Chemical Peels

A chemical peel can restore a more youthful appearance to wrinkled, unevenly pigmented,sun-damaged, or blotchy skin. However, a peel cannot reverse the aging process or completely remove deep scars. Wrinkled skin that is loose and sagging may also require a face-lift, laser resurfacing treatment, or combination of procedures for best results.

How is a chemical peel performed?

All chemical peels involve applying a chemical solution to remove the outer layers of skin so that a smoother, more evenly pigmented, glowing layer of skin can appear.

About Chemical Peels

There are three basic categories of chemical peels. Each type works differently, and produces different results. Your doctor may choose from the following three types of chemical peel, or he/she may tailor the treatment to the needs of your skin. In general, the stronger the chemical, the deeper the peel, and the more impressive the results. However, the deeper the peel, the more pain you’re likely to experience and the longer the recovery time will be.

Alpha hydroxy acids (AHAs), Beta hydroxy acids (BHAs) Light or “lunch hour” peels are the mildest of the chemical peels. These peels include glycolic, lactic, and fruit acid peels (AHA) or Salicylic Acid (BHA). They burn off only the outer layers of the skin to smooth out fine wrinkles and/or rough, dry skin. AHA and Beta lift peels may also be used to improve the texture of sun-damaged skin, balance out skin pigmentation, or diminish some types of acne scars. These peels are often repeated to achieve the desired results.

The application of AHA and Beta lift peels are relatively fast and simple. These peels are generally performed in the doctor’s office. No sedation or anesthesia is required, since the patient only experiences a slight stinging when the solution is applied. The treatment usually takes about 10 to 15 minutes, but the doctor may vary the concentration of the chemical solution or the length of time of the treatment.

Dr. Wittenberg will begin by thoroughly cleansing the area to be treated. Next, he/she will apply the AHA solution, wait up to 15 minutes, and then remove it. After the procedure, no ointments or salves will be necessary to cover the treated area. Monthly or weekly repetition is common.

Trichloroacetic acids (TCA) A TCA solution is used for medium depth peels. This is generally used to treat skin with moderate sun damage, surface wrinkles, and/or uneven tone or pigment abnormalities. Full-face TCA peels take approximately 15 minutes. Generally, TCA peels are performed in the doctor’s office or in a surgery center as an outpatient procedure.

Before applying the chemical solution, the doctor will thoroughly cleanse the area to be treated. A sedative may be given, but TCA peels often do not require anesthesia because the solution itself has a numbing effect on the skin. At first, the patient may feel a warm or burning sensation, followed by stinging. Sometimes two or more TCA peel treatments, at intervals of one to two months, are necessary to achieve the desired results. The TCA peels can be used in varying concentrations, the higher concentrations may require oral or liquid anesthesia medication.

Phenol acid Phenol acid is the strongest chemical peel solution, and it is used for the deepest possible chemical peel. Phenol peels are used to treat skin with coarse wrinkles and blotchiness. They may also be effectively used to treat patients with pre-cancerous growths.

Phenol peels should be used with caution because they can cause permanent lightening of the skin. For this reason, Phenol peels are not recommended for most patients with very dark skin tones.

Full-face Phenol peels take approximately one to two hours, but small-area phenol peels (such as on the upper lip) may take about 10 - 15 minutes. Generally, phenol peels are performed in the doctor’s office or in a surgery center as an outpatient procedure with anesthesia.

After completing the procedure, Dr. Wittenberg may apply petroleum jelly or a waterproof dressing tape to the treated area. This covering will be left on for a day or two. Unlike AHA and TCA peels, Phenol peels are only used once and create dramatic results.

AHA and TCA peels for the full face generally take 10 - 15 minutes. Full-face Phenol peels may take between one and two hours. Phenol peels for small portions of the face, such as the upper lip, may take only 10 to 15 minutes.

How much pain is there?
During the procedure, most people feel a brief burning sensation, followed by a feeling of numbness or stinging. The sensation will vary depending on the type of peel as well as the possible of pain medications in the case of deep peels. The AHA, BHA and TCA peeks are uncomfortable only during treatment. The phenol peel may have discomfort after the procedure.

What can I expect afterward?
After the procedure, most people experience some facial swelling and reddening. Your doctor may advise you to keep your head elevated. After a Phenol peel, the eyes often swell shut. Following a Phenol peel, a petroleum jelly or waterproof dressing may be applied to the treated area. This covering is left on for a day or two. After Phenol and deep TCA peels, you’ll need to arrange for someone to drive you home. Ride arrangements do not need to be made after having an AHA or a light TCA peel. The recovery period is different for each type of peel.

Light peels:
Alpha hydroxy acids (AHAs) AHA peels generally cause some flaking, redness and dryness, or skin irritation. These side effects diminish over time. Once the body heals itself naturally, the outer layer of skin will fall away. Patients are usually able to engage in normal public activities the day after an AHA peel.

Medium peels:
Trichloroacetic acids (TCA) TCA peels may cause significant swelling, depending on the potency of the chemical solution that was used. Swelling should diminish after the first week. The skin will heal sufficiently to resume normal activities in approximately 7-10 days. After TCA peels, some patients also have outbreaks of small whiteheads, called milia, which are formed in obstructed facial glands. Generally, these disappear with washing.