Skin peeling involves an application of a chemical solution to sun-damaged, unevenly pigmented, and finely wrinkled facial areas. The procedure is meant to diminish imperfections by peeling away the skin's top layers. It has proven to be a very popular nonsurgical cosmetic procedure. Chemical peels vary according to their specific ingredients and their strength. Depth of peeling action may also depend on factors such as how long solutions remain on the skin and whether they are lightly applied, or more heavily or vigorously applied.
A chemical peel is typically done in an office-based procedure room or outpatient surgical or aesthetic facility. Before the procedure, the skin specialist will clean your face and might cover your eyes with ointment, gauze, tape or goggles. He or she might also protect your hair. The specialist will select the best chemical or chemical mix for the individual patient.
Pain relief isn't typically needed for a light chemical peel.
If you're having a medium chemical peel, you might have the option of taking a sedative and a painkiller.If you're having a deep chemical peel, your doctor will likely numb your skin with a local anesthetic and give you a sedative or use regional anesthesia — which numbs a certain part of your body.
A solution is applied using a sponge, cotton pad, cotton swab or brush to the areas to be treated (or the entire face, avoiding the eyes, brows and lips). Generally, the most superficial peels are those using alpha hydroxy acids (AHA), such as glycolic, lactic or fruit acid. Various concentrations of an AHA may be applied weekly or at longer intervals to obtain the best result. A trichloroacetic acid (TCA) peel is stronger, and has a greater depth of peel compared to AHA's.
AHA:
- No anesthesia or sedation is needed, and the patient will feel only a mild tingling or stinging sensation when the solution is applied.
- Sometimes a single treatment will give skin a healthier, radiant look.
- No downtime - patient can immediately resume normal activities.
- Can be mixed with a facial cream or wash in milder concentrations as part of a daily skin-care regimen.
TCA:
- TCA is especially effective in treating darker-skinned patients.
- Can possibly be used to achieve some effects of a deep peel, depending on the concentration and manner of application.
- Generally shorter recovery time than with a deep (phenol) peel.
Both:
- Short, safe procedure.
- No covering or after-peel ointment is necessary.
- Other Considerations:
During a light chemical peel:
- A brush, cotton ball, gauze or sponge will be used to apply a chemical solution typically containing glycolic acid or salicylic acid. The treated skin will begin to whiten.
- You might feel mild stinging while the chemical solution is on your skin — up to 10 minutes.
- At the end the skin specialist will apply a neutralizing solution or wash treated skin to remove the chemical solution.
- Your doctor will use a cotton-tipped applicator or gauze to apply a chemical solution containing trichloroacetic acid, sometimes in combination with glycolic acid. The treated skin will begin to whiten.
- After a few minutes, your doctor will apply cool compresses to soothe treated skin. You might also be given a hand-held fan to cool your skin. No neutralizing solution is needed, however.
- You might feel stinging and burning for up to 20 minutes.
- You'll be given intravenous (IV) fluids and your heart rate will be closely monitored.
- Your doctor will use a cotton-tipped applicator to apply carbolic acid (phenol) to your skin. Treated skin will begin to turn white or gray.
- To limit your exposure to phenol, your doctor will do the procedure in portions at 10- to 20-minute intervals. A full-facial procedure might take 60 to 90 minutes.
After a chemical peel of any depth, follow your doctor's directions for cleansing, moisturizing and applying protective ointments to your skin.
After a light chemical peel, treated skin will be red, dry and mildly irritated — although these effects might be less noticeable with each repeat treatment. Your doctor might apply a protective ointment, such as petroleum jelly, to soothe the area. In some cases, a crust might form over treated skin as it begins to heal.
Treated areas develop new skin about three to seven days after a light chemical peel. New skin might temporarily be lighter or darker than normal.
After a medium chemical peel, treated skin will be red, tight and swollen. You'll feel stinging. Your doctor might apply a protective ointment, such as petroleum jelly, to soothe the area. Use ice packs for comfort and sleep in a semi-reclined position to reduce swelling.
You'll likely schedule a checkup 24 hours after treatment and another checkup two to three days after treatment so that your doctor can monitor healing.
As swelling decreases, treated skin will begin to form a crust and might darken or develop brown blotches. Treated areas develop new skin about five to seven days after a medium chemical peel, but redness might last for months.
After a deep chemical peel, you'll experience severe redness and swelling. You'll also feel burning and throbbing, and your eyelids might swell shut. Your doctor will apply a watertight dressing containing zinc oxide to treated skin. He or she might also prescribe painkillers. Sleep in a semi-reclined position to reduce swelling.
You'll likely schedule a checkup 24 or 48 hours after treatment so that your doctor can remove the dressing and clear away any yellowish liquid oozing from treated skin.
Treated areas will develop new skin within about two weeks after a deep chemical peel, although cysts or white spots might appear for several weeks and redness might last for months. Treated skin might become darker or lighter than normal or lose the ability to tan.
You might prefer to remain at home while you're healing from a chemical peel. Once new skin completely covers the treated area, you can use cosmetics to conceal any redness.
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