Chemical Peels

Once the first choice for facial rejuvenation, chemical peels now play second fiddle to newer, less invasive techniques, but still have a significant role. Peels are used to treat wrinkles, age spots, discoloration, precancerous skin growths, and superficial scarring. An acid solution is applied to the skin, dissolving skin cells and removing the top layers of the epidermis. Just how deeply the peel penetrates, and the effects, vary depending on the strength of the solution used. Chemical peels can be done on the hands as well as the face.

For a superficial peel, doctors use alpha hydroxy acids, beta hydroxy acids, or salicylic acid, typically in mild 10% to 70% solutions, to remove only the outermost layer of the epidermis. This peel can improve skin tone, enhance texture, and somewhat minimize fine lines and wrinkles. You'll be happy with these peels if you have only mildly sun-damaged skin or just want to make your skin look brighter without a dramatic change in appearance. For best results, repeat the treatment monthly for about six months, and then quarterly. Superficial peels are often called lunchtime treatments because they take just 15–20 minutes, are painless, and don't require any recovery time. Some people with very fair or sensitive skin may have some redness for a few hours, but most people feel comfortable going out in public immediately afterward. Expect to pay about $75–$250 per treatment. You can also get similar results with microdermabrasion or its newer cousin, Vibraderm, for about the same price for a similar series of treatments. These methods physically sand away the very top skin layer, leaving the skin smoother and fresher.

If you have more advanced sun damage or if you want a more noticeable improvement to mild wrinkles, skin tone, and coloring, you may consider a stronger peel. These peels dissolve the skin into the top layer of dermis and require a longer recovery time. A solution of 35%- to 50%-strength trichloroacetic acid (TCA) is commonly used. You may find that it stings a bit. The session will last about 35 to 45 minutes. Afterward, you'll have mild discomfort, and a few days to a week after the treatment, the superficial skin will darken, turn stiff, and peel off. Your skin may appear flushed for several weeks, but you should not have other side effects. Most people report noticeable improvement in medium-depth lines and wrinkles and coloration. Results last up to two years, but many people get annual repeats before the improvements fade over time.

Deep peels use phenol, a caustic chemical, to penetrate into the dermis. These peels are used to reduce deeper wrinkles, to smooth out blotchy skin, and to improve sun-damaged areas. Because they may lighten skin, they are best reserved for people with fair skin. This procedure, which takes about an hour, is more painful than other peels and requires more healing. You'll need sedation during a phenol peel. Afterward, expect mild to severe discomfort and to wear dressings on your skin for a few days. You may not be able to eat solid food during this time and might need to enlist someone to help care for you. Once the dressings are removed, your skin will be red, swollen, and oozing. Then over the next few weeks, the skin will darken, flake, and peel. When the peeling subsides, the skin will appear bright red for two to three months. Usually only a single treatment is needed. But because of the often painful, slow healing process and the risk of unwanted color changes, phenol peels have fallen out of favor.

After any chemical peel, you'll be more sensitive to sun exposure, so take extra precautions when outdoors.