Chemical peels achieve smoother, less wrinkled skin and alleviate imperfections, such as splotchy coloration and sun spots. Chemical peels are ideal for removing sun damage due to long-term sun exposure in combination with what is called photo aging or aging due to the sun’s ultraviolet A and B rays. It also achieves smoother skin with removal of fine wrinkles, to even medium-depth wrinkles. Peels can be performed on their own or in combination with other facial plastic surgery procedures. Dr. Perkins often performs chemical peels during facelift and blepharoplasty (eyelid) procedures to enhance the patient’s overall surgical results, as the skin will look as youthful as the newly rejuvenated eyes, neck and jawline. State-of-the-art chemical peeling involves choosing the proper chemical peel agent for the needs of each individual patient in the area of the face, neck or chest that most needs to be treated. It is safe and effective when directed by an experienced facial plastic surgeon.
Many surface or superficial peels can be done by skin care specialists, or estheticians. At Dr. Perkin’s office, we have a medical spa (Spa 170 West) with trained licensed estheticians performing light chemical peels and other treatments to the skin’s surface to improve the texture and discolorations. The estheticians use light settings for laser that, with multiple treatments, can improve some fine line wrinkling. In addition, red colors and brown spots can be treated with the same machine at a different setting called Intense Pulsed Light.
These procedures can be done under either topical numbing anesthesia or without the need for anesthetic and help mild degrees of aging skin and discolorations. However, when one is not achieving their desired results from these more superficial treatments, Dr. Perkins would recommend a medium-depth chemical peel, sometimes combining this with laser resurfacing or dermabrasion to get the best desired effect in each and every area of the face, neck and chest.
Whenever Dr. Perkins performs one of these medium-depth procedures or a deeper treatment, they require at least monitored sedation, but most commonly anesthesia administered by an anesthesiologist for a short period of time while the procedure is being performed.
What’s Involved In a Chemical Peel
The chemical peel involves the application of a special mixture of chemicals or a chemical to the skin. This is done after specially preparing the skin to remove any soaps or oils. Light, moderate and deeper peels are available and vary in the strength of their chemical mixture. The lighter and superficial-depth peels are performed by our licensed estheticians at Spa 170 West.
Light peels that our estheticians perform often involve the application of glycolic acid or other lighter chemical peeling agents, such as a combination of fruit acids. Our estheticians also perform lighter percentage treatments of a TCA (trichloracetic acid) peel. Dr. Perkins uses a stronger, medium-strength, TCA chemical peel to achieve a more one-time treatment, effect but it does require anesthesia and at least sedation in order to tolerate this. In the past, phenol mixtures were used frequently but, with lasers, they are used less frequently today. Dr. Perkins, however, does still use phenol as the chemical peel agent for certain areas, such as the crow’s feet and wrinkles under the eyes, as an excellent medium level chemical peel.
Phenol and TCA peels are very good for removal of dyschromias or irregular splotchy pigmentation and light to mild wrinkles of the face. Once the upper layer is peeled off, new skin (the epidermis) will heal fairly rapidly. The epidermis is the surface layer of skin. However, underlying the epidermis, is the collagen layer which becomes damaged and wrinkled with time, creating visible surface wrinkles. Even though much of this improvement is seen quite quickly, further collagen tightening and smoothing occurs over a three-to-four-month period of time.
Chemical Peel Down Time
Patient downtime varies by the depth of the peel. Lighter peels will leave the skin pink for a few hours, or even peel lightly and heal within four to five days. However, while deeper peels can have a healing time of several days (a week to a week and-a-half), the results can be significantly more dramatic. Lighter and medium peels can be thought of as a deep sunburn where the top layer of skin peels, “blisters off” in three to five days, leaving a pink, weepy surface. Within the next two to four days after that, fresh new skin is healed over. The deeper peels take between one and two weeks to heal because re-epidermal resurfacing occurs from sweat and oil glands deep within the dermis of the skin, the thickest and deepest layer of the skin.
Chemical peeling is a true skin rejuvenation procedure, removing precancerous skin cells (which is very important) as well as visible wrinkling and sun damage of the face that is already apparent. The results from a chemical peel can be quite dramatic and are long-lasting. Lighter or medium depth peels may be repeated in the future.