Procedure Description: Chemical peeling involves applying a chemical solution to remove the outer layers of skin, revealing a smoother, more evenly pigmented, glowing layer of skin. There are three basic categories of chemical peels. Each type works differently and produces different results. In general, the stronger the chemical, the deeper the peel, and the more impressive the results. However, the deeper the peel, the more pain you’re likely to experience and the longer the recovery time.
Light peels: Alpha hydroxy acid (AHA) and Beta hydroxy acid (BHA) peels are considered light or “lunch hour” peels. They are the mildest of the chemical peels. These peels include glycolic, lactic and fruit acid peels (AHA) or salicylic acid (BHA). They burn off only the outer layers of the skin to smooth out fine wrinkles and/or rough, dry skin. AHA and BHA peels may also be used to improve the texture of sun-damaged skin, balance out skin pigmentation or diminish some types of acne scars. These peels are often repeated to achieve the desired results.
Medium peels:Trichloroacetic acid (TCA) peels, which are considered medium-depth, involve applying a TCA solution to the skin. TCA peels are generally used to treat skin with moderate sun damage, surface wrinkles, and/or uneven tone or pigment abnormalities. Full-face TCA peels take approximately 15 minutes. Generally, TCA peels are performed in the doctor’s office or in a surgery center as an outpatient procedure.
Deep peels: Phenol acid is the strongest chemical peel solution, used for the deepest possible chemical peel. Phenol peels are used to treat skin with coarse wrinkles and blotchiness. They may also be effectively used to treat patients with pre-cancerous growths.
Length of Procedure: AHA and TCA peels for the full face generally take about 30 minutes. Full-face phenol peels may take between one and two hours. Phenol peels for small portions of the face, such as the upper lip, may take only 10 to 15 minutes.
Recovery: After a chemical peel, most people experience some facial swelling and reddening. Your doctor may advise you to keep your head elevated. The recovery period is different for each type of peel.
Light peels: Alpha hydroxy acid (AHA) peels generally cause some flaking, redness and dryness, or skin irritation. These side effects diminish over time. Once the body heals itself naturally, the outer layer of skin will fall away. Patients are usually able to engage in normal public activities the day after an AHA peel.
Medium peels: Trichloroacetic acid (TCA) peels may cause significant swelling, depending on the potency of the chemical solution used. Swelling should diminish after the first week. The skin will heal sufficiently to resume normal activities in approximately 7 to 10 days. After TCA peels, some patients also have outbreaks of small whiteheads, called milia, which are formed in obstructed facial glands. Generally, these disappear with washing, but in some cases a doctor will need to remove them.
Deep peels: After a phenol acid peel, your doctor may prescribe a mild pain medication to relieve any discomfort. If a waterproof adhesive is applied to the treated area, it will be removed in 1 to 2 days, and you’ll be instructed to cover the area with antiseptic powder several times a day. A scab will form and, within 7 to 10 days, new skin will form. While the skin will be red at first, the color will lighten over a few weeks to a few months. After any peel, it is critically important that the skin be protected from the sun. Ask your doctor to recommend a sunblock with both UVA and UVB protection, and apply it daily.
Risks: Significant complications with chemical peels are infrequent, but potential complications include:
- scarring;
- infection;
- temporary or permanent changes in skin tone or uneven tone (especially with phenol peels). These include: hyperpigmentation (a darkening of the skin, treatable in most cases with current bleaching techniques) ; hypopigmentation (a lightening of the skin, more difficult to treat);
- cold sore breakouts in patients who have a history of recurring blisters and cold sores, like herpes and shingles. (An anti-viral medication taken before the procedure can help prevent this.);
- risks for those with a family history of heart disease (phenol peel only).
Results: A chemical peel is long-lasting and can restore a more youthful appearance to wrinkled, unevenly pigmented, sun-damaged or blotchy skin. However, a peel cannot reverse the aging process or completely remove deep scars. Light peels are often repeated to achieve the desired results. For medium peels, sometimes two or more TCA peel treatments, at intervals of one to two months, are necessary to achieve the desired results. Unlike AHA and TCA peels, deep phenol peels are only used once and create dramatic results.
Estimated Cost: Costs vary among treatment providers and skincare manufacturers. Often, treatment providers will offer packaged pricing for multiple treatment sessions and the aftercare skincare regimen. Costs for the peel itself can range from $75 to $600 or more. Annual costs for a daily skincare regimen can be $750 or more.
