Chemical Peels

Chemical exfoliation of the skin dates as far back as the Egyptians. True exfoliation of the skin was first introduced in the early 1900s. Acids such as Phenol, Resorcinol and Salicylic acid were introduced around the 1940’s. The Baker-Gordon phenol formula was introduced in the 1960’s with wide acceptance by aesthetic doctors for resurfacing skin damaged from acne scarring, environmental factors or to even out pigmentation irregularities. Most of these peels were considered mid-depth peels, or deeper wound-inducing peels, and only performed by doctors.

As time went on, studies on patients undergoing facelifts who had previously had physician-performed mid depth peels showed vast improvement in collagen synthesis and formation, as well as significant improvements in pigmentation distribution. For that reason, patients considering facial surgeries are sometimes encouraged to plan a mid depth peel around the mouth and eyes simultaneously with the surgery. That way the skin texture and appearance in those areas is improved and rejuvenated too. There is also the additional benefit that recovery from the peel and the surgery can take place at the same time, minimizing patient inconvenience.

More recently, there has been a vast introduction of more superficial ‘lunchtime peels’ for ‘freshening up the skin’; AHAs, TCA, retinoic acid, jessner solution, even enzyme peels, to name just a few.

Some conditions that improve with chemical peels:

  • Fine lines under the eyes and around the mouth
  • Wrinkles caused by sun damage and aging
  • The appearance of mild scars
  • Certain types of acne
  • Age spots, freckles, and dark patches (melasma) due to pregnancy or birth control pills
  • Texture and tone

Prepare

Dr. Sabry will meet with you to determine if a mid depth or superficial chemical peel is the best course of treatment for you. He will explain each modality and recommend a treatment that addresses your priorities and comfort level. If you both decide that a superficial peel, or series of peels, is the best option, our medical aesthetician will go over the procedure details with you and explain any risks and possible complications and discuss scheduling. If you decide to do a mid depth peel, you will be asked to use medical grade skincare products for a few weeks prior to your peel in order to prepare properly. Skin that is properly prepared for mid depth peels heals faster and has few complications from pigmentation irregularities. Your medical and personal history will be reviewed, to make sure you have no contraindications. A few days prior to your peel you will be asked to take an anti-viral and possibly an antibiotic for prophylaxis of infection. Superficial peels generally do not require pre-treating of the skin or medication unless there is a history of herpes infection.

Procedure

Superficial peel
Your skin will be cleansed right before the peel with acetome. The peel will then be applied to with a small brush, gauze, or cotton-tipped applicators. The peel is left on the skin for several minutes, depending on the type used. Water, bicarbonate or alcohol may be used to neutralize the acid and end the chemical reaction, and then it is wiped off. You may feel a little burning while the chemical is on your skin. You may be given a handheld fan to help cool the skin and relieve any discomfort. Superficial peels are performed by our medical aesthetician.

Mid depth peel
A mid depth peel is similar to a superficial peel; however the peel solution is left on for a longer period of time. Medium peels are more painful than superficial peels, because the chemicals are stronger and they penetrate deeper into the skin. You may be given pain medication and a mild oral sedative to reduce discomfort and anxiety during the procedure. Cool compresses and fans can be used to cool the stinging and burning. The procedure takes about 40 minutes. There is little or no pain after the peel is finished. Mid depth peels are performed by Dr. Sabry.

Recovery

Mid Depth Peels
Dr Sabry does most peels a on an outpatient basis. If you have a mid depth peel you will need a few days to recover. A medium peel causes a second-degree burn of the skin. The skin takes 5 to 7 days to heal enough so that you can use makeup to hide the redness. There is little or no pain after the peel, but there may be some swelling, especially if the area around the eyes is treated. The skin will turn reddish brown in 2 to 3 days, become crusty, and then flake and peel over the next few days.

Superficial Peels
Patients having superficial peels can return to their normal activities immediately. The skin heals quickly after a superficial peel. You may appear a bit pink for a few days, and usually only minimal peeling occurs. You can use makeup to hide any redness until it fades.

Complications

Complications from peels may include all or some of the following: Redness, unexpected color changes in the skin, swelling, scarring, allergic reaction to the chemical, infection (people who have a history of herpes outbreaks are especially prone to infection after a chemical peel), increased sensitivity to sunlight.