Content provided by Cleveland Clinic.
Chemical peels, also known as chemexfoliation or dermapeeling, is 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. The new skin also is temporarily more sensitive to the sun.
What conditions does a chemical peel treat?
Chemical peels are often used to treat certain skin conditions or for aesthetic improvement; for instance, to reduce fine lines under the eyes and around the mouth. Wrinkles caused by sun damage, aging and hereditary factors can often be reduced or eliminated with this procedure. 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 face lift, brow lift, eye lift or soft tissue filler (collagen or fat). A dermatologic surgeon can help determine the most appropriate type of treatment for each individual case.
Chemical peels are performed on the face, neck or hands. They can help reduce:
- Mild scarring
- Certain types of acne
- Sun spots
- Age spots
- Liver spots
- Freckles
- Dark patches due to pregnancy or taking birth control pills (melasma)
Chemical peels can also help 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. Following treatment, new pre-cancerous lesions are less likely to appear.
Who is a good candidate for a chemical peel?
Generally, fair-skinned and light-haired patients are ideal candidates for chemical peels. Darker skin types may also have good results, depending upon the type of problem encountered.
How are chemical peels performed?
A chemical peel can be performed in a doctor”s office or in a surgery center as an outpatient procedure. 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 the skin.
Prior to the chemical peel, your doctor may ask you to stop taking certain drugs and prepare your skin with topical preconditioning medications such as Retin-A, Renova or glycolic acid. After the chemical peel, it”s important to use a broad-spectrum sunscreen every day.
24 hours before procedure: If you have been prescribed oral antibiotics or an oral antiviral medicine, you should begin taking those.
Day of peel: You will need preparation time for washing and scrubbing. Additionally, you will also need time for any sedation (which is optional). Remember: Ask your doctor if you need to have someone drive you home.
The procedure: During a chemical peel, the physician applies the solution to small areas on the skin. These applications produce a controlled wound, enabling new, regenerated skin to appear.
During the procedure, most patients experience a warm to somewhat hot sensation that lasts about five to 10 minutes, followed by a stinging sensation. Cool compresses may be applied to help alleviate this stinging. A deeper peel may require pain medication during or after the procedure.
What should be expected after the chemical peel?
Depending upon the type of chemical peel, a reaction similar to sunburn occurs following a chemical peel. Peeling usually involves redness, followed by scaling that ends within three to seven days. Mild peels may be repeated at one- to four-week intervals until the desired clinical effect is achieved.
Medium-depth and deep peeling may result in swelling and the presence of water blisters that may break, crust, turn brown, and peel off over a period of seven to 14 days. Medium-depth peels may be repeated in six to 12 months, if necessary.
You will work with your dermatologist to determine the depth of your peel. This joint decision can vary, depending upon the condition of your skin and the objectives of treatment.
After treatment, some peels may require bandages to be placed on part or all of the skin that has been treated. Bandages are usually removed in several days and may improve the effectiveness of the treatment.
It is important to avoid over-exposure to the sun after a chemical peel since the new skin is fragile and more susceptible to complications. The dermatologic surgeon will prescribe the proper follow-up care to reduce the tendency to develop abnormal skin color after peeling.
What are the possible complications of chemical peels?
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 (herpes infection) in patients with a history of herpes outbreaks. This problem is treated with medication as prescribed by the dermatologic surgeon. Your doctor may also choose to give you medication before, or immediately after, the peel in order to prevent a herpes outbreak. Prior to treatment, it is important for a patient to inform the physician of any past history of keloids (scar tissue overgrowth created at the site of a skin injury), or unusual scarring tendencies, past x-rays treatments to the face or recurring cold sores.