Although one peel can improve the appearance of the skin, a series of peels is often employed. Following treatment, new lesions or patches are less likely to appear.

Be mindful that sags, bulges and more severe wrinkles do not respond well to peeling and may require other kinds of cosmetic surgical procedures, such as an eyelid lift or soft tissue filler.

What is a Chemical Peel?

A chemical peel applies a controlled chemical burn to the top layers of your skin.

Chemical peels are categorized into superficial, medium and deep peels depending upon the severity of the patient's wrinkles and the degree of sun damage present.

The depth of the burn depends upon the concentration of acid that is used.

The peel itself should take no more than 30 to 60 minutes and may be painful for the first few hours following the procedure.

This pain is usually well controlled with oral pain medications.

Following a chemical peel, patients are usually sent home or to an outpatient nursing facility for a day or two.

The skin will begin to peel 24 to 48 hours following the application of the acid. New skin will replace the peeled skin within seven to ten days.

However, chemically peeled skin takes longer to look normal.

A pink hue to the skin can be expected for six months, easily covered with makeup.

There can be significant benefit from one acid peel, however, up to six treatments may be recommended for maximum benefits.

Chemicals Used

Glycolic acid is often used at concentrations of twenty to seventy percent in a series of 3 to 6 peels for the desired effect.

TCA< (trichloroacetic acid) is a very strong acid and is one of the most effective peeling chemicals. TCA is used at concentrations from fifteen to thirty-five percent.

Twenty to twenty-five percent TCA is a light peeling agent and if repeated every two to four weeks, can give the results of a deeper peel without the risk of scarring as sometimes seen with stronger agents.

In addition, the peel stimulates new cells to grow thereby tightening the skin, which decreases wrinkling.

Other acids such as salicylic acid, lactic acid, carbolic acid, or phenolic acid may also be used.

How is the Peel Performed?

Chemical peels are performed as an outpatient procedure in the doctor's office.

A solution containing the chemical is applied to your skin.

During the procedure, most patients experience a warm to somewhat hot sensation lasting about five to 10 minutes, followed by a stinging sensation.

Most patients choose not to use any sedation or anesthesia.

Deeper peels may require pain medication during or after the procedure.

When a chemical peel is applied to the skin, it causes the top layers of cells to dry up and peel off over a period of several days.

Medium-depth and deep peeling can sometimes result in swelling and blisters that may break, crust, turn brown, and peel off over a period of 7 to 14 days.

Sometimes surgical tape may be placed on the treated skin. When the old skin has peeled off, it exposes a new layer of fresh skin which has a smoother texture and more even color.

Most people heal within seven days after a peel. During the healing process there is no pain, but the skin looks as if it has had a severe sunburn.

The skin becomes more sensitive to sunlight for at least six to eight weeks after their peel. It is very important to protect the new skin with sunblockers, hats and by avoiding strong sunlight.

There is a small incidence of the reactivation of cold sores or Herpes simplex infection in patients with a history of fever blisters.

Chemical peeling will not remove deep scars. Dermabrasion, punch grafting, punch elevation, scar excision, or soft tissue fillers may be much more effective for scars and should be discussed with your dermatologist.

Skin "Deep-Peeling" Disasters

When deep skin peels are performed by poorly skilled doctors, disasters can result.

Because of this, many dermatologists are moving toward a series of milder skin peels rather than one deep peel.

For example, the Mayo Clinic now recommends a series of six peels to renew a skin area.

The following are true examples of calls we get at Skin Biology:

"I had a acne mark on my cheek and the dermatologist tried a strong phenol peel which left the area scarred worse then ever. Then two more dermatologists re-peeled the cheek area and things only got worse. Now I have a deep, scarred depression in my check. As a result of these peels, I contracted a staphylococcus infection and am now on three different antibiotics to control the infection."

"I had a 35% TCA peel four weeks ago and was very much misled on the seriousness of this peel and the possible complications. I am a young women with fair skin. Dr. "X" of the, ""X" Skin Institute," did the procedure in a very uncontrolled manner. The peel came out severely uneven. The result is that the right side of my face, and parts of my nose seem to be forming raised and very red scars [...] it has still only been a month but the healing process has been so extreme and the unevenness so unbelievable -- I look like I went through a windshield. What I am wondering is if there is anything I can do to speed up this healing process and what kind of hope do I have for looking "normal" in the future?"

Again, the best results with skin peels require highly skilled medical personnel using somewhat conservative and slower techniques. The "one peel to beauty" is often unsatisfactory.

Dermabrasion

Laser Resurfacing