Chemical Skin Peel

Chemical peels may offer a solution to blemished skin.
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What's Involved

Chemical peels are designed to clear up the skin's imperfections -- such as sun damage, uneven pigmentation, fine wrinkles, lesions, and growths -- by peeling away the top layers of skin. Doctors performed over 1.1 million chemical peels in 2004, an increase of 54 percent from 2003, according to the American Society for Aesthetic Plastic Surgery.

Two weeks before the procedure, you will need to cleanse your skin and apply special moisturizers and sunscreen. This skincare regimen will help with healing. Before the peel, the doctor will clean the skin. Some people receive a sedative or pain reliever, depending on the peel. Using a sponge, cotton, or a brush, doctors apply a chemical solution to the face. The solution varies by ingredients and strength depending on the desired effect. Depth of peeling action may also depend on the amount of time the solution remains on the skin, how many coats are used, and whether it is lightly or more vigorously applied. The surgeon will select the most appropriate chemical solution for each patient's needs. There are three basic types of chemical peels:

Superficial peels: Used to improve pigment changes, acne scars, and mild sun damage, superficial peels are the mildest peels and can be performed on all skin types. The solution contains a dilute acid, usually alphahydroxy acids (AHAs). Dry ice is sometimes used. The solution remains on the skin two to seven minutes. Water is applied to neutralize the acid and the chemical is wiped off.

Medium peels: These peels penetrate the skin more deeply. The chemical solution penetrates the skin to a depth that removes skin cells and can cause a sun-burned, raw appearance at first. They are used to treat mild to moderate wrinkles, long-term sun damage, pigment changes, and precancerous lesions. Trichloroacetic acid (TCA) is the main peeling agent. The procedure takes about 20 minutes.

Deep peels: This kind of peel -- used to treat severe wrinkles, long-term sun damage, more pronounced pigment changes, and lesions and growths on the skin -- is not very common. It uses trichloroacetic acid or retinoids to penetrate several layers of skin. Like medium peels, it will leave the skin with a sun-burned, raw appearance. In some cases, the patient may be put on a heart monitor and receive intravenous fluids during the procedure because phenol is toxic when absorbed by the body in large doses. After one area of the face is treated, there may be a 15-minute break to avoid absorption of too much phenol. The entire procedure may take up to 1 1/2 hours. In most cases, a deep peel can be done only once. It results in a more dramatic effect, but also has higher risks, increased pain, and a longer healing time.

Pain Level/Recovery Time: Right after the procedure, a handheld fan and cool compresses are often used to ease pain and discomfort. Recovery time depends on the type of peel. Following the procedure, the skin will peel for one to 14 days, depending on how deeply the chemical solution penetrated the skin. Proper skincare after the procedure is essential for healing and better, longer-lasting results. Your doctor will provide you with a skincare kit and instructions.

After a superficial peel, you can return to normal activities immediately. The skin may turn pink and peeling is minimal.

For medium peels, you may need a few days to recover. In five to seven days, you should be able to wear makeup to hide the redness. You may experience little or no pain, but some swelling may occur, especially around the eyes. The skin will turn reddish brown in two to three days, and then will become crusty and flake off over the next few days.

For deep peels, skin will be coated with petroleum jelly or a mask of adhesive tape for one to two days. Skin begins to grow back within 10 to 14 days. The skin will remain very red and tender up to three weeks. Some severe swelling may occur, so the head should be elevated. Antibiotics and pain relievers may be prescribed. Some people return to work and normal activities in two to three weeks. Complete healing may take several months. The effects are often dramatic and may last up to 20 years following the procedure.

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