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Chemical Peeling

Chemical peels are beneficial in the treatment of wrinkles around the eyes and mouth, skin discoloration and age spots, as well as dull skin texture and mild acne scars. A chemical solution is applied to remove outer layers of aged, discolored and/or irregular skin. Fresh skin is then generated, which is usually smoother, less wrinkled and more even in color. Chemical peels may produce a reddening of the face, similar to a sunburn, that typically lasts from a few days to several weeks, depending on the strength and depth of the peel.

Chemical peeling, typically performed on the face, neck or hands, is a technique used to improve the appearance of the skin. In this treatment, a chemical solution is applied to the skin that causes it to "blister" and eventually peel off. The new, regenerated skin is usually smoother and less wrinkled than the old skin. The new skin is also more even in color and, temporarily, more sensitive to the sun.

Dermatologists have used various peeling agents for the last 50 years and are experts in performing multiple types of chemical peels. A thorough evaluation by your dermatologist is imperative before embarking upon a chemical peel.

What Can a Chemical Peel do?

Chemical peeling is often used to treat fine lines under the eyes and around the mouth. Wrinkles caused by sun damage, aging and hereditary factors can often be reduced or even eliminated with this procedure. However, sags, bulges and more severe wrinkles do not respond well to peeling and may require other kinds of cosmetic surgical procedures such as a face lift, brow lift, eye lift or soft tissue filler.

Mild scarring and certain types of acne can also be treated with chemical peels. In addition, pigmentation of the skin in the form of sun spots, age spots, liver spots, freckles, splotching due to taking birth control pills and skin that is dull in texture and color may be improved with chemical peeling.

Chemical peeling may be combined with laser resurfacing, dermabrasion or soft tissue fillers to achieve cost-effective skin rejuvenation customized to the needs of the individual patient. Areas of sun-damaged, precancerous keratoses or scaling patches may improve after chemical peeling. Following treatment, new lesions or patches are less likely to appear. Generally, fair-skinned and light-haired patients are ideal candidates for chemical peels. Darker skin types may also experience good results, depending upon the type of skin problem encountered.

How are Chemical Peels Performed?

The procedure can be performed on the face, neck, chest, hands, arms and legs. Superficial, medium or deep chemical peels may be used to improve damaged skin. As a rule, the deeper the peel, the longer the recovery time.

Prior to surgery, instructions may include the elimination of certain drugs and the preparation of the skin with topical pre-conditioning medications. The patient may be advised to clean the area with an antiseptic soap the day before surgery.

A chemical peel can be performed in a doctor's office or in a surgery center as an out-patient procedure. At the time of treatment, the skin is thoroughly cleansed with an agent that removes excess oils, and the eyes and hair are protected. One or more chemical solutions - an alpha hydroxy acid, such as glycolic acid, salicylic acid, or lactic acid; trichloroacetic acid (TCA) or carbolic acid (phenol) - are used. Dermatologists are well qualified to select the proper peeling agent based upon the type of skin damage present. During a chemical peel, the physician applies the solution to small areas on the skin. These applications produce a controlled wound, enabling new, refreshed skin to appear. Most patients experience a warm to somewhat hot sensation which lasts about five to ten minutes, followed by a stinging sensation. A deeper peel may require pain medication during or after the procedure.

What Should be Expected after Treatment?

Depending upon the type of peel, a reaction similar to a sunburn occurs following a chemical peel. Superficial peeling usually involves redness, followed by scaling that ends within three to seven days. Medium-depth and deep peeling may result in swelling and the presence of water blisters that may break, crust, turn brown and peel off over a period of seven to 14 days. Some peels may require bandages to be placed on part or all of the skin that is treated. Bandages are usually removed in several days and may improve the effectiveness of the treatment. It is important to avoid overexposure to the sun after a chemical peel since the new skin is fragile and more susceptible to complications. The dermatologist will prescribe the proper follow-up care to reduce the tendency to develop abnormal skin color after peeling.

What are the possible complications?

In certain skin types, there is a risk of developing a temporary or permanent color change in the skin. Taking birth control pills, pregnancy or a family history of brownish discoloration on the face may increase the possibility of developing abnormal pigmentation. Although low, there is a risk of scarring in certain areas of the face, and certain individuals may be more prone to scarring. There is a small incidence of the reactivation of cold sores or herpes infection in patients with herpes. This problem is treated with medication as prescribed by the dermatologist. Prior to treatment, it is important for a patient to inform the physician of any past history of keloids, unusual scarring tendencies, extensive x-rays on the face or recurring cold sores.

What are the limitations of chemical peels?

Chemical peels cannot remove loose or sagging skin and do not serve the same function as a face lift, brow lift or eyelid lift. They do not eliminate the gravitational forces that produce loose skin.

Chemical peeling will not remove deep scars. Dermabrasion, punch grafting, punch elevation, scar excision or soft tissue fillers may be much more effective for scars and should be discussed with your physician.

Chemical peels cannot change pore size, nor can they predictably remove broken blood vessels on the face. However, chemical peels may improve the appearance of these conditions.