CHEMICAL PEEL

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 your surgeon 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.

Peel formulas at a glance

Alphahydroxy acids (AHAs)
Uses:

• Smooths rough, dry skin

• Improves texture of sun-damaged skin

• Aids in control of acne

• Can be mixed with bleaching agent to correct pigment problems

• Can be used as TCA pre-treatment

Considerations:

• A series of peels may be needed

• As with most peel treatments, sunblock use is recommended

Trichloroacetic acid (TCA)
Uses:

• Smooths out fine surface wrinkles

• Removes superficial blemishes

• Corrects pigment problems

Considerations:

• Can be used on neck or other body areas

• May require pre-treatment with Retin-A or AHA creams

• Treatment takes only 10-15 minutes

• Preferred for darker-skinned patients

• Peel depth can be adjusted

• Repeat treatment may be needed to maintain results

• Sunblock must be used for several months

• Healing is usually quick, much quicker than with a phenol peel

Phenol
Uses:

• Corrects blotches caused by: sun exposure, birth-control pills, aging

• Smooths out coarse wrinkles

• Removes pre-cancerous growths

Considerations:

• Used on the face only

• Not recommended for dark-skinned individuals

• Procedure may pose risk for patients with heart problems

• Full-face treatment may take one hour or more

• Recovery may be slow - Complete healing may take several months

• May permanently remove facial freckles

• Sun protection, including sunblock, must always be used

• Results are dramatic and long-lasting

• Permanent skin lightening and lines of demarcation may occur

Planning for a chemical peel
In some states, no medical degree is required to perform a chemical peel - even the strongest phenol peels. Many states have laws that permit non-physicians to administer certain peel solutions, but regulate the strengths which they are permitted to apply. You should be warned that phenol and TCA peels have been offered by inadequately trained practitioners claiming "miracletechniques" to rejuvenate the skin.

It is very important that you find a physician who has adequate training and experience in skin resurfacing. Your plastic surgeon may offer you a choice of peel techniques or suggest a combination of peels to obtain the best result for you.

During your initial consultation, it is important that you discuss your expectations with your plastic surgeon. Don't hesitate to ask any questions or express any concerns that you may have. Expect your plastic surgeon to explain the planned procedure in detail, including its risks and benefits, the recovery period and the costs. If you have a history of herpes, you should inform your physician prior to the procedure. Remember, chemical peel treatments are usually not covered by medical insurance unless they are performed for medically related problems.

Preparing for your chemical peel
Your plastic surgeon 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 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.

Continue reading about chemical peels in Southern California