Chemical Peels
A lifetime of unprotected exposure to the sun’s rays damages the skin giving it a blotchy, wrinkled, aged appearance.
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Each year billions of dollars are spent on cosmetic products in an attempt to achieve fresh, youthful looking skin. Despite advertising claims, lotions and skin care products can not repair sun damaged skin.
To improve smoothness and texture, the skin must be resurfaced.
Resurfacing removes old, damaged skin allowing new skin to take its place. Freckles, brown spots, fine wrinkles and acne scars can be removed using this technique.
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Chemical peeling has been practiced for over a century with renewed interest occurring over the past 10 years.
Advances in chemical peeling techniques allow treatment to be performed safely and easily as a day procedure.
What is a chemical peel?
In this procedure the skin is peeled to remove damaged sun affected layers. It freshens up the skin, giving a healthier complexion. A chemical peel also removes freckles, sun spots, brown marks and even superficial wrinkles.
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How does chemical peeling work?
An acid solution is applied to the skin. This destroys the top layers of the skin which have received the most sun damage.
The skin then regenerates itself by forming new skin layers which come from the depths of the hair follicles. This new skin has not been sun exposed and is therefore fresher, unblemished skin. It has been protected by being deep in the hair follicles.
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What are the types of chemical peel?
Superficial Chemical Peel
It is performed by using either 20% trichloracetic acid (TCA) solution or Jessner’s solution.
It is performed in the doctor’s surgery. Peeling occurs for 2-3 days and the skin is healed in 4-5 days.
This peel causes minimal pain and minimal disruption to your lifestyle. It may be repeated every few months. Complications with superficial peeling are rare.
Medium Depth Chemical Peel
This is the most common peel. A solution of 35% trichloracetic used with or without Jessner’s solution.
This peel removes most of the sun damaged skin. It will remove freckles, sun spots and fine wrinkles, especially around the eyes.
It is more painful and takes 7 days for the skin to heal, so one week off work is necessary.edium depth peels can be performed either in the doctor’s surgery or Day Procedure Theatre.
Sedation is necessary as the procedure is painful. However, after the procedure pain is minimal in most cases.
Complications with medium peeling are uncommon.
Deep Chemical Peels
These peels are performed using the Phenol. All sun damaged skin is removed and deep wrinkles disappear.
This procedure must be done in an operating theatre with heart monitoring as abnormal heart rhythms can occur.
It usually takes 10 – 14 days to recover from deep chemical peeling and redness of the skin may persist for 2-3 months. Complications are more common with deep peels.
What complications can occur?
Infection
This is rare. Infection can be treated with antibiotics.
Cold Sores
Cold sores may be stirred up by chemical peeling. It is best to take Zovirax before and after chemical peeling to prevent this complication.
Pigment change
Following a chemical peel your skin may develop an increase in pigmentation. This is more likely in darker skinned individuals. It may also occur if you are exposed to the sun within 3 months of a chemical peel. Pigmentation can be prevented by using a broad spectrum sunscreen and a de-pigmenting lotion.
A decrease in skin pigmentation (paler skin) may occur after chemical peel. This is more likely to occur with deep peels. It is much less likely to occur with medium or superficial peels.
Skin Redness
Redness will occur for a few weeks after a chemical peel. It may last up to three months with deep peels. This redness can be covered with special make-up.
Scarring
This is rare with superficial and medium depth peeling. It is more likely to occur with deep peels. Scarring can be treated by injecting the scars with cortisone. This may need to be repeated every month until the scarring disappears.
Demarcation lines
If a localised area of the face is peeled, there may be a demarcation zone between this area and non-peeled skin. It is best to peel the whole face or at least a whole cosmetic unit.
Lack of expected result
People may have unrealistic expectations about chemical peeling. Medium depth peels will not remove all wrinkles.
Will I need to be hospitalised?
Most chemical peels are performed in the surgery with sedation. Hospitalisation is rarely needed.
What can I expect the day after the chemical peel?
- You will have some swelling of the face, especially around the eyes.
- Your freckles will look darker
- You should have no or very little pain
- You will need to take antibiotics, Presnisolone and Zovirax tablets
- You will need to apply Vaseline to your face every 3-4 hours
- It is wise to take 2 sleeping tablets at night
What will happen over the next few days?
Your skin will start peeling slowly. Do not pick off the skin. Let it come off by itself. You should continue to apply Vaseline. Once the skin has completely peeled you can apply sunscreen and foundation. This usually occurs on day 7.
What precautions are necessary after chemical peel?
Avoid the sun for three months. This means complete sun protection with a broad spectrum sunscreen and foundation.
How long will the improvement last?
This varies from person to person and according to the depth of the peel.
Peels may be repeated every few months if necessary.
If you keep out of the sun the effectiveness of the peel will last much longer.
When can I go out socially?
Usually on the 7th day. You can also go back to work.
Is this procedure suitable for you?
- Chemical peel is suitable for people with sun damaged and prematurely aged skin. Fine lines are often improved or eliminated
- It is an excellent procedure for removing freckles and brown blotches
- It will often help remove scaly sunspots and pre-cancerous legions
- It may be helpful in acne scarring providing the scars are not too deep
Is this procedure unsuitable for you?
- If you have dark or Asian skin this procedure is unsuitable
- If you have olive skin this procedure may be unsuitable. You may need a test area done before chemical peeling If you have deep acne scars, other procedures may be more suitable
What are the alternatives?
Laser Rejuvenation
Laser can be used to resurface the skin, layer by layer until the skin contour is smoothed out.
Because laser is bloodless, the skin structures can be clearly seen and the correct amount of tissue is removed. This is a major advantage over chemical peel where the exact depth the chemical penetrates cannot be seen.
The Q switched pigment laser enables brown “age” or “live” spots to be removed leaving the skin with normal pigment and texture.
Alfa Hydroxy Acids (fruity acids)
Applied under medical supervision, high strength glycolic acid (50-70%) produces peeling of the skin but will not remove wrinkles.
Lower strength (10% or less) over the counter preparations may have little or no effect.
