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Chemical Peel
in Bethesda Maryland - Washington DC Metro Area
Chemical peel uses a chemical solution to improve and smooth the texture of the facial skin by removing its damaged outer layers. Phenol, trichloroacetic acid (TCA) and alpha-hydroxy acids (AHAs) are used for this purpose. Chemical peel may slow down the aging process; however it is not a substitute for excess skin that needs an excision.
How chemical peel can help you
If you have facial blemishes, wrinkles or uneven skin pigmentation, then chemical peel may be for you. Chemical peel may also remove pre-cancerous skin growths, soften acne facial scars and even control acne.
Your surgical consultation
Your physician will evaluate your general health and skin condition to determine the type of chemical peel that will produce your desired results. Several chemical peel formulas are available for consideration.
Alpha-hydroxy acids (AHAs), such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels. These types of peels can provide smoother, brighter-looking skin for people who can't spare the time to recover from a phenol or TCA peel. AHA peels may be used to treat fine wrinkling, areas of dryness, uneven pigmentation and acne. Various concentrations of an AHA may be applied weekly or at longer intervals to obtain the best result. Your doctor will make this decision during your consultation and as the treatment proceeds. An alpha-hydroxy acid, such as glycolic acid, can also be mixed with a facial wash or cream in lesser concentrations as part of a daily skin-care regimen to improve the skin's texture.
Trichloroacetic acid (TCA) can be used in many concentrations, but it is most commonly used for medium-depth peeling. Fine surface wrinkles, superficial blemishes and pigment problems are commonly treated with TCA. The results of TCA peel are usually less dramatic than and not as long-lasting as those of a phenol peel. In fact, more than one TCA peel may be needed to achieve the desired result. The recovery from a TCA peel is usually shorter than with a phenol peel. With a TCA peel, your healed skin will be able to produce pigment as always; the peel will not bleach the skin. However, TCA-peel patients are advised to avoid sun exposure for several weeks after treatment to protect the newly formed layers of skin. Even though TCA is milder than phenol, it may also produce some unintended color changes in the skin. Thirty to thirty-five percent peel is used for a deeper peel and eighteen percent (Obagi or blue peel) is used for a lighter peel.
Phenol is the strongest of the chemical solutions and produces a deep peel. It is used mainly to treat patients with coarse facial wrinkles.
Additionally, a patient may be a candidate for skin care by themselves using a variety of products available in the office.
The surgery
You may have to spend a month or more in a skin pre-treatment phase before your physician will schedule your actual peel. For example, 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.
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.
AHA peels/treatments: Your doctor will apply the AHA solution 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 plastic surgeon may add Retin-A or a bleaching agent to your at-home treatment schedule. After several weeks of at-home use, your doctor will examine your skin to determine if your regimen needs adjustment.
TCA peels: Typically, the skin is first thoroughly cleansed. Then, the surgeon will carefully apply the phenol or TCA solution. 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. Two or more TCA peels may be needed to obtain the desired result, and those may be spaced out over several months. Mild TCA peels may be repeated as often as every month.