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 Chemical Peels
 Chemical peels 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 chemical peel,
trichloroacetic acid chemical peel (TCA) and alphahydroxy acids (AHAs) are
used for this purpose. The precise chemical peel formula used may be
adjusted to meet each patient's needs.
A chemical peel is most commonly performed for cosmetic reasons by a
dermatologist -- to
enhance your appearance and your self confidence. Chemical peel may also
remove pre-cancerous skin growths, soften acne facial scars and even
control acne. In certain cases, health insurance may cover the peel
procedure. Be sure to check your policy and contact your insurance company
before the procedure is performed.
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. Dr. Rao will make this decision
during your consultation and as the treatment proceeds. An alphahydroxy
acid, such as glycolic acid, can also be mixed 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.
The results of TCA chemical peel are usually less dramatic than and not as
long-lasting as those of a phenol peel. In fact, more than one TCA
chemical peel may be needed to achieve the desired result. The recovery
from a TCA chemical peel is usually shorter than with a phenol chemical
peel.
Phenol is the strongest of the chemical solutions and produces a deep
peel. It is used mainly to treat patients with coarse facial wrinkles,
areas of blotchy or damaged skin caused by sun exposure, or pre-cancerous
growths. Since phenol sometimes lightens the treated areas, your skin
pigmentation may be a determining factor as to whether or not this is an
appropriate treatment for you. Phenol is primarily used on the face;
scarring may result if it's applied to the neck or other body areas.
TCA Chemical Peel
With a TCA peel, your healed skin will be able to produce pigment as
always; the peel will not bleach the skin. Even though TCA is milder
than phenol, it may also produce some unintended color changes in the
skin. Anesthesia is not required for TCA peels because the chemical
solution acts as an anesthetic.
Board Certified Dermatologist, Babar K. Rao, MD, FAAD, will carefully
apply the TCA solution to thoroughly cleansed skin. A stinging sensation,
as the peel solution is applied, but this feeling will quickly pass.
A full-face chemical TCA peel usually takes about 15 minutes.
Phenol Chemical Peel
With a phenol peel, the new skin frequently loses its ability to make
pigment (that is, tan). This means that not only will the skin be lighter
in color, but you'll always have to protect it from the sun. Phenol may
pose a special risk for patients with a history of heart disease. It's
important that you make your surgeon aware of any heart problems when your
medical history is taken.
It is also possible that phenol will cause some undesired cosmetic
results, such as uneven pigment changes. Certain modified phenol peels are
gentler and may be preferred in some circumstances.
Chemical Peel Forumulas At a Glance
Alphahydroxy Acid Chemical Peel (AHAs):
- Smooths rough, dry skin
- Improves texture of sun-damaged skin
- Aids in control of acne
- Can be mixed with bleaching agent to correct pigment problems
- Can be used as TCA pre-treatment
Trichloroacetic Acid (TCA) Chemical Peel:
- Smooths out fine surface wrinkles
- Removes superficial blemishes
- Corrects pigment problems
- Can be used on neck or other body areas
- Treatment takes only 10-15 minutes
- Peel depth can be adjusted
- Healing is usually quick, much quicker than with a phenol peel
Phenol Chemical Peel Uses:
- Corrects blotches caused by: sun exposure, birth-control pills, aging
- Smooths out coarse wrinkles
- Removes pre-cancerous growths
- Used on the face only
- Full-face treatment may take one hour or more
- May permanently remove facial freckles
- Results are dramatic and long-lasting
Planning for a Chemical Peel
During your initial consultation, it is important that you discuss your
expectations with the doctor. Don't hesitate to ask any questions or
express any concerns that you may have. Expect Board Certified
Dermatologist, Babar K. Roa, to explain the planned procedure in detail,
including its risks and benefits, the recovery period and the costs.
Remember, chemical peel treatments are usually not covered by medical
insurance unless they are performed for medically related problems.
Preparing for Your Chemical Peel
Board Certified Dermatologist, Babar K. Rao, MD, FAAD, will instruct you
on how to prepare for your peel treatment.
Sometimes Retin A - a prescription 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 Retin-A 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.
Where Will Your Chemical Peel be Preformed
Your chemical peel will be performed in Board Certified Dermatologist,
Babar K. Rao's Manhattan, New York or Fresno, California office.
About the Chemical Peel Procedure
AHA peels/treatments: Board Certified Dermatologist, Babar K. Rao 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
treatmentsmay 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 Retin-A or a bleaching agent to your at-home
treatment schedule. After several weeks of at-home use, the dermatologist
will examine your skin to determine if your regimen needs adjustment.
Phenol and TCA peels: Typically, the skin is first thoroughly cleansed.
Then, the dermatologist 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.
If phenol solution has been used, the dermatologist may coat the treated
area with petroleum jelly or a waterproof adhesive tape. With lighter
peels, no covering is necessary.
A full-face phenol peel generally takes one or two hours to perform, while
a phenol peel to a smaller facial region (perhaps the skin above the upper
lip) may take only 10 or 15 minutes. A single treatment usually suffices.
After Your Chemical Peel
After an AHA peel, it is common to experience some temporary flaking or
scaling, redness and dryness of the skin. However, these conditions will
disappear as the skin adjusts to treatment.
After a phenol or TCA peel, the doctor may prescribe a mild pain
medication to relieve any tingling or throbbing you may feel. If tape was
used to cover your face, it will be removed after a day or two. A crust or
scab will form on the treated area. To help your face heal properly, it is
essential that you follow your doctor's specific post-operative
instructions.
A TCA peel may also cause significant swelling, depending on the strength
of the peel used.
If you've had a phenol peel, your face may become quite swollen.
Getting Back to Normal After Your Chemical Peel
With an AHA peel, the temporary redness, flaking 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 Dr. Rao 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.
With a phenol peel, new skin will begin to form in about seven to ten
days. Your face will be very red at first, gradually fading to a pinkish
color over the following weeks to months. During this time, it is
especially important that you use a sunblock or blotchy, irregular skin
coloring may result.
About two weeks 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 your plastic surgeon for the ASPS brochure
on camouflage cosmetics.)
Your New Look After Your Chemical Peel
Improvements from AHA peels may be very subtle at first. You may detect a
healthier glow to your skin. With continued treatments, you will notice a
general improvement in the texture of your skin.
The results of a TCA peel are usually not as long-lasting as those of
phenol peel. However, your skin will be noticeably smoother and
fresher-looking.
If you're planning a phenol peel, you can expect dramatic improvement in
the surface of your skin - fewer fine wrinkles, fewer blemishes and more
even-toned skin. Your results will be long-lasting, although not immune to
the effects of aging and sun exposure.
If you have any questions about
chemical peels, or any questions about our dermatology or dermatopathology
procedures please feel free to contact Board Certified Dermatologist,
Board Certified Dermatopathologist, Babar K. Rao, MD, FAAD at his
Manhattan, New York, Newbrunswick, New Jersey, or Fresno, California
offices.
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