Chemical peeling is a process of facial
rejuvenation where chemical solutions are used to improve facial texture
and remove damaged layers of outer skin. It is helpful in patients with
facial blemishes, wrinkles, and uneven skin pigmentation. Chemical peels
include phenols, trichloroacetic acids (TCA), and alphahydroxy acids (AHAs).
Which is best for you needs to be decided based on your overall desire
for facial rejuvenation and your overall skin texture. Chemical peels
can be performed in conjunction with facelift procedures but it is
usually not a substitute for these kind of procedures nor will they
prevent or slow the aging process.
A chemical peel is most commonly performed for cosmetic reasons. It
usually enhances your appearance and your self-confidence. It also can
be used to remove precancerous skin lesions and soften facial acne.
Alphahydroxy acids such as glycolic acid or fruit acids are the mildest
peels. These peels can provide a smoother, brighter looking skin for
people who cannot spare the time to recover from a TCA or phenol peel.
These types of peels are excellent for fine wrinkling and treatment in
the areas of dryness or uneven pigmentation but do need to be repeated
multiple times. They are usually applied weekly for long intervals to
get the best results. The doctors can integrate this type of treatment
modality into your daily facial hygiene regimen. It can also be mixed
with facial washes or certain skin moisturizing creams to improve your
skin texture.
Trichloroacetic or TCA is an intermediate peel. It is used in many
concentrations but is most commonly used for medium depths. It treats
fine surface wrinkles, superficial blemishes, and pigment problems.
Results of TCA peel are less dramatic than those of the phenol peel and
can produce an excellent cosmetic result with minimal recovery time.
Phenol is the strongest peel and should be used only in selected
patients. It deeply penetrates the face for deep wrinkles and areas of
blotchiness and also can remove precancerous skin growths but must be
used with caution as it can produce abnormal facial scarring if not
performed under the most stringent conditions.
All peels carry some risks such as abnormal healing with either hyper or
hypopigmentation and, of course, most peels need more than one
application. HA peels may cause stinging or redness, irritation,
crusting. With a TCA peel, depending on the concentration of TCA, there
may be a longer healing time. Higher concentrations require long healing
times because they penetrate deeper. Patients are told to avoid sun
exposure for several months following this peel and may need to repeat
it. With the phenol peel, new skin frequently looses its ability to make
pigment, this means that not only will your skin be lighter in color but
also you have to be protected by heavy sun block from the sun forever.
These types of peels tend to permanently cause damage to the melanocytes
and although are excellent for removing wrinkles, do lighten the skin on
a permanent basis.
Which type of peel is good for you needs to be discussed carefully with
our doctors. In general, alphahydroxy acid peels are used to smooth
rough or dry skin, to improve the texture of sun damaged skin, aid in
the control of acne, can be mixed with a bleaching agent to correct
pigment problems. AHAs are used in the pretreatment of skin prior to TCA
peel. A series of peels may be needed to get an optimal result.
TCA smoothes out wrinkles, removes superficial blemishes, and corrects
pigment problems. It can be used in the neck or other body areas and
usually is coordinated with pretreatment with Retin-A or AHA cream.
Treatment usually takes 10-15 minutes and then may require sun avoidance
for several months.
Phenol is used to correct blotches, deep wrinkles, and remove
precancerous growth. It is used usually only on the face and is not
recommended at all in dark-skinned individuals and needs to be carefully
coordinated in terms of treatment with Dr. Stelnicki.
Your peel will typically be performed in
the office. During a TCA peel an AHA solution is applied that cleans your skin. This process usually takes up to 10 minutes. This
is followed by a cleansing of the skin. You may feel a slight tingling
sensation during this time. This will take up to 10-15 minutes for TCA
peels.
What you should expect in your chemical peel is that the doctor will
apply solutions to your face in preparations for the peel. It will
usually be a degreasing solution which helps open pours and make the
peel more effective. The peels may take up to 15 minutes, you will feel
a tingling during this and maybe even a slight mild burning sensation
similar to a light sunburn. The skin will then be lifted off and leaving
a sort of reddish hew to the face. The reddish hue to the face can last
anywhere from a few days to two months depending on the depth of the
peel. After your peel, wemay prescribe a mild pain
medication for you and will instruct you to keep your face clean of any
scabbing, using petroleum jelly, and covering it with a medicated gauze.
You should diligently keep any crusting from developing it on your face
as this can increase scarring and decrease the overall final result.
Your face may become slightly swollen, especially around the eyes, and
if your peel is done around the mouth, the doctor will usual
prescribe an antiviral medication to prevent any herpes or a cold sore
outbreak. Depending on the depth of the peel, you may be able to return
to work within a few days or it may be several weeks. Usually following
2-3 weeks of healing, most patients are able to return to normal life
and cover the results of the peel with topical makeup.
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