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Chemical Peel
Chemical Peel

Chemical Peel If you've ever overdone tanning on the beach and peeled afterward, you're halfway to understanding the cosmetic surgery principle used in chemical peeling. However, it’s not rays of the sun, but an acid solution which is painted on the skin of the face and, depending how deep you want the peel to go, you can choose from a 30 percent or 70 percent strength glycolic acid peel.

The American Academy of Facial Plastic Surgery estimates nearly 1,110,464 patients underwent chemical peels in 2011, making it the third most popular minimally invasive cosmetic procedure. Chemical peels use several types of acid solutions to improve and smooth the texture of your facial skin. The acid works by removing damaged outer layers and are sometimes also used on the neck and hands.

Chemical peels vary according to their specific ingredients and strength. The actual depth of the peeling can also depend on other considerations such as how long the solutions remain on the skin and if they are lightly, heavily or vigorously applied. The most commonly performed peel procedures are lightly applied to smooth rough dry skin and aids in control of acne.

"Chemical peels have been

proven to be among the most popular nonsurgical cosmetic procedures chosen by patients."

There are three common types of chemical peels: For light to medium uses, physicians use a solution known as AHA (alpha hydroxyl acid,) which include glycolic, lactic or fruit acid. AHA treatments may require a series of multiple applications.

TCA (trichloroacetic acid) is stronger and flays the skin down to a greater depth while Phenol, the strongest acid, is used for the deepest peels and is most commonly used to treat skin wrinkling around the lips and chin. However, Phenol may pose a special risk for patients with a history of heart disease so it’s important you make your surgeon aware of your condition. Moreover, Phenol is not usually applied to darker skins.

TCA peels are more effective in treating patients with darker skin and offer a shorter recovery time than with solutions used for lighter peels. A TCA peel may also require pretreatment with AHA or a Retin-A cream.

Deep peels are usually done once and provide longer-lasting results. The deep peel is usually used on patients who have the deepest wrinkling.

Although chemical peels may be done in conjunction with a facelift, the peel is not a substitute for that surgery, nor will it stop aging. A chemical peel is most useful for fine wrinkles on cheeks, forehead and around the eyes and the vertical wrinkles around the mouth.

Benefits of Chemical Peels

After the top layer of skin is peeled away, new, fresh skin regenerates without imperfections, lines and wrinkles. Deeper chemical peels are an effective treatment for the extreme wrinkling caused by spending too much time in the sun.

If your surgeon has selected an AHA peel, no anesthesia or sedation is needed. Sometimes, a single treatment can produce that radiant look of younger skin. Additionally, time off from your job and regular activities is not usually required with an AHA peel.

How are Chemical Peels Performed?

A full face chemical peel usually takes one to two hours to perform and is safely done in the physician’s office. Your physician may ask you to eliminate certain drugs from your system before doing the procedure. But a more limited procedure -- like treating only the wrinkling above the lip -- will generally take less than 30 minutes. Overall, your surgeon decides which solution is right for your case and applies it to the treatment area, avoiding eyes, brows and lips. After the peel solution has worked on the skin, it is neutralized with water. About an hour later, a thick coating of petroleum jelly is layered over the face and covers the protective crust left by the acid solutions. That crusty layer stays in place for one to two days. Some physicians use another technique for cases of severe wrinkling, whereby a mask made of adhesive tape, covers the patient’s face during the early stages of the healing process.

The solution is applied using a sponge, cotton pad, swab or brush. The treatment begins with a thorough cleaning of the skin to remove any traces of grease with rubbing alcohol or acetone. The peeling solution is left on the face for a few minutes then removed.

The deeper a peel penetrates, the more visible will be the results. However, the recovery time may be longer.

How Much Pain is Associated with Chemical Peels?

With AHA, the patient only feels some stinging or irritation and sees some redness on the face.

All three procedures can cause puffiness in the face which subsides after several days. Medium peels usually do not require anesthesia while the deep peels usually require intravenous sedation. Temporary flaking or scaling, redness and dryness are normal after effects. Ointments, used for seven to ten days following surgery, keep the skin supple. Some deep chemical peels require a break from normal activities for one to two weeks. With the deeper peel, the patient is usually monitored with an EKG.

What are The Long-Term Effects of Chemical Peels?

Sun block is always recommended after chemical peels, especially after a TCA treatment because your skin will be extremely sensitive to sunlight and may not tan evenly. The effects of a phenol chemical peel sometimes last as long as twenty years and have quite dramatic results, according to the American Society for Aesthetic Plastic Surgery. Possible post-op complications can include scarring and infection of abnormal pigmentation. Some patients wear special make-up so treated areas will match the untreated areas. Physicians also caution that the acid solutions used in chemical peels can activate latent cold sore infections.

Who would best Represent an Ideal Candidate for Chemical Peels?

The fair skinned, light haired patient who has a very wrinkled face or who has a face dotted with liver, age and sun spots, freckles or splotching due to taking birth control pills – and wants a younger, fresher look -- would be a good candidate for a chemical peel. The face that has a dull texture and color may be improved with chemical peeling. Precancerous keratoses or scaling patches may improve after chemical peeling. However, the procedure does not correct sags, bulges and deep furrows. Those conditions are often better treated by
face, brow and eyelid lifts or with soft tissue fillers like Juvederm and Restylane.

What Are the Risks and Limitations of Chemical Peels?

Experts say not everyone may be a suitable candidate for a chemical facial peel. Before surgery, your physician must evaluate the solutions’ effect on ethnic background, age, skin type and color. But because there can be serious consequences and unforeseen complications, the American Society for the Aesthetic Plastic Surgery says Phenol chemical peels should only be performed by a qualified physician. (In some states, non-physicians can apply chemical peels. Some inadequately trained practitioners claim in advertisements they have “miracle treatments” to rejuvenate the skin.) Overall, you must be free of skin infections, including acne and any type cold sore, especially herpes simplex sores. You must have not taken Acutance for twelve to 18 months before treatment, depending on your doctor’s specifications. And, you will be asked to limit your exposure to the sun for at least a month before undergoing the peel.

What Are The Typical Costs Associated With Chemical Peels?

While the American Society of Plastic Surgeons says the average cost of a chemical peel in the U.S. is $706, prices vary widely depending on the procedure and overall economic conditions where you live. For instance, one mild face peel costs around $100 per application but a Phenol full face peel can cost $3,000 to $4,000. And those are doctor’s fees. Be sure and check what other associated fees are involved before proceeding.

Ten Questions Every Chemical Peel Patient Should Ask Their Surgeon

Prior to all chemical peel procedures, a consultation will occur between the prospective patient and the providing surgeon. During this consultation the surgeon and patient will discuss the treatment plan like the desired outcome, various options that are available to achieve it, the procedure itself as well as various risks and limitations. The surgeon will also provide information regarding anesthesia options, the location and description of where the peel procedure will be performed (i.e., hospital vs. office surgical suite) and associated costs. A discussion regarding the patient’s medical history, as well as a physical examination of the area to be treated will also take place during the consultation.

To better educate the patient about chemical face peels, as well as assisting in formulating realistic expectations, it is recommended that the patient look at before and after photographs, speak with previous chemical peel patients, (you are always welcome to ask your doctor for referrals to previous patients and where to contact them) and get answers to the following questions:

  1. Are the desired results I described realistic?
  2. Where is the peel performed and how long will it take?
  3. In my case, what technique and which peel are most appropriate?
  4. What kind of anesthesia will the surgeon use during the surgery?
  5. How much do chemical peels cost and what other elements factor into that cost (i.e., hospital fee, anesthesia, etc)?
  6. What is the surgeon’s level of experience in performing chemical peels?
  7. What percentage of patients experience complications with the peels?
  8. What is the surgeon’s policy in regards to correcting or repeating the procedure if the peel does not meet agreed upon goals?
  9. What should I expect, post-operatively, in terms of soreness, scaring, activity level and so on?
  10. Have you ever had your malpractice insurance coverage denied, revoked or suspended?
You should also request and view several before and after photographs of recent patients who have received peels from the same surgeon. These photos may be supplemented with additional valuable information by requesting the names and contact information for several of the surgeon’s chemical peel patients.

In addition to the previously mentioned questions, it is imperative that chemical peel patients relay to their surgeon information regarding any allergies and serious medical conditions they may have. Furthermore, patients should inform the surgeon of any medications they are taking.

This site provides information about plastic/cosmetic surgery and is designed to help users make decisions regarding their own treatment options. But medical information is not the same as medical advice--the application of medical treatment to a person's specific circumstances. Although we go to great lengths to make sure our information is accurate and useful, we recommend you consult a qualified medical practitioner if you want professional assurance that our information, and your interpretation of it, is appropriate to your particular situation.

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