What are chemical peels?
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.
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