Chemical Skin Peels

Your skin is the largest living organ of the body. It comprises millions of skin cells or keratinocytes (epidermis) and its nourishment/support network (dermis). Each day, thousands of these cells die and are shed from the skin surface. They are then replenished by new cells from below. It normally takes 28 days for the deepest cells to reach the outermost layer. Unfortunately, sometimes this is a slow and haphazard process that does not allow your skin to shed evenly which over time and with sun exposure can lead to areas of varying pigmentation, textural changes and loss of elasticity.

Facial peels

The purpose of a facial chemical peel is to cause an even, controlled shedding of several layers of damaged skin cells, leaving behind a new, fresher layer of skin with a more even texture and colour, similar to a snake shedding its skin.

Different chemicals are used in facial chemical peels. The chemical used is dependent on the desired depth of the facial peel. In general, glycolic acid is used for superficial chemical peels and trichloroacetic acid for medium depth chemical peels. Deeper peels can be achieved with the chemical phenol, but this is more hazardous and is rarely used today with the advent of laser resurfacing for deeper wrinkles.

Alpha hydroxy acid (AHA) peels

Alpha hydroxy acid (AHA) peels are used for superficial peels. The most commonly used acid is glycolic acid. The AHA’s are a naturally occurring group of substances usually found in fruits so AHA’s are also referred to as fruit acids. They work by loosening the bonds between the superficial skin cells allowing them to be removed more easily. Often as preparation prior to a chemical skin peel your doctor will ask you to use products that contain AHA or tretinoin (a form of Vitamin A) to remove some of the surface skin layers, so that when your acid peel is applied the process is more even.

The strength of the glycolic acid chemical peel applied depends on your skin type and the condition that is being treated. A normal course of glycolic acid chemical peels is four to six depending on your individual needs and response to each peel. The typical response to a glycolic acid chemical peel is similar to a mild sun or windburn. The redness typically settles within 24 hours and peeling of the skin in small flakes lasts for three to five days to leave a fresher, smoother complexion. Repeat chemical peels are normally given at one to two week intervals.

Trichloroacetic acid (TCA) peels

The trichloroacetic acid (TCA) peel is helpful for:

  • blotchy pigmentation
  • freckling
  • sun damage
  • fine wrinkles
  • some acne scars

TCA chemical peels are performed as an outpatient procedure at our clinic.

A number of applications (one to several) of TCA are applied to your skin to create a controlled chemical burn.

Patients normally experience a few minutes of burning and stinging after the medication is applied. This usually stops within a few minutes without any further discomfort during the rest of the time you are peeling, although most patients experience itching during the healing process. Immediately following the chemical peel your skin will have a white, frosted appearance. During the following days your skin will turn darker, feel tighter, then crack and peel off, leaving you with a new, fresh layer of skin. There are no scabs, bleeding or bandages required.

How long does it take to heal?

During the healing process you should experience no pain. When peeling, most people look like they have sunburn. If you are not concerned by your appearance, you can return to work and resume your normal social activities. However sun exposure and activities that cause heavy perspiration should be strictly avoided.

  • The average chemical peel takes between five to six days to complete.
  • Deeper chemical peels for more heavily sun damaged and wrinkled skin may take up to ten  days.

How many chemical peels are required?

Most patients require more than one chemical peel to achieve the best result. The number of chemical peels depends on the specific skin problem being treated.

After care

  • You may continue to wash your face with your normal cleanser and lukewarm water twice daily, then gently pat dry and apply moisturiser. It is not necessary to remove every bit of moisturiser you may have applied. If you need to wash your hair, do this separately and avoid shampoo on the treated areas.
  • Do not pick off any crusts or scabs. Apply moisturiser liberally and as often as required to keep the treated skin moist (do not allow the skin to dry and crack).
  • Avoid ALL sun exposure while the skin is peeling, not even five minutes.
  • Do not cleanse any more frequently than recommended to speed up the peeling process, as this only increases the risk of infection and other complications.
  • If you feel flushed or warm when you bend over do not be alarmed, as this is a temporary condition that resolves after the skin has completely healed.
  • During the healing process it is normal to feel occasional itching and burning.
  • Try to minimize facial movements while healing, as excessive movement is likely to cause cracking of the skin. For this reason try to avoid seeing a humorous movie, visiting the dentist or taking large mouthfuls of food.
  • Avoid strenuous exercise and hot, humid conditions, as these may irritate the healing skin.
  • Swelling during the first two to three days is normal after your peel. In severe cases your eyelids may be very swollen, especially in the morning. This will settle spontaneously. However, if the swelling persists, sleep on an extra pillow. Avoid ice packs or cold compresses, which can cause peeling too early.
  • After all the skin has peeled, continue to use sun protection and sun avoidance measures.
  • You can wear make-up two days after peeling is completed.

Should you have any questions or concerns regarding chemical skin peels, please contact our practice. This also applies if you are unsure of any irritation, as this may be caused by infection.

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