How is a chemical peel performed?
You will typically get a chemical peel in a surgeon’s office. Below outlines the general steps for a chemical peel; however, these steps may vary depending on the type of treatment you and your aesthetic plastic surgeon choose (light, medium, deep).
- Your surgeon will clean your skin using a sterile technique to prevent postoperative infections.
- Your surgeon then applies a chemical solution to either your entire face or just to certain problem areas, such as the crow's feet area around your eyes or the vertical wrinkles around your mouth.
- Your surgeon applies the chemical solution lightly or rubs it more vigorously onto the skin using a sponge, cotton pad, swab, or brush (avoiding your brows, eyes, and lips).
- During application, you may experience a slight tingling (light to medium peels) or a burning sensation (deep peels).
- Your surgeon will determine the length of time the solution is on your face by carefully observing the changes in your skin. With certain types of chemical peels, the solution may "neutralize" after an appropriate amount of time has elapsed.
- With light to medium peels, you will not need a covering or after-peel ointment, and you can have little to no downtime.
- However, after a deep peel, your surgeon will apply a thick coating of petroleum jelly or another protective ointment over your face, covering the protective crust that develops rapidly over the area. You’ll need to leave this on for one to two days. In some cases, your surgeon may apply dressings, tape, or a bandage (this is particularly effective in cases of severe wrinkling). A deep peel requires a longer recovery period.
What are my chemical peel options?
There are several chemical peel options available. The different types of chemical peels vary according to their specific ingredients and strength. The depth of a chemical peel depends on factors such as how long the peel remains on your skin and how your surgeon applies the peel onto your skin.
Your aesthetic plastic surgeon will select an option based on the extent of your skin damage and your desired outcome. You’ll also want to consider the amount of time you have for recovery when selecting a particular chemical peel or determining the extent of your treatment.
Light to Medium Chemical Peels
Glycolic (AHA) Peel
Generally, the most superficial peels are those using alpha hydroxy acids (AHA), such as glycolic, lactic, or fruit acid. AHA peels can reduce the effects of aging and sun damage, including fine wrinkling and brown spots. Sometimes a single treatment with an AHA peel will give your skin a fresher, healthier appearance and a radiant glow. This treatment does not require anesthesia, and you will only feel a tingling or mild stinging sensation when the surgeon applies the solution. Immediately after the procedure, you will likely be able to wear makeup and can drive yourself home or back to work. Your surgeon can apply various concentrations of an AHA weekly or at longer intervals to further improve the texture of your skin. Your surgeon may recommend a maintenance program using AHA products that you can apply at home on a regular basis.
Trichloracetic (TCA) Acid Peel
A TCA peel is a stronger, medium depth peel. TCA peels can treat wrinkles, skin pigment changes, and blemishes. In addition to your face, you may also want to consider having a TCA peel on your neck and other parts of the body that have sun damage. Surgeons often prefer TCA formulas for spot peeling limited areas, such as around your mouth or eyes, because they have a reduced bleaching effect compared to phenol peels. Some surgeons have found TCA effective in treating darker-skinned patients. Your surgeon can repeat milder TCA peels frequently to achieve cumulative effects. Or your surgeon can use TCA to achieve a medium or even a deep peel, depending on the acid concentration and manner of application.
Deep Chemical Peels
Phenol Peels
A phenol peel is a deep peel that surgeons sometimes recommend when treating severe wrinkles (from fine lines to deep creases), sun damage, uneven skin tone and texture, and in some cases, precancerous skin conditions. Phenol is particularly useful for minimizing the vertical lines that often form around the mouth as a result of aging. Deep peels take longer to perform and will leave a healing crust on the skin that your surgeon covers with protective ointment. With a phenol peel, you will experience a burning sensation, but the solution also acts as an anesthetic. Phenol often has a significant bleaching effect, and you may need to wear makeup in order for your treated skin to match the skin color of the surrounding areas. Phenol cannot be used on your neck or other parts of your body. A phenol peel is the most serious procedure of all the chemical peel options. It is important you find a board-certified aesthetic plastic surgeon who specializes in chemical peels to complete your treatment.
Croton Oil Peels
Croton oil enhances the penetration of phenol and the depth of the peel. This peel treats severe wrinkles caused by sun damage and extensive acne damage. The ideal patient has fair, dry skin. This peel is painful, and likely will require intravenous sedation or general anesthesia. The pain should subside the following morning.