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A chemical peel involves the use of a chemical solution to improve and smooth the texture of the facial skin by removing its damaged outer layers. It is helpful for those individuals with facial blemishes, wrinkles and uneven skin pigmentation. Chemical peels are classified as superficial, medium and deep, depending on the depth of penetration by the agent.
Superficial Peels
Superficial peels treat the outer layer of the skin called the epidermis and mildly stimulate collagen formation in the uppermost part of the dermis. Alpha-hydroxy acids (AHAs) such as glycolic acids are commonly used to help smooth dry and rough skin, improve the texture of sun-damaged skin, and even out skin tone. AHAs are often referred to as fruit acids derived from sugar cane, citrus fruits and grapes. The recovery is short, and usually consists of some flaking and redness for several days. A series of treatments is generally required to obtain the best results. Results of an AHA peel are temporary. Periodic treatments are recommended to maintain the results.
Medium Peels
Medium peels treat deeper layers of the skin (the dermis). Trichloroacetic acid (TCA) is the preferred chemical for this type of peel. The usual candidate for a medium peel is someone with fair skin. It is sometimes combined with other treatments such as Jessner’s solution (containing lactic acid, salicylic acid and resorcinol), to intensify the effect. TCA treats the epidermis and upper dermis and causes the skin to peel within 5 to 7 days. A mild analgesic (like Tylenol) may be used to ease the burning and throbbing that occur with the peel. Immediately after the treatment a white frost forms from coagulation of the epidermis. The white frost quickly disappears as the treated area takes on a red, dark appearance, occasionally accompanied by swelling. Within a day the skin is brown in color and after several days a scab or crust forms. The scab generally persists for 7 to 12 days.
Medium peels can be used to treat a number of skin conditions, but they are most often used to treat the effects of sun damage including brown spots and wrinkles. Sometimes, a series of medium peels is required to achieve the best result.
Deep Peels
Deep peels cause similar but more intensified effects than medium peels. These peels, often accomplished by the use of phenol, produce the most dramatic results but are the most painful and require the most post-treatment care. Damage extends to the mid dermis. After a deep peel, the area is swollen and raw. The proper post-treatment care is essential to avoid complications and produce the best results. This often involves the use antibiotics, compresses, special soaks and ointments. Normal activities are usually resumed after 2 weeks. After the scab heals, the skin appears red for 2 to 3 months. A single treatment is usually sufficient to provide the desired results.
