Chemical Peels
“Beauty is skin deep, but so is age and sun damage.”
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, acne, wrinkles and uneven skin pigmentation.
Peels are grouped into three categories based on the type (and strength) of acid used. Phenol is the strongest and only used in extreme circumstances. Trichloroacetic acid (TCA) is not as strong and used more. But the most widely used of all is the mild alphahydroxy acids (AHAs).
All chemical peels carry some uncertainty and risk The American Society of Plastic Surgeons recommends that the procedures be performed by a qualified, experienced plastic surgeon’s office such as Brevard Plastic Surgery & Skin Treatment Center.
Consultation & Preparation
During your initial consultation, it is important that you discuss your expectations with Dr. Guy or one of the BPSSTC aestheticians. Don't hesitate to ask any questions or express any concerns that you may have. The planned procedure will be explained in detail, including its risks and benefits, the recovery period and the costs. If you have a history of cold sores, a form of herpes, inform the aesthetician prior to the procedure.
Your Brevard Plastic Surgery & Skin Treatment Center aesthetician 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 dead 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.
The Skin Treatment
ALPHAHYDROXY ACIDS (AHAs), such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels. These types of peels can provide smoother, brighter-looking skin for people who can't spare the time to recover from a phenol or TCA peel. AHA peels may be used to treat fine wrinkling, areas of dryness, uneven pigmentation and acne. Brevard Plastic Surgery & Skin Treatment Center aestheticians can analyze your skin to determine which of the following AHA-based peels are right for you.
PCA Peel
This special blend of naturally occurring AHA’s (fruit acids) work in your skin for 5-7 days helping to lift out hyper pigmentation (brown spots) caused by hormones or sun damage. It also reduces surface lines and improves the overall texture and clarity of your skin. Results show lighter, tigher and brighter skin. The PCA Peel is wonderfully effective in inhibiting active acne.
Esthetiques Peel
Advanced formula of L-asorbic, L-lactic, L-retinol smoothes, tightens and improves skin texture and clarity. The Esthetique Peel is loaded with antioxidants, vitamins, and humectants resulting in fresh, hydrated, healthy skin.
Purifying Peel
The peel is perfect for oily impure skin. Effectively kills bacteria, reduces breakouts and balances oil production. Our purifying peel also promotes healing and reduces hyper pigmentation caused by sun damage or old breakouts.
Sensi Peel
Formulated primarily for sensitive skin conditions, gently yet effectively works deep within the skin helping to lighten hyper pigmentation (brown spots) exfoliates dead dull skin resulting in smoother, fresher more resilient looking skin.
TRICHLOROACETIC ACID (TCA) can be used in many concentrations, but it is most commonly used for medium-depth peels. Fine surface wrinkles, superficial blemishes and pigment problems are commonly treated with TCA. 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 and may require pre-treatment with Retin-A or AHA creams.
A full-face TCA peel usually takes no more than 15 minutes. Two or more TCA peels may be needed to obtain the desired result, and those may be spaced out over several months. Mild TCA peels may be repeated as often as every month.Dr. Guy will determine when a TCA peel is appropriate.
Obagi Blue Peel
After years of development and testing, Obagi has created an innovative physician-administered chemical peel. The Obagi Blue Peel, if repeated over a period of time, can achieve the same result as a deeper chemical peel or a laser. Healing occurs usually in just 7-10 days.
The Obagi Blue Peel represents a significant breakthrough in skin rejuvenation. Unlike other AHA-based peels, the Obagi Blue Peel uses slow acting TCA, instead of glycolic acid to enable the physician to control the peel process and its depth. The process is tailored to the nature of the problem to be corrected: wrinkles, scars, laxity or
pigmentation problems.
PHENOL is the strongest of the chemical solutions and produces a deep peel. It is used mainly to treat patients with severe coarse facial wrinkles, areas of blotchy or damaged skin caused by sun exposure, birth-control pills, aging, 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. Phenol is primarily used on the face; scarring may result if it's applied to the neck or other body areas.
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 Dr. Guy aware of any heart problems when your medical history is taken. It is also possible that phenol will cause some undesired cosmetic results, such as uneven pigment changes. Certain modified phenol peels are gentler and may be preferred in some circumstances.
If phenol solution has been used, Dr. Guy or one of her aestheticians may coat the treated area with petroleum jelly or a waterproof adhesive tape. With lighter peels, no covering or a light cream is necessary.
A full-face phenol peel generally takes one or two hours 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 usually suffices.
Recovery & Results
AHA Peel:
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 and will not prevent you from working or engaging in your normal activities. A fresher and improved skin texture will result with continued AHA treatments. Remember, protecting your skin from the sun is also important following these mild acid peels. Use a recommended sunblock with adequate UVA and UVB protection every day.
Improvements from AHA peels may be very subtle at first. You may detect a healthier glow to your skin. With continued treatments, you will notice a general improvement in the texture of your skin.
TCA Peel:
A TCA peel may also cause significant swelling, depending on the strength of the peel used. 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.
The results of a TCA peel are usually not as long-lasting as those of phenol peel. However, your skin will be noticeably smoother and fresher-looking.
Phenol Peel:
With 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. 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. (For makeup tips, see one of our aestheticians or ask Dr. Guy for the ASPS brochure on camouflage cosmetics.) Eventually, you can expect dramatic improvement in the surface of your skin - fewer fine wrinkles, fewer blemishes and more even-toned skin. Your results will be long-lasting, although not immune to the effects of aging and sun exposure.
After a phenol or TCA peel, Dr. Guy 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 may form on the treated area. To help your face heal properly, it is essential that you follow Dr. Guy's specific post-operative instructions.
