Chemical Peels

Chemical peeling is a cosmetic dermatologic procedure that reduces many of the signs of aging including fine and heavy wrinkling, leathery skin, pigmentation, and scaling, and premalignant keratoses. We offer three types of chemical peels, superficial, medium, and deep. The depth of the peel is determined by the specific peeling agent used, how aggressively it is applied, and how long it is left on the skin. Peeling is a delicate procedure that requires a skilled and experienced operator.

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What is Beta Lift® and why is it redefining the superficial peel?

Beta Lift features beta hydroxy acid, i.e., salicylic acid. Beta Lift takes just minutes to apply and there is little to no downtime. Your skin immediately looks and feels smoother and tighter. Your face will temporarily appear a bit rosy, and in a day or two your face may begin to peel sightly. The degree of peeling can vary from barely visible to mild to noticeable peeling or flaking. Beta Lift is best done as a series of treatments, and can also help tone down the redness of rosecea.

What about medium-depth peels?

Our medium depth peel uses trichloroacetic (TCA) solution concentrations ranging from 20–50%. This peel is the most popular peel for mild-to-moderately-severe sun damage and other signs of aging. It has been used by dermatologists for fifty years. It differs from the lighter peel in that the healing time occurs over two to seven days, and, depending upon the strength, signs of healing can be mild enough so that social activities need not be significantly altered. Alternatively, when more aggressively applied, five to seven days may be needed to heal. This peel improves but does not eliminate crinkly, leathery sun-damaged skin, but has the advantage of allowing a patient to begin with lower concentrations and the procedure can then be repeated as desired at higher concentrations. This cautious approach helps to minimize side effects while maximizing benefit.

What are the benefits of these procedures?

Lighter chemical peels help freshen skin, even tone, and help ameliorate early signs of premature aging. The main purpose of medium peels is to improve wrinkling, especially around the eyes, cheeks, lips, and forehead. The stronger the solution, the deeper the peel, and the greater the improvement attained. Many individuals want to correct the fine-line wrinkles (crow’s feet and lip lines) that a face lift will not remove (a face lift re-drapes and stretches sagging skin, but does not resurface). Deeper facial creases will appear more shallow. This process will help reduce or remove freckles and other blotchy pigmentation and even precancerous growths, depending upon the skin type. Also see Fractional Laser Resurfacing and laser resurfacing results for the same kind of benefit and improvement.

How are chemical peels performed?

You are requested to wash your face thoroughly and arrive at the office without makeup. The facial skin is then cleansed with acetone. In accordance with your consultation and decision as to the type of peel selected, the solution is applied to a small section of the face at a time until the entire face is treated. Upon application, you may feel a stinging sensation for five to ten minutes for trichloracetic acid. The peels take about a half hour to complete.

Swelling of the face occurs after the solution has been applied; the stronger the solution, the greater the swelling, and the skin will turn a tan or brown color.

After the procedure, the goal is to keep the peeling areas soft, which is done by applying a moisturizing ointment several times a day (Vaseline is fine), and by frequently rinsing the skin with water in a shower to remove debris and tissue fluids. The peeling must never by picked or peeled off—to do so may cause pain, bleeding, and possible scarring.

Healing time varies with the strength of the peel. The weakest peels heal in about three days, intermediate to deeper peels in four to seven days.

What are regional peels?

The upper lip in women is frequently a cause of concern, as these deep wrinkles seem to draw lipstick upwards. A localized peel can be effective when a full-face peel is not necessary. It is even possible to touch-up deep crease lines if not improved enough by the original peeling by simply applying a small amount of peel solution. Localized peels are less successful in very sun damaged and darker skinned persons, as a marked a change in skin pigmentation between the peeled and unpeeled areas may occur. Regional peeling of eyelids can greatly improve fine wrinkling and crow’s feet that blepharoplasty (cosmetic eyelid surgery) can not improve. Also see Fractional Laser Resurfacing and laser skin resurfacing.

What should I expect and how should I protect my new skin?

The peeled areas will appear pink—similar to a sunburn—for one to three weeks, depending on the strength of the solution used, and then gradually return to a normal hue. The new skin will be sensitive and delicate and should not be rubbed or washed with a wash cloth or treated with strong astringents or exfoliatives for at least one month after healing. A sunscreen with a protective factor of at least 45 with a total UVA screen should always be applied (women should apply it before make-up) whenever you go out the house during daylight hours. Minimize sun exposure and avoid direct sunlight for four to six months as excessive sun exposure can cause possible permanent discoloration. With the passage of time, the peeled skin will become less sensitive to sun exposure, extremes of temperature, and strong wind.

What are possible complications?

The incidence of complications is infrequent, but the following may occur: infection; scarring; discoloration with the skin healing lighter, darker, or mottled; prolonged redness; etc. Dr. Binstock will cover these possible complications in detail during your consultation. These are the same risks associated with laser resurfacing.

How long will the benefits last?

This varies greatly with the age of the patient, the severity of the aging process, the condition of the skin, and the type of penetration of the acid mixture. Generally speaking, the trichloroacetic acid peels result in a freshness and crispness of the skin that fades over months to years.