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 Chemical peel 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, trichloroacetic acid (TCA) and alphahydroxy acids (AHAs) are used for this purpose. The precise formula used may be adjusted to meet each patient's needs. Although chemical peel may be performed in conjunction with a facelift, it is not a substitute for such surgery, nor will it prevent or slow the aging process. This brochure provides basic information about certain types of chemical peel treatments and the results you might expect. It won't answer all your questions, since a lot depends on your individual circumstances. Once you and your plastic surgeon have decided on a specific peel program, be sure to ask about any details that you do not understand.
Deciding if chemical peel is right for you Chemical peel is most commonly performed for cosmetic reasons -- 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. Your doctor 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 peel are usually less dramatic than and not as long-lasting as those of a phenol peel. In fact, more than one TCA peel may be needed to achieve the desired result. The recovery from a TCA peel is usually shorter than with a phenol 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.
All chemical peels carry some uncertainty and risk. Chemical peel is normally a safe procedure when it is performed by a qualified, experienced plastic surgeon. However, some unpredictability and risks such as infection and scarring, while infrequent, are possible.
AHA peels may cause stinging, redness, irritation and crusting. However, as the skin adjusts to the treatment regimen, these problems will subside.
With a TCA peel, your healed skin will be able to produce pigment as always; the peel will not bleach the skin. However, TCA-peel patients are advised to avoid sun exposure for several months after treatment to protect the newly formed layers of skin. Even though TCA is milder than phenol, it may also produce some unintended color changes in the skin.
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.
What is a chemical peel?
A chemical peel is a cosmetic procedure which uses an exfoliating chemical solution to remove aged or damaged layers of skin, resulting in a softer, more youthful appearance. There are different chemicals which may be used including trichloroacetic acid (TCA), phenol, and alpha hydroxy acids (AHAs). Chemical peels come in three different strengths. Superficial peels are the mildest peels which often use solutions like glycolic acid or dry ice and they are safe for use on all skin types. Medium peels commonly use trichloroacetic acid and, being harsher than a superficial peel, they create a second-degree burn of the skin. Deep peels, which typically involve phenol, are the harshest and are capable of penetrating through several layers of skin. Deep peels are usually not appropriate for use on dark-skinned patients as they can bleach the skin.
Is there anything that needs to be done to prepare for a chemical peel?
Several weeks before undergoing the chemical peel, you will be required to prepare your skin with a regimen including a twice daily cleansing, the application of moisturizer once or twice daily, and daily application of sunscreen. This regimen will help the skin to peel more evenly, aid in the healing process, and minimize the risk of infection, uneven skin color and other complications. It’s important to select a qualified cosmetic surgeon for your chemical peel procedure and he or she will provide you with a precise skin care regimen that will need to be followed before your procedure.
How are chemical peels performed?
Though procedures and techniques will vary, the chemical peel procedure typically begins by prepping the skin with skin care treatments or microdermabrasion. The skin will also be scrubbed and a mild toner applied in order to remove any oils on the skin. The acidic solution is then gently applied to the skin in layers, peeling away the aged or damaged surface. The amount of time that the solution is left on the skin will depend on the procedure and the particular solution used. The solution is then removed, the skin is wiped clean, and an antibacterial cream is applied to promote comfort and healing.
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