Chemical peeling is a technique used to improve the appearance of the skin that is typically performed on the face, neck or hands. In this treatment, a chemical solution is applied to the skin that causes it to "blister" and eventually peel off. The new, regenerated skin is usually smoother and less wrinkled than the old skin. The new skin is also temporarily more sensitive to the sun.
Dermatologic surgeons have used various peeling agents for the last 50 years and are experts in performing multiple types of chemical peels. A thorough evaluation by a dermatologic surgeon is imperative before embarking upon a chemical peel.
What can a chemical peel do?
Chemical peeling is often used to treat fine lines under the eyes and around the mouth. Wrinkles caused by sun damage, aging and hereditary factors can often be reduced or even eliminated with this procedure. However, sags, bulges and more severe wrinkles do not respond well to peeling and may require other kinds of cosmetic surgical procedures such as a facelift, brow lift, eye lift or soft-tissue filler.
Mild scarring and certain types of acne also can be treated with chemical peels. In addition, pigmentation of the skin in the form of sun spots, age spots, freckles, splotching due to taking birth control pills and skin that is dull in texture and color may be improved with chemical peeling.
Chemical peeling may be combined with laser resurfacing, dermabrasion or soft-tissue fillers to achieve cost-effective skin rejuvenation customized to the needs of the individual patient. Areas of sun-damaged, precancerous keratoses or scaling patches may improve after chemical peeling. Following treatment, new lesions or patches are less likely to appear. Generally, fair-skinned and light-haired patients are ideal candidates for chemical peels. Darker skin types may also experience good results depending upon the type of skin problem encountered.
How are chemical peels performed?
Prior to surgery, instructions may include the elimination of certain drugs and the preparation of the skin with topical pre-conditioning medications. The patient may be advised to clean the area with an antiseptic soap the day before surgery.
A chemical peel can be performed in a doctor's office or in a surgery center as an outpatient procedure. At the time of treatment, the skin is thoroughly cleansed with an agent that removes excess oils, and the eyes and hair are protected. One or more chemical solutions – an alpha hydroxy acid, such as glycolic acid, salicylic acid, or lactic acid; trichloroacetic acid (TCA); or carbolic acid (phenol) – are used. Dermatologic surgeons are well-qualified to select the proper peeling agent based upon the type of skin damage present. During a chemical peel, the physician applies the solution to small areas on the skin. These applications produce a controlled wound, enabling new, refreshed skin to appear. Most patients experience a warm to somewhat hot sensation that lasts about five to 10 minutes, followed by a stinging sensation. A deeper peel may require pain medication during or after the procedure.
What should be expected after treatment?
Depending upon the type of peel, a reaction similar to a sunburn occurs following a chemical peel. Superficial peeling usually involves redness, followed by scaling that ends within three to seven days. Medium-depth and deep peeling may result in swelling and the presence of water blisters that may break, crust, turn brown and peel off over a period of seven to 14 days. Some peels may require bandages to be placed on part or all of the skin that is treated. Bandages are usually removed in several days and may improve the effectiveness of the treatment. It is important to avoid overexposure to the sun after a chemical peel since the new skin is fragile and more susceptible to complications. The dermatologic surgeon will prescribe the proper follow-up care to reduce the tendency to develop abnormal skin color after peeling.
For more information and referrals
For more information on skin conditions and treatments, along with a list of ASDS members in your state, please visit the Find a Dermatologic Surgeon section of our website.