Chemical Peels Surgery

A chemical peel is a body treatment technique used to improve and smooth the texture of the facial skin using a chemical solution that causes the dead skin to slough off and eventually peel off. The regenerated skin is usually smoother and less wrinkled than the old skin. Thus the term chemical peel is derived. Some types of chemical peels can be purchased and administered without a medical license, however people are advised to seek professional help from a dermatologist, esthetician, plastic surgeon, or otolaryngologist on a specific type of chemical peel before a procedure is performed.

Types of chemical peels

Alpha hydroxy acid peels

Alpha hydroxy acids (AHAs) are naturally occurring carboxylic acids such as glycolic acid, a natural constituent of sugar cane juice and lactic acid, found in sour milk and tomato juice. This is the mildest of the peel formulas and produces light peels for treatment of fine wrinkles, areas of dryness, uneven pigmentation and acne. Alpha hydroxy acids can also be mixed with a facial wash or cream in lesser concentrations as part of a daily skin-care regimen to improve the skin's texture.
There are five usual fruit acids: citric acids (citrus-derived), glycolic acid (derived from sugar cane), lactic acid (although derived from milk, this is still considered a "fruit acid"), malic acid (derived from apples) and tartaric acid (derived from grapes). Many other alpha hydroxy acids exist and are used.

• Citric acid: Usually derived from lemons, oranges, limes and pineapples. These peels are simple and effective, although not incredibly invasive or capable of significant improvement with one treatment.^{[citation needed]}
• Glycolic acid: Formulated from sugar cane, this acid creates a mild exfoliating action. Glycolic acid peels work by loosening up and exfoliating the superficial top layer. This peel also stimulates collagen growth.^{[citation needed]} High strength peels are good in terms of efficacy but they irritate more. Some glycolic peels claim the use of strontium nitrate in order to try to reduce skin irritation. Nevertheless, strontium nitrate is a product which is strictly prohibited in cosmetic products since it has an high toxic potential ^[1]
• Lactic acid: This acid is derived from either sour milk or bilberries. This peel will remove dead skin cells, and promote healthier skin.^{[citation needed]}
• Malic acid: This peel is the same type of mildly invasive peel derived from the extracts of apples. It can open up the pores, allow the pores to expel their sebum and reduce acne.^{[citation needed]}
• Tartaric acid: This is derived from grape extract and is capable of delivering the same benefits as the above peels.^{[citation needed]}

AHA peels are not indicated for treating wrinkles.
AHA peels may cause stinging, cause skin redness, cause mild skin irritation, cause dryness, and take multiple treatments for desired results.

Beta hydroxy acid peels

It is becoming common for beta hydroxy acid (BHA) peels to be used instead of the stronger alpha hydroxy acid (AHA) peels due to BHA's ability to get deeper into the pore than AHA^{[citation needed]}. Studies show that BHA peels control oil, acne as well as remove dead skin cells to a certain extent better than AHAs^{[citation needed]} due to AHAs only working on the surface of the skin.

Jessner's peel

Jessner's peel solution, formerly known as the Coombe's formula,was pioneered by Dr Max Jessner, a German-American dermatologist. Dr Jessner combined 14% salicylic acid, lactic acid, and resorcinol in an ethanol base. It is thought to break intracellular bridges between keratinocytes.^{[citation needed]} It is very difficult to "overpeel" the skin due to the mild percentages associated with the acid combination.

Retinoic acid peel

Retinoic acid is derived from retinoids. This type of facial peel is also performed in the office of a plastic surgeon or a dermatologist in a medical spa setting. This is a deeper peel than the beta hydroxy acid peel and is used to remove scars as well as wrinkles and pigmentation problems.^{[citation needed]} It is usually performed in conjunction with a Jessner; which is performed right before, in order to open up the skin, so the retinoic acid can penetrate on a deeper level. The client leaves with the chemical peel solution on their face. The peeling process takes place on the third day. More dramatic changes to the skin require multiple peels over time.

Trichloroacetic acid peels

Trichloroacetic acid (TCA) is used as an intermediate to deep peeling agent in concentrations ranging from 20-50%. Depth of penetration is increased as concentration increases, with 50% TCA penetrating into the reticular dermis. Concentrations higher than 35% are not recommended because of the high risk of scarring.
Trichloroacetic acid peels:

• are preferred for darker-skinned patients over Phenol
• smooth out fine surface wrinkles
• remove superficial blemishes
• correct skin pigment problems

Trichloroacetic acid peels may:

• require pre-treatment with Retin-A or AHA creams
• require repeat treatment to maintain results
• require the use of sunblock for several months (this is a must)
• take several days to heal depending on the peel depth

Phenol peels

Phenol is the strongest of the chemical solutions and produces a deep skin peel. Some publications claim that phenol peel affect could be due to the action of croton oil and that phenol would not be effective without this oil. This should be longer studied and double blind comparative studies should be done to prove this claim. In reality, many phenol peel solutions exist(ed) that do (did) not contain croton oil. This last is only a penetration enhancer, acting at the epidermal very superficial layers. Croton oil is not the only penetration enhancer that can be used. After 15 seconds as a maximum, phenol penetrates inside of the dermis and the most important question seems to be actually : How to do in order to slow down phenol penetration and give it a major possibility of interaction with skin proteins (coagulation effect)? Effects of a phenol chemical peel are long lasting, and in some cases are still readily apparent up to 20 years following the procedure. Improvements in the patient’s skin can be quite dramatic. A single treatment usually achieves the desired result.
Phenol peels are used to:

• correct blotches caused by sun exposure or aging
• smooth out coarse deep wrinkles
• remove precancerous growths

Phenol peels may:

• pose a risk of arrythmias if applied without following strict rules
• permanently remove facial freckles
• many formulas cause permanent skin lightening by reducing the ability to produce pigment
• require increased protection from the sun for life

Anesthesia

Light chemical peels like AHA and glycolic acid peels are usually done in medical offices. There is minimal discomfort so usually no anesthetic is given because the patient feels only a slight stinging when the solution is applied. No pain killer is needed.
Medium peels like TCA are also performed in the doctor’s office or in an ambulatory surgery center as an outpatient procedure and are a bit more painful. Frequently, the combination of a tranquilizer like Valium and a pain pill usually suffice. TCA peels often do not require anesthesia even if the solution itself has - at the contrary of phenol - no numbing effect on the skin. The patient usually feels a warm or burning sensation.Phenol is the classic deep chemical peel. Old phenol peel solutions are very painful and most practitioners will perform it under either general anesthesia, administered by an MD-anesthesiologist or nurse anesthetist. More recent formulas easily allow a simple heavy sedation, usually intravenous. Recent phenol peel formulas can be applied locally (chemical blepharoplasty or cheiloplasty)without any kind of anaesthesia.


Guide To Chemical Peel
The Patient's Guide is the most respected online publication providing information about chemical peels. Our aim is to provide you with unbiased, detailed information about treatment and applications. The information published here is written and provided by some of America's foremost dermatologists and skin surgery experts. Information provided by individuals on this site should be considered opinion and cannot replace the advice of and consultation with a physician, but can be educational and help let you know more about chemical peels.

Chemical Peel Providers

The goal of the Patient's Guide is to provide quality information about TCA, Glycolic and various other acid types, as well as a list of physicians who offer treatment near you. There are an abundance of treatments marketed today, both for in-home use as well as in spas and clinics, which claim to be highly effective. The best option is, and always has been, to consult with a physician with experience and knowledge of skin care. These professionals are the most likely to give you the range of options available to you and help you form a treatment course which will give you results you can be satisfied with.

Chemical Peels - A Quick Way to Improve Skin

Many people are looking for a simple way to improve their skin without surgery or a facelift. Aging and sun-damaged skin may develop redness, blemishes, facial veins and pigment, deep wrinkles, cancerous or precancerous lesions or spotting. Its important to have a plastic surgeon or dermatologist look at your skin to evaluate your needs. This procedure uses a chemical solution, usually an acid, to ‘peel’ away the top layers of the epidermis in order to improve conditions such as acne, irregular pigmentation or wrinkles. Chemical peels have been in use for a number of years and are a highly popular way to improve the texture and look of skin. Over half a million people have a session performed each year. There are a wide variety of peels available, each with its own unique benefits as well as risks. This website is dedicated to providing people looking for better skin a place to become educated about the use of these peels, and whether they may be right for you. Note that patients taking Retin-a may be more sensitive and should notify their doctor. 

Chemical Peel Candidates

In general, patients with fair skin and light hair are the best chemical peel candidates. However, patients with other skin pigmentation and hair color can achieve good results as well. Ideal candidates for the chemical peel procedure are individuals who are unhappy with the appearance of their skin, have realistic expectations of their procedure, and do not smoke.

Cost of Chemical Peels

The cost of chemical facial peels varies from state to state and doctor to doctor. The current chemical peel price range is approximately $600 to $900. Possible additional expenses to keep in mind, especially with deep chemical peels, are the cost of anesthesia, use of the surgical facility, and a possible hospital stay. The final cost of your procedure will depend on the type of peel you want, the condition of your skin, and other factors unique to your case. Light chemical peels can cost as low as $150, while deep chemical peels are generally the most expensive, as much as $6000.

Risks and Benefits of Chemical Facial Peels

Chemical peels rarely result in serious complications, but certain risks do exist. These risks include scarring, infection, swelling, changes in skin tone, and cold sore outbreaks. You can reduce the risks associated with facial peels by following all of the doctor’s instructions completely and by providing your doctor with a complete medical history.
A chemical facial peel can provide several benefits to the skin. The procedure can restore a more youthful appearance to skin and reduce wrinkles, uneven pigmentation, sun-damage, and blotchy patches. DocShop provides extensive information about chemical peel risks and benefits to help you fully understand the procedure.

Light Chemical Peels

Your cosmetic dermatologist will use a specific formula for your chemical peel based on the characteristics of your skin and your desired result. Light chemical peels are used to treat fine wrinkling, areas of dryness, uneven pigmentation, and acne. The solution used for light chemical peels is usually comprised of alphahydroxy acids (AHAs), such as glycolic, lactic, salicylic, or fruit acids. Light chemical peels are ideal for people who want the benefits of a facial peel but do not wish to spend the time required to recover from a deeper peel.

Medium Chemical Peels

For medium facial peels, many doctors use trichloroacetic acid (TCA). This chemical works well for treating fine surface wrinkles, superficial blemishes, and pigmentation problems. Similar to the light chemical peel, medium chemical peels require less downtime than a deeper peel. TCA peels are the preferred choice for patients with darker skin.

Deep Chemical Peels

Deep chemical peels are the strongest of the facial peels. The chemical used for deep chemical peels is phenol acid. Deep peels are used to treat coarse facial wrinkles, blotches caused by aging or sun exposure, and pre-cancerous growths. While a deep chemical peel produces the most dramatic, longest-lasting results, the procedure takes longer than other peels (one to two hours) and requires the most healing time. Phenol acid is typically used only for facial peels. Because a deep chemical peel may cause permanent lightening of the skin, prospective patients should seek advice from a qualified cosmetic dermatologist before undergoing the procedure.

Acne Chemical Peel

Certain chemical peel solutions are useful for treating acne blemishes and diminishing existing acne scars. Light chemical peels administered with a solution of alphahydroxy acids (AHA) can be beneficial for treating acne. A lower-strength AHA solution can be mixed with a facial wash as part of a daily skin-care routine. DocShop provides detailed information about acne chemical peels to help you decide if this treatment is right for you.

Chemical Peel Side Effects

When performed by an experienced cosmetic dermatologist or plastic surgeon, chemical facial peels are safe. With light and medium peels, relatively mild chemical peel side effects such as redness, stinging, and crusting usually subside within a day or two after the treatment. The side effects of deep chemical peels are typically more pronounced, and recovery time is longer. More serious side effects, such as infection and scarring, are possible, especially with medium and deep chemical peels. However, serious side effects are rare when the procedure is performed by a qualified doctor.

Chemical Peel FAQs

Before undergoing a chemical peel for the first time, patients often have many questions and concerns. Being well informed about every aspect of your chemical peel procedure can help ensure that you are satisfied with the outcome of your treatment. DocShop provides a detailed Chemical Peel FAQs page where you can find information on cost, the different types of facial peels, recovery from the procedure, and much more.

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 being treated.

What Conditions Do a Chemical Peel Treat?

Chemical peels are performed on the face, neck or hands. They can be used to:

• 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. Following treatment, new pre-cancerous lesions are less likely to appear. 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). A dermatologic surgeon can help determine the most appropriate type of treatment for each individual case.

The Chemical Peel Procedure

Chemical peels are performed in a doctor's office. Deeper peels require anesthesia, but lighter peels often do not. The procedure takes about 15 minutes, then one to three weeks of recovery.
The number of treatments varies among individuals. Results can last up to several months.
During the procedure, the chemical solution is applied to the affected area (usually over the entire face). The chemical agents then work to separate and "peel" the outer surface layers of the skin. These layers often contain dead skin, which is removed during the process. The chemical agents stimulate the generation of new skin cells through the healing process.
During the application, you may experience a cool, warm or hot sensation that can last for 10 minutes or more. You may also feel a stinging sensation

The Cost of Chemical Peels

Chemical peel costs include the:

• Number of treatments required to achieve the desired result
• Ongoing treatments required to maintain the result
• Anesthesia
• Type of peel
• Aftercare daily skincare regimen

Costs vary among treatment providers and skincare manufacturers. Often package pricing is available for multiple treatment sessions and the aftercare skincare regimen. Costs for the peel itself can range from $75 to $600 or more. Annual costs for a daily skincare regimen can be $750 or more.