Chemical peels are techniques that employ chemical treatments to produce improved appearance of the face. Chemical peels produce controlled injury to the skin which promotes growth of new skin with improved appearance. Many different chemicals are used for chemical peels and include glycolic acid, trichloroacetic acid (TCA), salicylic acid, “Jessners” solution, and phenol. The different chemical solutions produce different degrees of injury of the skin. There are two layers of the skin; the outer layer is called the epidermis and the inner layer, the dermis. Superficial peels (such as glycolic acid peels) produce very superficial injury, confined to the epidermis. Superficial peels can help improve conditions such as acne and discoloration. Deeper peels (e.g. phenol peels) produce injury within the dermis and can reverse moderate-to-severe photoaging and wrinkles. In general, the deeper peels offer the most dramatic results but require longer recovery and carry a higher risk of complications.
What are chemical peels used for?
Chemical peels are used for the treatment of photoaging (from sun damage), wrinkles, scarring, acne, precancerous lesions, and discoloration (including melasma, freckles, and age spots).
How are chemical peels performed?
There are many different kinds of peels and each one is performed differently. In general, chemical peels usually begin with vigorous cleansing of the skin. Very light peels (e.g. low potency glycolic acid, 10-20% TCA) only penetrate the dead skin cells that sit atop the epidermis and produce almost no injury. Sometimes, this level of peel is called “exfoliation”. Light peels (70% glycolic acid, 25-35% TCA) injure the entire epidermis and stimulate the regeneration of a new epidermis. This level of chemical peel may produce a burning sensation during the procedure. Medium depth peels involve injury to the upper level of the dermis. Injury to the dermis stimulates the formation of collagen and “plumps” up the skin. 35% TCA, in combination with another chemical such as glycolic acid, is used safely with minimal discomfort. Burning is the most common complaint during the procedure and this is usually well controlled with cool compresses, and sometimes topical anesthetic. Deep peels involve injury to the mid dermis and are usually performed using a phenol solution and anesthesia.
How long do chemical peels take?
Most peels are performed in less than one hour, depending on size of the area being treated.
What will my skin feel like after a chemical peel?
The state of your skin after a peel depends on what kind of peel you had. The superficial peels have limited effects, the medium peels may cause some redness and the deeper peels may require weeks to recover.
How many peels will I need?
The superficial peels are usually done several times over the course of several months. The deeper peels usually only need to be performed once to achieve the desired effect. Regardless of the technique, you will likely need repeat treatments in the future. You and your physician will decide what is best for you.
How long do the results last?
With good sun protection, results can last months to years, depending on the depth of the peel. Generally, the deeper peels have a more long lasting effect.
What are the risks of chemical peels?
Superficial peels are quite safe although rarely minor irritation of the skin can occur. The risks of deeper peels include infection, scarring, redness, and discoloration. Furthermore, during a deep peel, anesthesia must be used and vital signs must be monitored throughout the procedure.
How long after a chemical peel before I can return to normal activities?
Superficial peels require no recovery time (hence the name “lunchtime peel”). Recovery from a deep peel requires occlusive bandages and can take weeks to months under normal circumstances.
How much do peels cost?
The cost is variable and depends on the depth of the peel and how many peels are needed. Cost per peel can range from hundreds to a thousand dollars.