Chemical peel is helpful for wrinkles, light acne scarring and irregular pigmentation such as freckles and age spots.
Due to the nature of this procedure intravenous sedation is typically required.
For superficial Chemical Peel, please refer to the Medi-Spa section.
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. Trichloroacetic acid (TCA) and phenol 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.
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.
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.
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.
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.
Phenol and TCA peels: Intravenous sedation may be required. Local anesthetics may also be given to reduce stinging associated with chemical peels. After thoroughly cleansing the skin, a small applicator is used to apply the chemical solution to an area of the face. Excess solution is removed and the procedure is repeated on other areas.
The surgeon will then carefully apply the phenol or TCA solution.
A full-face TCA peel usually takes about 15 minutes. Two or more TCA peels may be needed to obtain the desired result, and those may be spaced out over several months.
If phenol or TCA solution has been used, your plastic surgeon may coat the treated area with a waterproof silicone dressing.
A full-face phenol peel generally takes about one hour 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 will usually suffice in correcting the wrinkles.
Trichloroacetic acid (TCA)
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Phenol
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Your plastic surgeon 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. You may have to spend a month or more in the pre-treatment phase before the doctor will schedule your actual peel.
You will need to arrange for someone to drive you home and help you out for a day or two if you are having a phenol or deeper TCA peel.
The results of a TCA peel are usually not as long lasting as those of phenol peel. Your skin, however, will be noticeably smoother and fresher looking.
If you're planning on a phenol peel, you can expect dramatic improvement in the surface of your skin, fewer wrinkles, fewer blemishes and more even skin toned. Your results will be longer lasting, although not immune to the effects of aging and sun exposure.
After a phenol or TCA peel, your doctor may prescribe a mild pain medication to relieve any tingling or throbbing you may feel. The silicone dressing will peel off on its own after 5-7 days. A crust or scab may 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 or phenol peel may also cause significant swelling. Your eyes may even be swollen shut temporarily. You will need someone to help care for you during the first few days of recovery.
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.