Chemical peels have been a mainstay in cosmetic procedures in the treament of fine lines, sun damage, rosacea, discoloration, and skin resurfacing by dermatologists for years. The American Academy of Dermatology has documented the popularity of chemical peels over the last 50 years. Plastic surgery alone cannot treat the surface or quality of the skin. That is where your dermatologist can create a good skin care routine and combine it with a different types of peels to exfoliate and rejuveante your skin. A chemical peel is a type of skin resurfacing treatment which uses a chemical solution that is applied to the skin to removes the outer layers of dead skin. Chemical peels, through chemical exfoliation, stimulates cell turnover correcting skin discoloration, unclogging the pores, giving the skin a vibrant glow.
There are Different Strengths and Types of Chemical Peels
The different types of chemical peels use include acids such as BHA’s (beta hydroxy acids), AHA’s (alpha hydroxy acids), Lactic Acid, Jessner solution and TCA’s (Trichloroacetic acids), amongst others which are applied to the skin. These acids, through chemical reaction with the skin, gently penetrate the layers of the skin breaking down dead skin cells. The chemical reaction with the skin causes the dead skin cells to gently peel off. The shedding of dead skin cells can be dramatic or superficial depending on the type of acid and the strength used. The type of peels used for each patient is matched both with the patient’s skin type and also the degree of exfoliating that you desire. Chemical peels can help improve the appearance of your skin by reducing fine lines and wrinkles, sun damage as well as evening out skin tone. Chemical peels are a great alternative for patients who want to give their skin a fresh, vibrant look with minimal downtime.
Chemical peels can be done in different strengths – light, medium or deep -depending on your skin type, issue and desired results. For each strength of chemical peel, a different chemical formulation is needed.
Which Skin Conditions does a Chemical Peel Treat?
A chemical peel is one of the most popular procedures in dermatology and can be used to treat a variety of skin conditions such as acne/rosacea, hyperpigmentation, wrinkles, age spots, acne scars, acne, freckles, and melasma. Dr. Green will decide which chemical peel is right for you depending on both your skin problem and skin type.
A peel should be selected based upon your specific complexion concerns and severity of changes in your skin. Changes limited to the superficial layers of the skin include increased skin pigmentation and a roughened skin texture without wrinkles, both of which can be treated with a superficial peel. When the textural changes include wrinkling around the eyes and mouth, the changes in the skin have extended deeper into the skin. The most severe changes in the skin include generalized deep wrinkling with a leathery appearance and feel to the skin. These changes imply still deeper damage to the skin, and Dr. Green recommends a more aggressive peel in these cases.
Before & After – 6 months
Types of Chemical Peel:
The American Society of Dermatology has categorized three levels of chemical peels.
Light chemical peels are a superficial peel, also referred to as a “lunch” time peel. This type of acid peel is perfect for someone with relatively good skin who just wants a refresher. Light chemical peels can treat superficial fine lines and wrinkles in addition to correcting uneven skin tone. Light chemical peels can be done as often as every two weeks. Light peels generally peel for just a few days with little down time.
Medium peels are stronger peels which may require a day or more of downtime due to mild to moderate flaking and peeling of the skin. The chemicals used to administer these peels are a stronger type or concentration and are used to achieve a deeper peel. After these medium peels there can be some temporary pigmentary changes and peeling can take over a week to resolve.
Dermatologist and plastic surgeons use Deep peels to treat deeper wrinkles, hyperpigmentation, melasma and acne scarring. These peels require more downtime as they penetrate deeper into the dermal layers of the skin. Skin color is a determinant of a patient’s appropriateness for a deep chemical peel. Deep peels often require the use of a topical anesthetic applied 30-60 minutes prior to the application of the peel and should be performed by a licensed trained professional. The healing time of a deep acid peel can be two to three weeks and you are bandaged immediately after the procedure. A potential side effect of improper peels can be blisters or burns. Immediately after all chemical peels, cool compresses are applied to the treated area. Lotion is applied for dryness and SPF 30 or higher is used on a daily basis.
What you Should Know Before Getting a Chemical Peel:
A chemical peel should not be performed if you have an active cold sore, eczema flare of psoriatic flare. In addition, if you are prone to cold sores you should tell your doctor before doing a chemical peel. Pre-treatment with an antiviral medication, such as Valtrex, should be started before the chemical peel if there is a history of cold sores or Herpes. Also, if you are prone to scarring or have a history of keloids you should not do deep chemical peels to prevent a viral infection.
Depending on your skin type and the reason for the chemical peel, you may be prescribed a topical retinoid or hydroquinone cream to pre-treat the skin prior to treatment. Retinoids and hydroquinones are particularly beneficial if you are treating hyperigmentation or sun damage.
Darker skin types can certainly do chemical peels however, one should be knowledgeable about the different acid strengths and type four and five skin types in order to get good results.
Female patient chemical peels, 2 months
What Should I Expect?
During the treatment you will experience a mild tingling sensation or feel heat on the skin. The acid is then neutralized and the skin cleaned. It is important that you avoid sun exposure and wear sunscreen while outdoors. After getting a peel you should avoid sun exposure for at least 1-2 weeks is vital as your skin goes through the process of regenerating new skin cells it is important that the skin is not exposed to the sun as this can cause hyperpigmentation. You will start to notice slight peeling or flaking of the skin by the second day after your peel. You should refrain from pulling, picking or peeling the skin and apply hydrating moisturizer two to three times daily.
You should avoid heat or exercise immediately following a chemical peel. Due to the exfoliation the skin is more sensitive and heat exposure and exercise can cause discomfort and skin irritation.
In addition, you should also avoid the use of topical exfoliants, or skin care products containing retinol, retin a, tretinoin, adapalene, tazarotene, benzoyl peroxide, glycolic acid or salicylic acid for 2 weeks after your chemical peel treatment.
Before & After – 3 weeks
Recovery and Results
A superficial peel has a recovery period of a few hours to a few days, depending on how aggressive the treatment was. Recovery from a medium depth peel generally takes about one week. A deep chemical peel will take from several weeks to several months to completely recover.
Generally speaking, a light to medium depth chemical peel is not painful. Most patients experience a warm to somewhat hot sensation that lasts for five to ten minutes. This may be followed by a mild stinging sensation. However, a deep chemical peel may require pain medication during and after the procedure.
Wrinkles that occur during muscle action (known medically as dynamic wrinkles), deep scars, and skin sagging due to aging are generally not improved with chemical peeling. For this reason, other procedures like dermal fillers, BOTOX® Cosmetic, Sculptra, or other cosmetic injectables should be incorporated into your treatment regime. Many patients will also have the Thermage FLX for skin tightening before a series of peels to produce new collagen and tighten the skin.
If you’re unhappy with the tone and texture of your skin, there’s finally a solution that can help. Contact us online today or call 212-535-3088 to learn more about whether chemical peels may be right for you.