Chemical Peel

A chemical peel is a skin resurfacing procedure in which a chemical solution issued to apply to the skin in order to remove the top layers. The skin that regrows after chemical peel is smother and appears younger.

Chemical peels are used in the treatment of wrinkles, skin discoloration and scars typically on the face.

A chemical peel can be done alone or it can be combined with other cosmetic procedures. Chemical peels can be done at varying depths, light, medium or deep.

Each kind of chemical peel makes use of a different chemical solution. Deeper chemical peels produce more dramatic results, but also involve longer recovery times.

Here are the most common reasons to receive the procedure. A chemical peel can be used as a treatment method for various skin condition.

You will choose a chemical peel in one of three depths, depending on the issues you are addressing with the procedure:

• Light chemical peel: Also known as a superficial peel, a light chemical peel removes the outer layer of the skin (epidermis). It can be used to treat fine wrinkles, acne, uneven skin tone and dryness. You might have a light chemical peel as often as once a week for a period of up to six weeks, depending on your desired results.
• Medium chemical peel: This type of chemical peel removes skin cells from the epidermis and from portions of your upper layer of you middle layer of skin (dermis). A medium chemical peel can be applied in the treatment of wrinkles, acne, scars and uneven skin tone. You might repeat a medium chemical peel after 12 months to regain the results.
• Deep chemical peel: A deep chemical peel removes skin cells from epidermis and from portion of you middle to lower layer of your dermis. Your doctor might recommend a deeper chemical peel if you have deeper wrinkles, scars or precancerous growths. A chemical peel cannot eliminate deep scars or reduce the size of pores.

The following potential risks can be caused by a chemical peel:

• Scarring: In rare cases, a chemical peel can lead to scarring, typically on the lower part of the face. Antibiotics and steroid medications can be useful in the softening of then appearance of these scars.
• Redness: Normal healing from a chemical peel involves redness of the treated skin. After a medium or deeper peel, redness might last for several months.
• Changes in skin color: A chemical peel can cause the treated skin to become darker than it should be (hyperpigmentation) or lighter than it should be (hypopigmentation). Hyperpigmentation commonly occurs after superficial peels, while hypopigmentation is more common after a deep peel. Changes in skin color are more common in individuals who have darker skin and can be permanent.
• Infection: A chemical peel cause a flare-up of the herpes virus, the virus that causes sores. In a rare case, a chemical peel can cause a bacterial or fungal infection.
• Heart, kidney or liver damage: A deep chemical peel makes use of carbolic acid (phenol) which can cause harm to the heart muscles and lead to an irregular heartbeat. Phenol can also harm the kidneys and liver. In order to limit exposure to phenol, a deep chemical peel is done in portions at 10 to 20-minute intervals.

A chemical peel cannot be applied by anyone. Your doctor might advise against a chemical peel or certain types of chemical peels for the following reasons:

• If you have taken the acne medication isotretinoin (Amnesteem, others) within the past six months.
• If you have a darker complexion.
• If you have red hair and a pale, freckled complexion.
• If you have a personal history of ridged areas that are caused by an overgrowth of scar tissue (keloids).
• If you have abnormal skin pigmentation.
• If you have facial warts.
• If you have a history of frequent or severe outbreaks of cold sores.

To prepare for the chemical peel your doctor will likely do the following:

• Review your medical history: You must be prepared to answer questions about any current and past medical conditions, especially a heart, kidney or liver conditions if you are making a consideration of deep chemical peel.

  Tell your doctor about any medications you are taking or have recently taken, particularly those that might make you skin sensitive to the sun, as well as any cosmetic procedures you have had in the past. You must be sure to tell your doctor if you have been using a retinoid cream (tretinoin), which has the ability to enhance the penetration of some chemical peels.

• Do a physical exam: Your doctor will make an inspection of your skin and the area that needs treatment. This will enable him or her to determine what type of chemical peel you might benefit from most and how your physical features, for instance, the tone of your skin might affect your results.
• Discuss your expectations: Discuss with your doctor about your motivations and expectations, as well as the potential risks. Make sure you completely understand how many treatments you might need, how long the healing process will last and what your results might be.

If you make a decision to proceed with the chemical peel, you might also need the following:

• Take antiviral medication: If you have a history of herpes infection around your mouth, your doctor will likely prescribe an antiviral medication before and after the procedure to prevent a viral infection.
• Use glycolic acid lotion: If you will undergo a light chemical peel, you doctor might recommend using a glycolic acid lotion for two weeks before treatment to make sure a more uniform peel. Using the lotion ahead of time also helps you find out if you are sensitive to glycolic acid.
• Use retinoid cream: If you decide to have a light or medium chemical peel, your doctor might recommend making use of retinoid cream (tretinoin) beforehand to shorten the time of the treatment and speed up the healing process.
• Use a bleaching agent: Your doctor might recommend using a bleaching agent (hydroquinone) and retinoid cream (tretinoin) before or after the procedure to prevent skin darkening.
• Avoid unprotected sun exposure: It’s vital to consistently use sunscreen at least four weeks before the procedure to help prevent any irregular pigmentation in the treated areas. Discuss sun protection and acceptable sun exposure with your doctor.
• Avoid certain cosmetic treatments and certain types of hair removal: You will be advised to stop waxing or using depilatory hair removal products. You should also avoid bleaching, massages or facial scrubs in the week prior to your peel.
• Arrange for a ride home: You will be sedated during medium or deep chemical peel. You will need help getting home following the procedure.

Here’s what you can expect before, during, and after your procedure. A chemical peel is typically done in an office-based procedure room or outpatient surgical facility.

Before the procedure

• Your doctor will clean your face and might cover your eyes with ointment, gauze, tape or goggles.
• He or she might also protect your hair.
• Pain relief isn't typically needed for a light chemical peel. If you're having a medium chemical peel, you might have the option of taking a sedative and a painkiller.
• If you're having a deep chemical peel, your doctor will likely numb your skin with a local anesthetic and give you a sedative or use regional anesthesia — which numbs a certain part of your body.

During the procedure

• During a light chemical peel:
  • Your doctor will use a brush, cotton ball, gauze or sponge to apply a chemical solution typically containing glycolic acid or salicylic acid.
  • The treated skin will begin to whiten. You might feel mild stinging while the chemical solution is on your skin.
  • Your doctor will apply a neutralizing solution or wash to remove the chemical solution from the treated skin.
• During a medium chemical peel:
  • Your doctor will use a cotton-tipped applicator or gauze to apply a chemical solution containing trichloroacetic acid, sometimes in combination with glycolic acid.
  • The treated skin will begin to whiten.
  • After a few minutes, your doctor will apply cool compresses to soothe treated skin. You might also be given a hand-held fan to cool your skin.
  • No neutralizing solution is needed, however. You might feel stinging and burning for up to 20 minutes.
• During a deep chemical peel:
  • You'll be given intravenous (IV) fluids, and your heart rate will be closely monitored.
  • Your doctor will use a cotton-tipped applicator to apply carbolic acid (phenol) to your skin.
  • Treated skin will begin to turn white or gray.
  • To limit your exposure to phenol, your doctor will do the procedure in portions at about 15-minute intervals.
  • A full-facial procedure might take about 90 minutes.

After the procedure

After a chemical peel off any depth, follow your doctor's directions for cleansing, moisturizing and applying protective ointments to your skin.

• After a light chemical peel treated skin will be red, dry and mildly irritated — although these effects might be less noticeable with each repeat treatment. Your doctor might apply a protective ointment, such as petroleum jelly, to soothe the area. Treated areas develop new skin about four to seven days after a light chemical peel. The new skin might temporarily be lighter or darker than normal.
• After a medium chemical peel, treated skin will be red, tight and swollen. You'll feel stinging. Your doctor might apply a protective ointment, such as petroleum jelly, to soothe the area. Use ice packs or the breeze from a fan for comfort. Over-the-counter pain-relieving medication, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others), may help reduce any discomfort. You'll likely schedule a checkup soon after your treatment so that your doctor can monitor your healing. As swelling decreases, treated skin will begin to form a crust and might darken or develop brown blotches. Treated areas develop new skin about five to seven days after a medium chemical peel, but redness might last for months.
• After a deep chemical peel, you'll experience severe redness and swelling. You'll also feel burning and throbbing, and your eyelids might swell shut. Your doctor will apply a watertight dressing to the treated skin. He or she might also prescribe painkillers. Sleeping in a semi-reclined position may help reduce swelling. Treated areas will develop new skin within about two weeks after a deep chemical peel, although cysts or white spots might appear for several weeks and redness might last for months. The treated skin might become darker or lighter than normal or lose the ability to tan.

You might prefer to remain at home while you're healing from a chemical peel. Once new skin completely covers the treated area in about two weeks, you can use cosmetics to conceal any redness.

A light chemical peel can make an improvement to skin texture and tone, as well as decrease the appearance of fine wrinkles. The results will be subtle at the beginning, but will increase with repeated treatments.

After a light chemical peel, avoid sun exposure until new skin completely covers the new area. If you have a medium chemical peel, your skin will be smoother than it was before the chemical peel. Your doctor will recommend avoiding sun exposure for several months.

After a deep chemical peel, will notice a dramatic improvement in the look and feel of the treated areas. You will have to protect you skin from the sun permanently to prevent any changes in skin color.

You must keep in mind that chemical peel results might not be permanent. With age, you will continue to acquire lines by squinting and smiling. New sun damage can also reverse your results and lead to changes in your skin color.