WHAT IS CHEMICAL PEELING?
Chemical Peeling is exactly what it says - peeling of the skin using a chemical. A chemical peel removes the outer layers of the skin. This freshens the skin, removes some sunspots and rough scaly patches, and reduces freckles and irregular pigmentation.It also reduces fine wrinkles. There is some evidence that it may reduce the risk of skin cancer. It is safest and most effective on the face. Hands can be peeled but the risk of scarring is higher and the results less predictable.
WHAT IS THE HISTORY OF CHEMICAL PEELING?
Cleopatra and the ancient Romans used various food acids to peel their skin. In the early 1900s, European and Americal women underwent 'non-medical' peels in salons with secret formulae, which were probably mild acids. In the early 1950s, the phenol peel was developed. This was a fierce deep peel that could remove years of wrinkles, but also gave peeling a reputation for complications - pigmentation, depigmentation, scarring and even abnormal heart rhythms due to absorption of the chemicals. However, when done under controlled conditions by an experienced physician phenol peeling is safe and effective. Trichloroacetic acid, being a more gentle acid, has made a comeback in popularity because although it will not make a 50 year old look 25 again, it rejuvenates the skin without the risk of serious side effects. Other agents used include combination peels and pyruvic acid.
WHO IS SUITABLE?
Fine wrinkling can be reduced, though deeper lines will remain, (some of which can be improved by other methods) with chemical peeling. Most brown marks, freckles and pigmentation can be removed or lessened, especially age and liver spots (lentigines). However, pigment changes can be caused by a peel in people prone to this complication due to their skin type. Those known to develop brown discolouration after injury such as a mild burn should have a test area peeled first before undergoing a full face chemical peel. Scaly patches and rough skin (keratoses) can be removed. Very thick keratoses may need additional treatment for complete removal. Skin that is thin and fragile eg sun-damaged skin, bald scalpskin, can be significantly rejuvenated. Chemical peeling is not a substitute for a facelift. It does not tighten sagging skin, stimulate collagen production or remove broken capillaries. Chemical peeling is not appropriate for people who will continue to have excessive sun exposure.
ARE THERE ANY COMPLICATIONS?
Scarring can occur with strong acids, but is unusual with weaker ones. The most common causes of scarring are infection, and pulling off the skin before it is ready to peel. Both of these are avoidable. Cold sores can be activated in those prone to this kind of condition. Anti viral medication can prevent this. Increased pigmentation may occur, and resolves with time. It can be largely prevented by religious use of sunscreen for three months after the peel.
WHAT IS THE PROCEDURE?
The skin may have had preparation with Vitamin A, Alpha Hydroxy Acid or other preparations. Firstly the skin is thoroughly cleansed with acetone or other cleanser. The acid is then painted onto the face and monitored. A stinging or mild burning sensation may be experienced. Usually the first treatment will last only a few minutes. Subsequent peels are usually carried out at 2 weekly intervals until the desired effect is reached.
WHAT HAPPENS AFTERWARDS?
The skin will redden and there may be some mild swelling over the next 24 hours. Once the initial burning has worn off it is not painful, but feels tight. Over the next few days the skin dries but you will be prescribed a regular moisturizer and night cream to offset this. Water will do no harm but soap should be avoided. Depending on the intensity and type of peel chosen the skin will begin to peel between 2 and 5 days later, and must be left to come off at its own pace. As soon as the skin has healed, make up may be applied over the new, pink skin.
Sunscreen is mandatory for at least three months, and moisturisers are helpful. Deep chemical peels will achieve quicker results but at the expense of some 'downtime'. It can be repeated after three months, but this is not usually necessary. It can also be repeated at any time in the future and will not harm the skin. The habitual use of sunscreen will prevent further sun damage and therefore maintain the improved skin quality. Additionally, the use of vitamin creams, AHA creams or enzyme creams can continue to improve the skin texture and reverse some of the effects caused by years of sun exposure.