Chemical Peel FAQ's

Answers to your most frequent questions about Chemical Peel treatments..

• What is a Chemical Peel?
• What are Salicylic Acid (Light) Chemical Peels
• What are Alpha Hydroxy Acid (AHA) Chemical Peels?
• What are Trichloroacetic Acid (TCA) Chemical Peels?
• What are Phenol (Advanced) Chemical Peels?
• How do Chemical Peels work?
• What do Chemical Peels treat?
• Who is a good candidate for Chemical Peel treatments?
• Who is NOT a good candidate for Chemical Peel treatments?
• How should I prepare for my Chemical Peel treatment?
• How many Chemical Peel treatments will be needed?
• Who should administer Chemical Peel treatments?
• What results should I expect from a Chemical Peel treatment?
• What Can Be Expected During a Chemical Peel?
• What Happens After a Chemical Peel?
• What Are the Possible Complications of Chemical Peels?
• How Should I Care for My Skin After a Chemical Peel?
• How long does a Chemical Peel treatment take?
• Are Chemical Peels safe?
• Are Chemical Peel treatments painful?
• How soon are the results of Chemical Peels noticeable?
• Are there side effects from Chemical Peels?
• How are Chemical Peels different from Microdermabrasion and Laser Resurfacing?

What is a Chemical Peel?

Chemical Peels have been used for decades to revitalize and resurface skin. Also known as chemexfoliation or derma peeling, chemical peels are a technique used to improve the appearance of the skin. In this treatment, a chemical solution is applied to the skin, which causes it to "blister" and eventually peel off. The new, regenerated skin is usually smoother and less wrinkled than the old skin.

Chemical peels are commonly performed on the face, chest and hands. Light, medium and deep peels penetrate to different levels and, consequently, produce different aesthetic results. Generally, the deeper the peel penetrates, the more profound the results, but the more lengthy the recovery period.

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What are Salicylic Acid (Light) Chemical Peels?

Beta hydroxy, salicylic acid chemical peels are known to have superior exfoliating properties without causing the irritation associated with more aggressive peels. Because salicylic acid peels exfoliate both the surface of the skin and within the pores themselves, they are a perfect option for patients who wish to rid themselves of years of dry, dull skin buildup. Salicylic acid facial peels are a safe and effective way to improve the look of sun-damaged and aging skin, and they are also beneficial in the reduction of mild acne scars.

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What are Alpha Hydroxy Acid (AHA) Chemical Peels?

Glycolic acid peels are the most common chemical facial peels using alpha hydroxy acid, or AHA. Glycolic peels are acids used to exfoliate the skin. These peels have been shown to improve fine lines and wrinkles, smoothen mild acne scars, reduce the appearance of light brown spots, and give a refreshing glow to your skin. After the peel, your skin will be red and you will have a sunburn feeling, but you are able to return to normal activities. It is recommended that makeup not be applied for 24-48 hours.

Glycolic acid peels are often used in conjunction with microdermabrasion treatments to produce faster and more dramatic results. If you have moderate wrinkles, acne scarring, or skin discoloration, glycolic acid peels may be the solution for improving your complexion.

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What are Trichloroacetic Acid (TCA) Chemical Peels?

TCA chemical peels are mid-level peels that involve applying trichloroacetic acid to the skin. TCA peels are done on an outpatient basis, but may require light sedation depending on the concentration of trichloroacetic acid used. Higher concentrations of acid will penetrate the skin more deeply, resulting in more dramatic improvements, but may also cause more patient discomfort during the procedure and a longer recovery time afterward.

Though TCA chemical peels are applied in the same way as more mild chemical peels, the acid used in TCA peels is much more potent, causing a more significant burn. After TCA peels, a superficial crust forms over the treated area, then peels off within three to seven days. The newly revealed skin may appear reddish, but the discoloration will soon fade to reveal dramatically improved texture, color, and overall appearance. TCA chemical peels are popular because they are an excellent "spot" treatment, can be used on any exposed area of the body, and can be completed in as little as 15 minutes.

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What are Phenol (Advanced) Chemical Peels

Phenol chemical peels are the most aggressive of the skin peels available today. A phenol peel is a good remedy for severely sun damaged and wrinkled skin because it actually bleaches the skin. Phenol peels are performed under carefully monitored conditions, because anesthesia is usually required for the discomfort associated with this intensive chemical peel. Furthermore, patients should be cautioned that in rare cases, phenol peels have had adverse effects on the heart. Because a phenol peel uses carbolic acid to bleach the skin, this procedure is not suitable for treating selected areas, but rather must be used for full-facial peeling.

Patients are often amazed at the dramatic rejuvenation they see after a phenol peel: their skin is much brighter, more elastic, and the appearance of even deep wrinkles and severe discoloration is significantly reduced. A phenol peel will literally take years off your look.

A phenol peel treatment usually takes between one and two hours, during which time the patient is sedated. After a phenol peel, the patient's face will be swollen and uncomfortable. Full recovery after a phenol peel can take up to a month, but patients will begin to see results in only seven to ten days. Patients must be aware that their new skin will be unable to tan, and therefore it is important to take proper precautions against sun damage after treatment with this highly effective facial chemical peel.

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How does a Chemical Peel work?

The skin is thoroughly cleansed with an agent that removes excess oils and the eyes and hair are protected. One or more chemical solutions, such as glycolic acid, trichloroacetic acid, salicylic acid, lactic acid or carbolic acid (phenol), are applied to small areas on the skin. These applications produce a controlled wound, enabling new, regenerated skin to appear.

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What skin conditions can be treated Chemical Peel?

All chemical peels reduce fine lines, wrinkles, pore size, scars, age spots and other signs of premature aging. However, the results will depend on the type of peel performed, and in the case of light or medium peels, may require subsequent procedures for more long-lasting results.

Chemical Peels improve:

• Reduce fine lines under the eyes and around the mouth.
• Treat wrinkles caused by sun damage, aging and hereditary factors.
• Improve the appearance of mild scarring.
• Treat certain types of acne.
• Reduce age spots, freckles and dark patches due to pregnancy or taking birth control pills (melasma).
• Improve the look and feel of skin that is dull in texture and color.
• Areas of sun damage, which may contain pre-cancerous keratoses that appear as scaly spots, may improve after chemical peeling.

However, sags, bulges and more severe wrinkles do not respond well to chemical peels. They may require other kinds of cosmetic surgical procedures, such as carbon dioxide laser resurfacing, a facelift, brow lift, eyelid lift or soft tissue filler (collagen or fat).

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Who is a Good Candidate for Chemical Peel treatments?

Generally, fair-skinned and light-haired patients are ideal candidates for chemical peels. Good results may also be achieved for persons with darker skin, depending upon the type of problem being treated.

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Who is NOT Good Candidate for Chemical Peel treatments

Chemical peels are not for everyone. Persons who are in poor general health should not get peels. Also, active infections and certain medications (such as Accutane) may preclude the use of certain types of chemical peels, especially medium and deep peels. Sometimes, people with abnormal scarring, certain skin diseases, or recent surgeries should not have a chemical peel. You and your physician should decide if chemical peels are safe for you.

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How should I prepare for my Chemical Peel treatment?

Prior to your chemical peel, you may be asked to stop taking certain drugs and prepare your skin with topical preconditioning medications such as Retin-A, Renova, or glycolic acid. If you have been prescribed oral antibiotics or an oral antiviral medicine, you should begin taking those as directed. Typically, the oral antibiotics are prescribed depending on the depth of the chemical 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.

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How many Chemical Peel treatments will be needed?

Mild peels may be repeated at one to four-week intervals until the desired clinical effect is achieved. However, a single peel will give your complexion a healthy, radiant glow within a week.

Medium-depth peels may be repeated in six to twelve months, if necessary.

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Who should administer Chemical Peel treatments?

It is very important that you find a physician who has adequate training and experience in skin resurfacing. Your physician may offer you a choice of peel techniques or suggest a combination of peels to obtain the best result for you.

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What results should I expect from a Chemical Peel treatment?

The results of a chemical peel vary depending on the peel that you receive. A superficial peel only slightly reduces the signs of aging and skin damage and the results are minimal. Medium peels are effective in reducing signs of sun damage and fine wrinkles. A deep peel noticeably tightens the skin and eliminates wrinkles and the effects are commonly dramatic. Repeated deep peels are not recommended.

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What Can Be Expected During a Chemical Peel?

During a chemical peel treatment, most patients experience a warm to somewhat hot sensation that lasts about 5 - 10 minutes, followed by a stinging sensation. Cool compresses may be applied to help alleviate this stinging. A deeper peel may require pain medication or general anesthesia during the procedure.

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What Happens After a Chemical Peel?

Depending upon the type of chemical peel, a reaction similar to sunburn occurs following the procedure. Peeling usually involves redness, followed by scaling that ends within three to seven days.

Medium-depth and deep peeling may result in swelling, as well as the presence of water blisters that may break, crust, turn brown and peel off over a period of seven to 14 days.

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What Are the Possible Complications of a Chemical Peel?

In certain skin types, there is a risk of developing a temporary or permanent color change in the skin. Taking birth control pills, subsequent pregnancy or family history of brownish discoloration on the face may increase the possibility of developing abnormal pigmentation.

Although low, there is a risk of scarring in certain areas of the face, and certain individuals may be more prone to scarring. If scarring does occur, it can usually be treated with good results.

There is a small risk of reactivation of cold sores in patients with a history of herpes outbreaks. This problem is treated with medication as prescribed by the physician. Your doctor may also choose to give you medication before or immediately after the peel in order to prevent a herpes outbreak.

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How Should I Care for My Skin After a Chemical Peel?

After treatment, some peels may require bandages to be placed on part or all of the skin that is treated. Bandages are usually removed in several days and may improve the effectiveness of the treatment. It is important that you avoid over-exposure to the sun after a chemical peel since the new skin is fragile and more susceptible to complications.

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How long does a Chemical Peel treatment take?

The medical peel process takes about 15-20 minutes. Although the results are usually not permanent, maintained improvement can be accomplished by periodic treatments.

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Are Chemical Peels safe?

Chemical Peels are normally a safe procedure, however, as with any medical procedure, they have some potential risks and complications. Adverse reactions can include scarring, numbness, and infection. After mild to medium peels, patients can reasonably expect mild irritation, redness, and peeling. This usually lasts only for a few days. More advanced chemical peels may require more recovery time, and the peeling and/or crusting of the skin will be more pronounced.

Phenol peels, because they require anesthesia, do pose some risk to the patient's heart. However, when the procedure is properly performed under close and qualified supervision, these risks are minimized. The great majority of persons undergoing chemical peel treatments experience no ill-effects as a result of their procedures. Refer to Chemical Peel Side Effects.

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Are Chemical Peel treatments painful?

You may experience a warm or tingling sensation and depending upon the strength of the peel, a stinging sensation.

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How soon are the results of Chemical Peel treatments noticeable?

You will start noticing pink, fresh skin emerging from under the peeling, damaged skin. Do not pull or rub the damaged skin off. Within a few weeks the pinkness will fade for most, light peels. Depending upon the depth and type of the peel, you may have lingering pinkness resembling mild sunburn or flushed appearance.

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Are there side effects from Chemical Peels?

Any chemical peel procedure is associated with some risk for side effects of chemical peels. Common side effects of chemical face peels that can occur during recovery include, stinging, tightness, redness, a feeling comparable to a sun burn, and irritation. These side effects of chemical face peels are generally mild and subside within a few days. In very rare cases, the side effects of chemical face peels can include infection and scarring.

The lighter peels pose less risk for side effects of chemical face peels, though patients may still experience some of the aforementioned recovery side effects of chemical face peels. Medium depth chemical peels are associated with a greater risk for side effects of chemical face peels. Deeper chemical peels carry a greater risk of side effects of chemical face peels. Phenol treatments may result in a patient’s inability to produce pigment in the skin or tan. The side effects of chemical face peels for these peels can also include pigment imperfections and lines of demarcation.

It is crucial for any chemical peel patient to avoid the sun when possible and comply with all after care instructions after this procedure to mitigate their risks for side effects of chemical peels.

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How are Chemical Peels different from Microdermabrasion and Laser Resurfacing?

The most relevant difference between chemical peels and microdermabrasion is that microdermabrasion is a non-chemical procedure, and attacks imperfections by actually "sanding" flaws from the skin surface. While treatment plans for microdermabrasion and mild chemical peels like glycolic acid (AHA) chemical peels are similar, with up to eight procedures repeated at one to two week intervals, more advanced chemical peels require only one session. However, deep chemical peels like the phenol peel also require much more recovery time than microdermabrasion and the more mild peels. Also unlike microdermabrasion, deep chemical peels change the actual pigmentation of the skin through bleaching. Because of this, microdermabrasion is more suitable for patients with naturally darker complexions.

The benefits and drawbacks of chemical peels versus laser resurfacing are somewhat more difficult to determine, due to the relatively new nature of the laser resurfacing procedure. However, recent research has shown that on a microscopic level, the improvement to patients' skin after laser skin resurfacing was essentially equivalent to that seen with chemical peels and microdermabrasion. Lasers do allow doctors to target specific flaws and imperfections with much more precision than chemical peels, and there is no risk of a change of pigmentation with laser treatments as there is with the more aggressive chemical peels.

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For more information about Chemical Peel treatments...

We'll be glad to answer your Chemical Peel questions personally, so don't hesitate to call or email The Elizabeth Roche M.D. Med Spa in New Jersey at 201-505-1020.