What is a chemical peel?
A chemical peel is the application of a chemical solution to the skin which is designed to correct a variety of problems including sun damage, mild scarring, removal of fine wrinkles and improvement in irregular pigmentation.
A facial chemical peel works like a snake shedding its skin. It causes the even, controlled shedding of several layers of damaged skin cells to leave a new fresh layer of skin which has a more even texture and colour.
|Sun damage can be treated with chemical peels such as TCA. Images reproduced with permission of Dr Davin Lim|
A chemical peel may be superficial or medium or deep depending on how deeply it penetrates the skin. Deep peels are now rarely performed and have been largely replaced by laser ablation.
What is involved in a chemical peel?
A chemical peel may be performed in the doctor’s surgery or day-care facility.
Superficial peels are usually well tolerated without the need for any pain medication. Discomfort may be decreased by using a fan during the peel or by taking two aspirin an hour beforehand. Medium-depth peels will require stronger pain relief, often in the form of a short general anaesthetic.
Initially the skin is cleaned with a liquid soap and then further prepared with alcohol or acetone to remove all oils and grease from the skin surface. Make-up should not be worn on the day of a chemical peel.
The chemical solution is applied in either a single layer or sometimes several layers. Immediately after application, a stinging sensation may be experienced, which subsides within 5 to10 minutes. The solution stays on the skin for a variable period of time, as determined by the practitioner, after which it is removed either with water or a neutraliser. It can be removed earlier if excessive discomfort is experienced.
What happens after a chemical peel?
Recovery time after a peel will depend on its depth.
In the first few days after most peels, the skin turns darker, will feel somewhat tight and then peels or flakes to leave a new fresh layer of skin. There are no scabs, bandages or bleeding.
The recovery period and side-effects of a superficial peel is much less than with a medium-depth peel. It usually takes 3 to 5 days after a superficial peel for the skin to return to normal. It usually takes up to 7 to 10 days after a medium-depth peel for the skin to settle.
How many treatments are needed?
Superficial peels are typically performed between 3 to 6 times, spaced every two weeks or so apart.
Most people are pleased with the result from a single medium-depth peel.
Can a chemical peel be combined with other procedures?
A chemical peel may be combined with other procedures to improve contour and texture of skin. Procedures such as laser treatment, injectable filling agents and muscle relaxants are often combined with chemical peels. (Laser ablation may be performed to treat more heavily wrinkled areas or for pitted scarring. Filling agent injections may be required to touch up wrinkles and scars.)
How much time off work is needed after a chemical peel?
Superficial peels may warrant a day or two off work, although many people are able to cover up with make-up and continue working the next day.
A medium-depth chemical peel may require one week for the skin to heal and it may be beneficial to arrange two weeks off work. At this time the face will be somewhat reddened with an appearance like sunburn but otherwise should appear unaffected. The redness can be camouflaged by a tinted moisturiser or make-up.
Are there any complications with chemical peels?
As with all procedures complications may occur after a chemical peel. The most common is a change in skin colour. People with dark, olive skin are prone to an increase in skin colour. These changes tend to settle over weeks to months, but in rare cases can persistPigment stabilising creams may be used both before and after the chemical peel to try to minimise this complication. A mild decrease in skin colour may be noted after medium-depth facial peeling and there may be a slight demarcation between the peeled and unpeeled skin. The peel usually stops underneath the jawline to minimise such an effect.
Mild scarring can occur in rare cases but usually responds to the use of creams and injections. Rare complications include: bacterial infection, reactivation of cold sores, persistent redness and a more reactive skin for up to six months or so. Occasionally, mild acne-like pimples can occur due to the use of ointment in the post-peel period.
What chemical peels cannot do:
- Chemical peels cannot tighten loose skin; such change may require a surgical procedure e.g. a face-lift.
- Chemical peels cannot improve deep scarring. Laser treatment and other procedures are more effective.
- Chemical peels cannot always totally remove hyperpigmentation in dark-skinned people of Caucasian or Asian background and may not be indicated.
- Chemical peels cannot remove broken blood vessels on the face.
This information has been written by Dr Shawn Richards