Chemical Peel

Chemical peeling is a process whereby a chemical solution is applied to the surface of the skin to peel away the outermost skin cells.  The body’s natural healing process then promotes the emergence of fresh, new skin. 

Who can benefit from a chemical peel?

Chemical peels can rejuvenate the skin of men and women of all ages. Although there are peels of varying strength levels to fit almost anyone, it is still important to consider your skin type.  The best candidates are usually those with fair, thin skin that has a tendency toward fine wrinkling or scarring on the face. Deeper chemical peels are usually not recommended for highly pigmented skin, such as Asian, black and Mediterranean, or oily, complexions.

A chemical peel can correct or improve the appearance of many superficial skin conditions.  Some of the common treatment applications include the following:

  • Reduction of fine wrinkles
  • Improve skin texture
  • Softening of scars and acne scars
  • Correction of uneven pigment
  • Removal of blemishes

We are fortunate to have several different types of chemical peels to suit the needs of different people with different skin types and skin problems.  A customized formula is often tailored to meet your needs.  Some of the most common solutions include the following:

Your Chemical Peel Consultation

During your free initial consultation, it is important that you discuss your expectations with Dr. Branman.  Don't hesitate to ask any questions or express any concerns that you may have. The procedure will be explained in detail, including its risks and benefits, the recovery period and the costs.

Before the Chemical Peel

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.  Most patients are given a prescription for an antiviral and antifungal to help prevent viral outbreaks and fungal infections.

Where will the peel be performed?

Most chemical peels may be safely performed in our office, or in an outpatient surgical center.  Anesthesia is not required for most peels. However, sedation may be used before and during the procedure to relax you and keep you comfortable.No anesthesia is needed for AHA peels since they cause only a slight stinging sensation during application.

The Chemical Peel Procedure

AHA peels/treatments: AHA solution will be applied to your cleansed facial skin, a process that usually takes no more than 10 minutes. No "after-peel" ointment or covering is required. Depending on the strength of the peel, periodic treatments may be necessary until the desired effects are achieved.  For some patients, the application of an AHA-based face wash or cream once or twice a day at home will be sufficient to accomplish the desired goal. Your cosmetic surgeon may add Retin-A or a bleaching agent to your at-home treatment schedule. After several weeks of at-home use, your skin will be examined to determine if your regimen needs adjustment.

Phenol and TCA peels: Typically, the skin is first thoroughly cleansed. Then the phenol or TCA solution is applied. You may feel a stinging sensation as the peel solution is applied, but this feeling will quickly pass.  A full-face TCA peel usually takes no more than 15 minutes. 

With phenol solution, Dr. Branman may coat the treated area with petroleum jelly or a waterproof adhesive tape. With lighter peels, no covering is necessary.  A full-face phenol peel generally takes one or two hours to perform, while a phenol peel to a smaller facial region (perhaps the skin above the upper lip) may take only 10 or 15 minutes. A single treatment usually suffices.

After the Chemical Peel

After an AHA peel, it is common to experience some temporary flaking or scaling, redness and dryness of the skin. However, these conditions will disappear as the skin adjusts to treatment.

After a phenol or TCA peel, your doctor may prescribe a mild pain medication to relieve any tingling or throbbing you may feel. If tape was used to cover your face, it will be removed after a day or two. A crust or scab will form on the treated area. To help your face heal properly, it is essential that you follow your doctor's specific post-operative instructions.

A TCA peel may also cause some swelling, depending on the strength of the peel used.
With stronger phneol peels, the swelling may be more noticeable.  You will need someone to help care for you for a day or two. In some cases, a liquid diet and will be necessary and activities will have to be limited. 

Returning to Normal

With an AHA peel, the temporary redness, flaking and dryness that you experience will not prevent you from working or engaging in your normal activities. A fresher and improved skin texture will result with continued AHA treatments. Remember, protecting your skin from the sun is also important following these mild acid peels. Ask your doctor to recommend a sunblock with adequate UVA and UVB protection and use it every day.

With a TCA peel, the moderate discomfort and mild swelling you may experience will subside within the first week. In about a week to ten days, your new skin will be apparent and you should be healed sufficiently to return to your normal activities. It is best to avoid sun exposure unless you are adequately protected.

With a phenol peel, new skin will begin to form in about seven to ten days. Your face will be very red at first, gradually fading to a pinkish color over the following weeks to months. During this time, it is especially important that you use a sunblock or blotchy, irregular skin coloring may result.

About two weeks after treatment, you may return to work and resume some of your normal activities. Your skin should be healed enough for you to wear makeup. (For makeup tips, ask your cosmetic surgeon for the ASPS brochure on camouflage cosmetics.)

Chemical Peel Results

Improvements from AHA peels may be very subtle at first. You may detect a healthier glow to your skin. With continued treatments, you will notice a general improvement in the texture of your skin. The results of a TCA peel are usually not as enduring as those of phenol peel. However, your skin will be noticeably smoother and your complexion will be improved. If you're planning a phenol peel, you can expect dramatic improvement in the surface of your skin, with fewer fine wrinkles, fewer blemishes and more even-toned skin. Your results will be long lasting, although not immune to the effects of aging and sun exposure.

Chemical Peel Risks

Like all surgery, chemical peels involve some level of risk. Chemical peels are a normally safe and popular way to treat facial wrinkling and fine scarring. To help ensure a successful outcome, the patient should be a good candidate, the surgeon should be well trained in chemical peeling techniques, the surgical facility should be properly equipped and the patient should follow the doctor's instructions and advice.

While complications are uncommon, you should discuss the risks and possible side effects with your doctor. Patients with liver, kidney or heart ailments need to make their cosmetic surgeon aware of them.

You should have realistic expectations and realize that the true results may not be apparent for up to a year. Chemical peels can offer softer, smoother skin to those who never thought it was possible. Discuss the benefits and risks with your surgeon given your particular circumstances.