Chemical Peels for Acne Scars and Wrinkles
The reasons people seek a chemical peel (sometimes called a chem peel or a derma peel) is to gain a fresh, clean, tighter and younger appearance for their face. Chemical peels can be effective in reducing or eliminating wrinkles, acne scars, uneven skin tone, superficial scars and age spots or other blemishes.
General Skin Improvements from a Chemical Peel:
Lighter
Tighter
Clearer
Younger
One of the advantages of the chemical peel over beauty products is that it can be done in one sitting or in a few sessions instead of waiting for results after weeks or months product applications.
Also the procedures aren't as drastic, invasive and permanent as some plastic surgery techniques. Chemical peels are much more than subtle adjustments to skin moisture levels or promises to strengthen collagen like some over the counter creams offer.
A peel does what it sounds like; it actually removes layers of skin to expose the underlying cells and causes new cells to grow. Because the re-grown skin is new it has a fresh, bright, tight appearance and fewer blemishes or wrinkles.
Chemical Peels for Dark Skin and Light Skin
Peels work best on fair skinned people because there is less chance of a visible difference in skin tone after the procedure. People with dark skin can benefit from mild chemical peels as long as they're done carefully to ensure that the product is applied evenly resulting in an even skin tone across all areas of the face.
Deep chemical peels leave the skin unable to tan normally and even in lighter skin care must be taken to blend the treated skin with the old skin at the forehead and neckline. Deep peels are not recommended for darker skinned people due to difficulty in matching skin tones from treated and untreated areas.
What Does a Chemical Peel Do?
Chemical peels can address a variety of facial skin issues such as reducing the appearance of large unsightly pores prone to acne and blackheads as well as reducing surface scars such as old acne or chicken pox scars, age spots or other blemishes. Stronger chemical peels are used to tighten sagging skin and wrinkles such as frown lines at the mouth and crows feet around the eyes and even out uneven skin tone. Peels can also help reduce the chances of developing skin cancer by removing precancerous lesions.
Problems Addressed by Chemical Peels:
Superficial Scars
Wrinkles
Brown Spots/Uneven Tone
Acne/Blackheads
The Three Types of Chemical Peels
There are three general categories of chemical facial peels, The depth of the peel determines the level of results seen in the skin and the length of the healing process.
The lightest is the superficial peel which uses a mild acid to work on outer skin layers. A medium peel uses a stronger acid for deeper penetration. A deep peel removes several layers of skin to treat significant skin problems and requires the longest healing time.
The severity of the problems and the desired results will determine the depth and type of chem peel needed to address the issues. Lighter blemishes, clogged pores and acne issues often respond well to a light glycolic peel.
To take off enough skin to reduce wrinkles a medium TCA (trichloroacetic acid) peel is often required. Skin with significant wrinkles, uneven skin tone and pigmentation or other deep surface issues may require a deep peel like a phenol peel.
About the Glycolic Acid or Alpha Hydroxy Peel
A glycolic peel works on the most superficial level of the skin. This is a simple procedure that can be done in about 30 minutes in a visit to a doctor's office or health spa. It's also called alpha-hydroxy acid or AHA peel.
The glycolic peel uses glycolic acid to initially remove only the top layers of dead skin. It's unlikely significant results will be seen after one glycolic peel which is why many people have the procedure done once every four to six weeks. By having them regularly the results build up and can become more noticeable because once the dead skin cells are removed the peels begin removing and refreshing deeper layers of skin.
Glycolic peels with concentrations of about 10% glycolic acid are considered light or superficial peels. Some over-the-counter products contain alpha hydroxy acid (AHA) or glycolic acid in the 3 to 7% range and can be used safely at home.
Glycol Peel Procedure and Recovery
Patients report some stinging as the acid is applied but pain medication is almost never used and the pain goes away as soon as the neutralizing wash is applied at the end of the few minutes procedure.
Glycolic peels are the least invasive and therefore the least painful and have the shortest healing time. Because there is little skin damage there's no visible signs of healing. There may be a little redness and sun should be avoided. Patients can easily go back to work or go about their day without any discomfort or outward signs of the procedure having been done.
TCA Peel - Medium Depth Peel
The medium level TCA peel typically uses a 20-25% concentration of trichloroacetic acid to remove more layers of skin than the glycolic peel. The advantage of a TCA peel is that more results can be achieved in one procedure compared to a light peel.
A TCA peel is equal to about six glycolic peels. The concentration of the acid, length of time it remains on the face and the corresponding depth of skin layers affected are determined between dermatologist and patient depending on the condition of the skin and results desired.
TCA peels are effective at smoothing minor wrinkles, evening-out skin tone and reducing minor blemishes. The downside of a TCA peel is that it's more intrusive because it takes off more layers of skin. Therefore it's more painful and the recovery time can take weeks. For the first several days to a week after a TCA peel, the face will be red and peeling as though recovering from a bad sunburn.
Sometimes blistering and broken skin occurs as a result of the peel and bandages are applied. It's usually recommended that the patient have someone drive them home and often people undergoing a TCA will take a few days off from work during the first few days of healing. Noticeable healing will be visible for a week or more, a TCA peel is not a lunch time procedure you walk away from without anyone knowing it's been done.
Additional TCA peels can be performed once or twice a year to build on results.
Deep Peels Using Phenol
Deep chemical peels are performed with a chemical called phenol and are used to address significant wrinkle and pigmentation problems. The results can be powerful because the entire top layer of skin, known as the dermis, is taken off giving the body the chance to regrow the whole outer layer. The American Society for Aesthetic Plastic Surgery ( http://www.surgery.org/ ) and Dr. Mehmet Oz ( http://www.sharecare.com/question/different-types-skin-peels ) report that deep peels can make a person look 20 years younger.
As one can imagine from the description, the procedure is more involved and more painful than a light or medium level peel. There is a burning sensation during the application of the chemicals to the face but it's often not more painful than a TCA peel.
However, it's the after effects when the pain and discomfort are noticed. Since the top layer of skin has been removed, the underlying tissue is red and raw.
Once the treatment is finished the area is covered with a sterile gel and bandage to help healing and reduce risk of infection. The recovery time can be one to two weeks and often people elect to be out of work or and to limit their normal activities during this time.
Chemical Peel Preparation
In the week prior to a skin peel of any depth it's usually recommended that patients clean the skin regularly to reduce chance of infection and the use of moisturizer is recommended to promote even results and fast healing. Often a doctor will recommended applying sunscreen daily prior to the procedure.
Antibiotics might be recommended and anti-viral medications too if one suffers from cold sores which can appear as a result of the peel. Vitamin A skin formulas like tretinoin or retin-A can be used to spot-treat dark spots prior to treatment which will help the final result be more even. Sometimes other skin lighteners such as those contain hydroquinone are used to develop a more even skin tone prior to the procedure. However, usually all these superficial treatments are stopped at least a week before the peel is to take place.
Broad spectrum (UVA, UVB), high SPF sunscreen is always required after a peel as well as sometimes suggested for use before the procedure. This is to prepare and protect the new, less pigmented skin that will be exposed. Moisturizer is used post-peel to help the skin heal and keep it hydrated and healthy.
Chemical Peel Risks
Skin peels using chemicals are considered safe, however as with any medical procedure there are potential side effects
Some conditions will not be improved by a chemical peel
There's a risk of cold sores or "fever blisters" being activated. Antiviral medications might be prescribed prior to procedure if history of cold sores
Rare potential for scarring, picking at healing skin can increase risk of scars
Permanent skin bleaching or blotchy skin
Summary
Consultation with a qualified dermatologist or plastic surgeon is a key part of successful skin peels. Patients should be able to articulate what they hope to accomplish with the procedure and the time they have available to devote to healing. The doctor will need to know medical history including allergies and use of medications and topical face products currently being applied. With patient education and a doctor's consultation a chemical skin peel can be a safe and effective procedure.
Karen Walpole is a professional researcher and writer on issues of health and home.
She has written many skin treatment product reviews including an article on Obagi Blue Peel a TCA chemical peel.
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