Chemical Peels and Dermabrasion remove the top layer of skin in an effort to reduce fine lines and wrinkles, treat sun damaged skin or scarring due to acne. Peels can range from mild peels or masks that can be done at home to medium peels that can be applied by a trained skin care specialist, to the more radical treatments which only doctors should apply. Dermabrasion is a manual method of removing the top layer of skin. Dermabrasion is not used as widely today as chemical peels or laser techniques, but is still an effective treatment when done by a skilled physician.

Interesting facts about chemical peel and dermabrasion:

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Are There Any Alternatives to Surgery?

How Can I Prepare for Surgery?

How is the Procedure Done?

What Can I Expect Pre- and Postoperatively?

Tell Me About Recovery

What Kind of Risks / Complications Are There?

Still You…Only Better!

ALTERNATIVES TO SURGERY
There are alternatives to the deeper peels and dermabrasion. A good skin care specialist, such as a medical esthetician or a dermatologist should be consulted to begin a healthy skin regimen. Peels that can be done in the office can give your skin a healthy glow and maintain better skin elasticity. However, these methods will not be as long lasting or produce the dramatic changes that the deeper peels or dermabrasion will.

PREPARING FOR SURGERY
At your initial consultation, you and your doctor will discuss your expectations, the type of peel, and explain the healing and postoperative period. There will be a review of your medical history, a discussion about the results you’d like to achieve and to explain the procedure to be performed.

You will also be given pre-and postoperative instructions which will include information on eating and drinking and what prescription medications to take and those to avoid. Be sure you and your physician agree on the surgical approach and understand the potential risks and complications involved with the procedure.

THE PROCEDURE
Chemical peels range from mild peels which can be administered at home, to medium peels that should be applied by a trained skin care specialist to the strongest peels that must be applied by trained physician. Most are performed in a similar manner and are much less expensive than laser resurfacing.

Over-the-Counter Peels
These peels use alpha hydroxy acids (AHAs), which are derived from apples, olives, or sugar cane. They loosen the dead cells from the surface of the skin (exfoliate) and speed up the skin’s natural replenishing process. These can be applied daily at home. When applied, they give a slight burning or tingling sensation.

Glycolic Acid Peel
This is the mildest peel used by doctors or trained skin-care specialists. It removes only the outer layers of the epidermis (outermost layer of skin). This peel will speed up the process of cell replacement, resulting in a slightly smoother and fresher look. Glycolic peels can be used on the face and neck. Often referred to as the "lunchtime" peel these peels are administered once a week for two to six weeks. The strength of the acid and length of time it is left on the face are gradually increased. The acid is rinsed off thoroughly after being left on the face for two to five minutes. A soothing lotion is usually then applied.

The immediate sensation is that of a mild sunburn. Sensitive skin may swell and blister, or become irritated. If the patient experiences any burning sensation, rinsing the skin periodically with cool water can relieve it. Makeup must not be applied for several hours after the peel.

Trichloroacetic Peel (Trichloroacetic Acid/TCA)
This is a more aggressive peel used by doctors and should only be administered by the members of a doctor’s staff who have had specific training. It removes the entire epidermis and only the most superficial portion of the dermis (the secondary layer of skin). It is usually done in sections and may cause discomfort. Different strengths may be used on different areas of your face. A very mild strength may be used on the neck.

The solution is applied with a cotton-tipped swab and left on the skin. Your skin initially turns white but quickly turns red (similar to a severe sunburn). The redness usually subsides in a few hours and will generally start to peel in three to five days.

You may be able to start to wear makeup again in about five days, although it usually takes one to two weeks for the skin to completely heal. Refrain from strenuous physical activity for about a week. The sun must be avoided for six to eight weeks afterward, and an increased sensitivity to the sun should be expected. The TCA peel takes approximately thirty minutes.

Phenol Peel (Carbolic Acid)
This is the most aggressive peel. It removes the entire epidermis, down to the middle of the dermis. It can be applied to the full face or a region of the face. Intravenous (IV) sedation or general anesthesia is usually necessary. Your vital signs must be monitored. The chemical is absorbed into the bloodstream so if it is applied too quickly, arrhythmias (irregular heartbeats) can occur. Therefore, the chemical is applied one section at a time, usually in fifteen-minute intervals.

With a cotton-tipped swab, the solution is applied and left on the face. A smaller amount is used around the eyes. Your face will initially turn white then bright red. A full-face phenol chemical peel takes approximately one and one-half hours.

Two techniques are used for protecting the face after a phenol peel. Some physicians apply a special dressing that stays on for a few days to a week; others apply an antiseptic ointment, which may be replaced in a few days with petroleum jelly.

Dermabrasion
This is a mechanical method of softening the skin and irregularities of the surface. Dermabrasion is sometimes suggested for darker skin, as the tendency to create pigmentation changes may be less.

PRE- AND POSTOPERATIVE INSTRUCTIONS
These recommendations are intended to make you more comfortable and help you heal:

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RISKS/COMPLICATIONS
Although problems are unlikely, you need to be aware of what can happen and what action you should take. Most risks/complications will be avoided if you make an informed decision, choose a qualified physician, and follow your physician’s instructions.

The kinds of complications that can occur with chemical peels or dermabrasion are infection, scarring, discoloration, changes in the texture of the skin, ectropian or scleral show (retraction of the lower lid if the skin under the lid tightens too much) vision impairment or blindness (in rare cases if the chemical splashes into the eye) and arrhythmia (irregular heartbeats) if a phenol peel is applied too quickly.

STILL YOU…ONLY BETTER
Chemical Peels and Dermabrasion can make a dramatic difference in the texture and the feel of your facial skin. Healing and getting back to normal take a little longer with these procedures, but most patients report that the results are worth it.