Chemical Peels

Chemical peels are an immensely popular cosmetic procedure with total chemical peel procedures done in 2009 amounting to 1,142,949 peels of varying types. Chemical peels are also known as chemexfoliation or derma-peeling, and are a technique used to improve the appearance of the skin. In this treatment, a chemical solution is applied to the skin, which causes it to react and eventually flake or peel off. The new, regenerated skin is usually smoother and less wrinkled than the old skin. The new skin also is temporarily more sensitive to the sun. Even if the flaking or peeling reaction is not seen, the skin still benefits through skin cell turnover, the surfacing of new skin cells that are better at creating collagen, better at regulating pigment, and better at protecting from skin cancer.
Chemical peels are said to have been used since ancient times, notably in Cleopatra’s Egypt women used goat’s milk or soured goat’s milk, as well as fermented grape peels on their skin. This makes sense as the lactic acid in the goat’s milk is even now considered a hydrating agent, and the resveratrol found in fermented grape skins is currently a very hot topic as an anti-aging molecule.
Some of our more modern peels were not discovered or invented until the 19th century. Two of the earliest chemical peels were phenol and trichloracetic acid, which were very powerful. Increasingly, the trend in peels is to use less aggressive, less powerful peels, in a series, to achieve good results and avoid potential undesirable side effects. Where deeper effects are wanted, currently lasers are used because of their greater precision.
What conditions are treated by a chemical peel?
Chemical peels can be performed almost anywhere on the body and are commonly performed on the face, neck, or hands. They can be used to:
Reduce fine lines under the eyes and around the mouth
Treat wrinkles caused by sun damage
Improve the appearance of mild scarring
Treat certain types of acne
Reduce age spots, freckles, and dark patches called melasma
Improve the look and feel of skin that is dull in texture and color
Who Is a Good Candidate For a Chemical Peel?
Generally, fair-skinned and light-haired patients are ideal candidates for chemical peels. Darker skin types may also have good results, depending upon the type of problem being treated. However, the risk of an uneven skin tone after the procedure is increased. Sometimes pre-treatment with a lightening agent can help reduce the risk of post inflammatory hyperpigmentation in darker skin types. There are also more gentle peels that do not carry any risk for darker skin types.

Is it safe to have a chemical peel during pregnancy?

Some peels are safe during pregnancy. Usually the peels that are safe during pregnancy are milder and less penetrating, but still beneficial.
How is a Chemical Peel performed?
During a chemical peel, a chemical solution is applied to the skin and allowed to soak in. It may or may not require neutralization. Over the next 1 to 14 days, depending on how deeply the chemical penetrated the skin, the skin flakes or peels off. This procedure destroys parts of the skin in a controlled way so that new skin can grow in its place. The chemicals used are sometimes called exfoliating or wounding agents.

The types of chemical peels differ based on how deeply the chemical penetrates and what type of chemical solution is used. Factors that may affect the depth of a peel include the acid concentration in the peeling agent, the number of coats that are applied, and the amount of time allowed before the acid is neutralized. Deeper peels result in more dramatic effects as well as higher risks, increased pain, and longer healing time.

When will the results of a peel be evident and how long will the results last?

There may be an almost immediate glow to the skin, followed by a period of flaking or mild dryness for a few days to a week. Once the flaking stage is over the skin is softer, smoother, clearer and more even in tone. A series of peels will be additive in effect. Depending on how deep the peel is or how many peels in a series have been done, the effects can last anywhere from 6 weeks to 4 months.

What type of care does the skin need after a peel?

The number one rule after a peel is no sun exposure, so sun block should be worn every day, extended time in the sun should be avoided and a hat should be worn when outdoors in the daytime. The skin will require extra hydration, so a good moisturizer twice a day can be helpful. Avoidance of any aggressive treatments or products for 2-5 days after a peel will allow the necessary healing to take place.

How often can peels be done?

Depending on how sensitive the skin is and how rapid the recovery is, a peel can be done every 2-6 weeks in an initial series. Once the initial series is complete, a maintenance peel can be done every 1-4 months.

Can peels be done with other treatments?

Peels can be done with other treatments or alternated with other treatments. Commonly a mask is applied immediately following a peel for increased effect; the peel allows greater penetration of the mask. Also, peels are often alternated with treatments such as vibradermabrasion (a skin polishing treatment combined with vibrational energy) or collagen stimulating laser treatments.

In summary, there are a variety of types and strengths of peels. One treatment will improve the skin, but a series of peels will create much more improvement. Appropriately chosen peels can be performed safely for all skin types and conditions. Expected results are softer, smoother skin with more even tone. Peels can be combined or alternated with other treatments for even greater effect.