more information on Cosmetic Surgery
Dr. Vincent
specializes in plastic and cosmetic surgery and his practice is located in
Ogden, Utah. Patients from the following cities and areas of Salt Lake City, West
Valley City, Provo, Sandy, Park City, Orem, Layton, Taylorsville, St. George,
Utah (UT) and Twin Falls, Idaho (ID) can conveniently schedule an appointment
with our Ogden, Utah office.
