Chemical Peel

Chemical peel uses 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 fruit acids/alphahydroxy acids (AHAs) are used for this purpose. The surgeon will adjust a precise formula to meet each patient’s individual needs. Chemical peel is most commonly performed for cosmetic purposes. It enhances your appearance and your self-confidence.

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. Your doctor will make this decision during your consultation and as the treatment proceeds. An alphahydroxy acid, such as glycolic acid, can also be used 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. 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 from a phenol peel.

Your plastic surgeon will instruct you on how to prepare for your peel treatment. Sometimes Retinol – a 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 Retinol 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 deep TCA peel. You won’t need any extra assistance if you’re having an AHA peel or superficial TCA peel.

Most chemical peels may be safely performed our office, an office-based surgical facility, or an outpatient surgical center. 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.

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. 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 Retinol or a bleaching agent to your at-home treatment schedule. After several weeks of at-home use, your doctor will examine your skin to determine if your regimen needs adjustment.

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.

With an AHA peel, the temporary redness 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.

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. About one week 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 us for the ASPS brochure on camouflage cosmetics.)

There is no recovery time after an AHA peel. You may have it during a lunch break and return to work. Your skin will be softer and you may see a healthier glow to your skin. With continued treatments, you will notice a great improvement in the texture of your skin.