What is a chemical peel?
Chemical peeling uses a chemical solution to improve its appearance, reducing or eliminating fine lines under the eyes and around the mouth, correcting uneven skin pigmentation, removing pre-cancerous skin growths and softening acne or treating the scars caused by acne. A chemical peel can also treat wrinkles caused by sun damage and scarring, as well as skin blemishes common with age and heredity.
The chemical solution is applied to the skin causing the top layer of skin to separate and peel off. The new, regenerated skin underneath is usually smoother, less wrinkled and more even in color than the old skin.
What substances are used?
Phenol, trichloroacetic acid (TCA), and alphahydroxy acids (AHAs) are used for chemical peels. The precise formula used may be adjusted for each specific patient.
1. Alphahydroxy Acids
Alphahydroxy acids (AHAs) such as glycolic, lactic or fruit acids are the mildest of the peel formulas and produce light peels that can often provide smoother, brighter-looking skin. Generally, no anesthesia is needed for AHA peels since they cause only a slight stinging sensation during application. It’s important to protect the skin from the sun following an AHA peel.
AHA peels may be used for the following:
- Areas of dryness
- Fine wrinkling
- Uneven pigmentation
- Aid in the control of acne
- Smooth out rough, dry skin
- Improve texture of sun-damaged skin
AHA peels may cause the following:
- Stinging Redness
- Crusting, flaking or scaling
2. Trichloracetic Acid
Trichloroacetic acid (TCA) can be used in many concentrations and is used to accomplish the following:
- Smooth fine surface wrinkles
- Remove superficial blemishes
- Correct pigment problems
It can be used on the neck or other body areas, and may require pre-treatment with Retin-A or AHA creams. It is preferable for darker-skinned patients.
Anesthesia is not usually required for TCA peels because the chemical solution acts as an anesthetic. Although, sedation may be used before and during the procedure to help the patient relax. Two or more TCA peels may be needed over several months to obtain the desired result, although mild TCA peels may be repeated more frequently.
The results of a TCA peel are usually less dramatic than, and not as long-lasting as, those of a phenol peel. More than one TCA peel may be needed to achieve the desired result.
TCA-peel patients are advised to avoid sun exposure for several months. It also may produce some unintended color changes in the skin.
Phenol is the strongest of the chemical solutions and produces a deep peel. A phenol peel is mainly used to accomplish the following:
- Correct blotches caused by sun exposure, birth control pills or aging
- Smooth out coarse wrinkles
- Remove pre-cancerous growths
Phenol should be used on the face only, as scarring may result if used on the neck or other body areas. It is not recommended for darker-skinned individuals and may pose risk for patients with heart problems. Phenol may also permanently remove facial freckles, cause permanent skin lightening or leave lines of demarcation.
Recovery from phenol chemical peels may be slow, and complete healing may take several months. After a phenol peel, new skin may lose its ability to produce pigment. The skin will be lighter, and will always have to be protected from the sun.
Considerations before having a chemical peel
It is very important to find a physician who has adequate training and experience in skin resurfacing.
In some states, a medical degree is not required to perform a chemical peel—even the strongest phenol peels—and many states have laws that permit non-physicians to administer certain peel solutions, but regulate the strengths which they are permitted to apply.
Possible complications associated with chemical peels may include, but are not limited to, the following:
Chemical peels can cause scarring. However, if scarring occurs, it can usually be treated effectively.
- Change in skin tone color
For certain skin types, there is a risk of developing a temporary or permanent skin color change. Taking birth control pills, pregnancy or a family history of brownish discoloration on the face may increase the possibility of developing the abnormal pigmentation.
- Cold sores and fever blisters
Those who are susceptible to cold sores, or Herpes simplex infections, may have a reactivation of cold sores or fever blisters following a chemical peel.
A chemical peel is most commonly performed for cosmetic reasons, to enhance appearance and self-confidence, and may be performed in conjunction with a facelift. However, a chemical peel is not a substitute for a facelift, and does not prevent or slow the aging process.