Chemical peeling uses a chemical solution to improve the skin's appearance. It can reduce or eliminate fine lines under the eyes and around the mouth, correct uneven skin pigmentation, remove precancerous skin growths, and soften acne or treat scars caused by acne. The procedure can also treat wrinkles caused by sun damage and scarring, as well as skin blemishes common with age and heredity. Chemical peels can be performed on the face, neck, chest, hands, arms, and legs.
Chemosurgery is commonly known as 'chemical peeling'. It involves using chemical agents to treat a number of skin conditions like increased pigmentation on the face or body, superficial scars due to acne and fine wrinkles. Chemical peeling is a widely used and poorly understood procedure. We will discuss few frequently asked questions about chemical peeling.
Types Of Chemical Peels
Superficial (Mild) PeelDuring a superficial peel, an acid solution applied to the skin removes only a portion of the outer layer of skin (epidermis). Mayo Clinic offers glycolic acid and salicylic acid superficial peels. Superficial acid peels achieve a subtle change, giving the patient smoother skin, a healthy glow and a refreshed look. These peels improve skin color irregularities, mild scarring and acne, and the appearance of fine lines and wrinkles.
Medium-depth PeelMedium-depth acid peels remove the epidermis and a small portion of the middle layer of skin (dermis). Mayo Clinic uses trichloroacetic (TCA) acid for medium-depth peels. This type of acid peel is recommended for patients with fine wrinkles, sun damage, skin color abnormalities and precancerous spots. After the procedure, patients may wear a facial bandage for one or more days.
Preparing For Your Chemical Peel
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. You probably won't need any extra assistance if you're having an AHA peel or superficial TCA peel.
How Is Chemical Peeling Performed?
Chemical peeling is an office procedure. It does not require any hospitalization. After properly studying the skin type and its sensitivity, the dermatosurgeon decides on the type of peeling agent or agents and their concentration. The selection of the chemical agent also depends on the extent and depth of skin damage. The skin is first cleaned with soap water to remove excess oil. The peeling agent is then applied gently onto the lesion or on the full face till the 'end point' is achieved. During or shortly after the procedure, the patient might experience warmth or stinging sensation for a few minutes. pigmentation persists, the procedure can be repeated after 3 weeks.
A chemical peel can be performed in a doctor's office or in a surgery center as an outpatient procedure.
The skin is thoroughly cleansed with an agent that removes excess oils and the eyes and hair are protected. One or more chemical solutions, such as glycolic acid, trichloroacetic acid, salicylic acid, lactic acid or carbolic acid (phenol), are applied to small areas on the skin. These applications produce a controlled wound, enabling new, regenerated skin to appear.
What Happens After Chemical Peeling?
After a superficial peel, redness appears and there is peeling of skin over three to seven days. More than one sitting may be required. In the Indian skin type, only superficial and medium depth peeling is recommended.
After Your Treatment
After an AHA peel, it is common to experience some temporary flaking or scaling, redness and dryness of the skin. However, these conditions will disappear as the skin adjusts to treatment.
After a phenol or TCA peel, your doctor may prescribe a mild pain medication to relieve any tingling or throbbing you may feel. If tape was used to cover your face, it will be removed after a day or two. A crust or scab will 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 peel may also cause significant swelling, depending on the strength of the peel used.
If you've had a phenol peel, your face may become quite swollen. Your eyes may even be swollen shut temporarily. You will need someone to help care for you for a day or two. You may also be limited to a liquid diet and advised not to talk very much during the first few days of recovery.
RisksRisks associated with chemical peel include, but are not limited to: -
- Pigmentation changes, either increased or reduced pigmentation, particularly among patients with darker complexions
- Infection — rare, if instructions about skin care are closely followed
- Skin scarring
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