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One of NYC’s best dermatologists, Dr. Michele Green’s, favorite procedures is treating acne and acne marks with chemical peels. Dr. Green considers it one of the best procedures for overall skin brightening. A chemical peel is a rejuvenation process which is used to improve the appearance of the skin. A chemical solution, of varying types and strengths, is applied to the skin, which causes the top layer to exfoliate, and peel off.  Dr. Green will help customize the right chemical peel based on your skin type and cosmetic concern.  Peels are used to improve various skin conditions, on the face, neck, chest, back, hands, arms, or legs. The main purpose of chemical peels, especially for acne and acne marks, is to even out the skin tone, texture, areas of discoloration and hyperpigmentation.  Another added benefit of chemical peels is reducing fine lines and wrinkles. Dr. Green routinely uses acid peels in conjunction with her MGSkinLabs line of products to provide the best skin resurfacing with very little downtime. Peels are the one of the fastest cosmetic procedures in dermatology to yield visible results. Chemical peels have been proven effective for reducing moderate acne, restoring uneven skin tone, and in dramatically reducing the appearance of acne scars.

How does a chemical peel work?

In the process of a chemical peel, the skin is cleaned of all makeup, sunscreen, and oils.  Patients are advised not to use exfoliating products, including Retinols and Retin-A  for 24 hours before the chemical peel. A chemical agent is applied to the clean skin, to remove the outermost layer of the skin, the stratum corneum.  Depending on the strength of the acid used to peel the skin, the solution may be left on the skin for 1 to 5 minutes. During the chemical peel, the topical solution which is applied to the skin and causes the surface skin cells to exfoliate and peel off.  This allows new skin cells to regenerate. As the dull skin peels off, your complexion becomes more radiant, acne and acne scars are reduced, and your skin is rejuvenated.  The result is new skin which is luminous, brighter, with an improved texture, and even skin tone.

In addition to treating acne and acne scars, chemical peels are commonly used to treat fine lines and wrinkles, and hyperpigmentation which results from sun damage. Chemical peels also improve skin tone, including discoloration such as sunspots, age spots, and melasma which can result from pregnancy or from taking birth control pills. Pre-cancerous skin lesions, actinic keratoses, caused by too much sun exposure, can also be treated with chemical peels.

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How do I select the best chemical peel for my skin type?

Dr. Green offers a wide range of chemical peels in order to provide patients with the best choice of treatment options. Dr. Green will work closely with you to guide your selection of the type of chemical peel which is  best suited to your skin type and problem area, also taking into account the amount of downtime your schedule allows.  She will review the risks and benefits in deciding between a glycolic peel versus a deeper peel.

A peel should be selected based upon your specific skin tone and the various skin conditions which need to be addressed.  A superficial peel is effective for changes to the superficial layers of the skin, including hyperpigmentation and skin texture.  Dr. Green may advise a deeper chemical peel when addressing deeper lines and wrinkles, especially for problem areas around the eyes (periocular) and mouth (perioral wrinkles).

The Best Chemical Peels for acne and acne scars

In general, the best superficial chemical peels for acne consist of  glycolic acid or light trichloroacetic acid (TCA). Alpha hydroxy acids, such as glycolic acid at 30-50%, are idea for superficial chemical peels for acne and acne scars. These acids help to unclog the pores, and through the process of exfoliation, remove the dead skin cells. Through this peeling process, the pimples and acne breakouts are unclogged and the acne is under much better control.  In terms of acne scars and hyperpigmentation, when the new skin forms after the peel, the blemishes are lighter and the discoloration improved.  Dr. Green often combines chemical peels with the home use of her MGSkinLabs lines of skin-care products, containing hydroquinones, Retin-a, tretinoin and Vitamin C serum, to further improve your acne and acne scars. In addition, salicylic acid has been used for decades and remains a good peeling agent for patients with acne.

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You will see improvement in your skin’s complexion even after one chemical peel.  The best results for acne and acne scars is a series to 3 to 6 chemical peels, depending on the degree of acne, acne scars, and hyperpigmentation. Proper SPF protection should be used throughout this chemical peel process, to avoid a sunburn or further sun damage. As a result of the chemical peel, your new skin will be even-toned and radiant.

Best Medium depth chemical peels

Medium depth peels are usually done using done with an acid solution containing a 20%  trichloroacetic acid (TCA) solution, or higher.  The higher the strength of acid used, the more care needs to be used in proper patient selection.  Darker skin patients run the risk of hypopigmentation or hyperpigmentation from higher strength acid solutions.  Dr Green will help you decide which percentage and type of acid would be best for your skin type.

A common medium strength chemical peel is a Jessner peel. A Jessner peel has been traditionally been a combination of acid acid, salicylic acid, and resorcinol in a 95 percent ethanol solution. There are some health concerns about the resorcinol, since it is a phenol derivative, and most Jessner’s peel now being replacing resorcinol with TCA.  This type of chemical peel is called a modified Jessner’s peel. This medium strength chemical peel involves removing skin cells not just from the top layer of the skin, but also the top layer of the dermis.  Jessner’s peels have been around for over one-hundred years.  While they are safe and effective, the specific radio of alpha and beta-hydroxyacids needs to be maintained with a pH of the overall solution typically around 1.9.  It is essential to control the pH of the acid solution, since this controls any unwanted side effects from the chemical peel.  Retinols and other AHAs, such as phyytic, azelaic, glycolic, and mandelic acids, can be used to modify the Jessner’s formulation for added benefits.

The benefits of a medium strength chemical peel is that while removing the skin cells, it causes new skin to heal and remove more hyperpigmentation, acne scarring, and wrinkles. The result is smoother, softer, tighter, and more even skin tone and texture.

Deep chemical peels

These deep peels are rarely performed because of the long healing time required and the higher risk of hypopigmentation and hyperpigmentation to the skin. Deep peels remove skin cells from the epidermis and from the mid to lower layer of your dermis. Deep peels are recommended if you have deep lines and wrinkles, and extensive sun damage.  Most patients prefer a series of light or medium strength peels, which have a cumulative effect over time, over such a strong chemical peel.

A deep peel can only performed once. Deep chemical peels cannot be done on patients with darker skin tones, since this can damage the skin. There can often be a significant contrast in coloration, or demarcation, after a deep peel in the area peeled compared to the untreated skin. Deep chemical peels are not needed to treat moderate acne. Since deep chemical peels are painful, they require anesthesia or pain management both before and after the procedure. You will leave the office with your face bandaged after the procedure.

The Best Chemical peel for all skin types

Cosmelan peels are an amazing depigmentation peel which treats dark marks from acne, acne scars, melasma, and overall skin hyperpigmentation. Many patents are unhappy after the acne marks and dark discolorations which remain after their acne breakouts heal. Cosmelan peels can be used in patents of all skin types, no matter what the skin tone. In this two part chemical peel, which is performed in the office of Dr. Michele Green, the cosmelan peel is applied on the patient’s skin with strict instructions for at home removal and corresponding at-home skincare products. Strict sun avoidance with a high SPF is needed after this procedure.

Recovery time and expected results

A superficial peel, such as one to improve moderate acne, or acne scars requires very little recovery time with some dryness or flaking for just a few days. Recovery from a medium depth peel generally takes about one week. After a deep chemical peel, several weeks or more must be allowed for a complete recovery.

A light to medium depth chemical peel, including those used to treat acne and acne scars, has no discomfort. During the peel patients may feel a slight stinging sensation which lasts a few minutes.  A deep chemical peel, on the other hand, may require significant pain medication both during and after the treatment.

How do I take care of my skin after a chemical peel?

Dr. Green will review the best skin care products to use at home after your chemical peel. It is very important to continue moisturizing your skin after your chemical peel with rich moisturizers that do you contain any irritating ingredients. Daily moisturizers counteract the irritation or peeling that can occur from the chemical peel. A gentle skin cleanser is also important to use.  Dr. Green recommends avoiding retinoids, Retin-A, exfoliating products and any alpha hydroxy acids for one week after the peel, or until your skin is back to normal.  Careful use of a broad spectrum sunscreen with an SPF 50 is essential to prevent further discoloration and the recurrence of pigmentation.  Your new skin is more susceptible to the sun after your chemical peel, so the daily use of sunscreen is very important.

What is the Best Skin Care to use with chemical peels?

If you are undergoing treatment for your acne at the same time as your chemical peels, Dr. Green will most likely prescribe a topical antibiotic for daily use.  In addition, using a retinoid, Retin-A, or Differin gel at night time, helps to exfoliate the dead skin, controls acne breakouts, and helps make your chemical peels more effective.

If the main objective of your chemical peel is for the discoloration caused by old acne breakouts and acne scarring, Dr. Green will recommend a combination of products from her MGSkinLabs line of products including HQRA (which combines Retin-A and hydroquinone), topical Vitamin C serum (powerful antioxidant), and high potency hydroquinones to use with your chemical peels. Dr. Michele Green specially compounds these products for her private patients and customizes her products based on the individual and their skin tone.

Side effects of chemical peels

There are several potential side effects of chemical peels.  This is one of the reasons that an expert in dermatology should only be treating you with chemical peels. The most common risks of a chemical peel include:

  • Redness (although redness is expected and normal from any chemical peel)
  • Crusting
  • Hypopigmentation or loss of pigment
  • Scarring
  • Increased Photosensitivity
  • Infection
  • Herpes flare (If you have a history of herpes infections, an antiviral medication may need to be taken for one week)

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What is the cost of a cosmetic peel?

The price for cosmetic peels varies in the type of peel and the experience of the provider.  According to the American Society of Plastic Surgeons, the average price for a cosmetic peel is approximately $650.  A deep peel is more expensive since it requires anesthesia in a doctor’s office as well.

Who performs the best chemical peel?

While estheticians and spas do perform chemical peels, chemical peels of medium strength or higher, or those containing trichloroacetic acid (TCA), can only be performed by a dermatologist.  It is always best to consult a board certified dermatologist who is experienced in the different skin types, cosmetic procedures, and potential side effects.  Dermatologists are experts in treating acne and acne scars, and are in the best position to perform these in office chemical peels.

DIY at home chemical peels

Dr. Michele Green cautions against at home chemical peels. The first consideration is understanding if you have sensitive skin and only using a product from a reputable cosmetic company.  If your skin is sensitive, you may only want to use glycolic or salicylic acid peel pads. Glycolic acid peel pads are very good for oily skin types and exfoliate the top layer of your skin.  Lactic acid is good for all skin types and fading acne scars. Mandelic acid and Phytic acid are good for fading dark spots on darker skin tones, especially for patients with sensitive skin or who are suffering from post-inflammatory hyperpigmentation from acne.  It is very important when looking at treatment options for at home chemical peels for your acne or blackheads, to avoid any strong acids since these chemical peeling agents can cause blisters and scarring if applied incorrectly.

Chemical Peels versus Laser Treatment

In simple terms, chemical peels and laser treatments are both designed to “remove” the top layer of skin and rejuvenate the skin by reducing pigmentation, sun damage, wrinkles or acne scars. The choice of lasers or peels depends on many factors. Key to the decision is your skin type. Skin types I and II (light skin) can be safely treated by both lasers or peels. However, skin types III and darker (darker skin) are generally more sensitive to lasers and careful choice of lasers is paramount to avoid pigmentation and worsening of the current condition. Dr. Green is an expert in treating hyperpigmentation caused by lasers and cautions patients with darker skin tones about the importance of doing their research.

During your consultation with Dr. Green in her NYC office, she will review all of the chemical peels and cosmetic dermatology procedures and will help design a treatment protocol for you. Contact us today or call 212-535-3088 to find out if a chemical peel is the right choice for you.

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