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Erma L. Benitez, M.D.
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Chemical Peels
Chemical peeling is a technique used to improve the appearance of the skin. A chemical solution is applied to the skin which causes it to separate, peel off, and allows new skin to regenerate. The new skin is smoother and less wrinkled than the old skin, and may also be more even in color.

Millions of chimical peels are performed each year. Dermatologist have used various peeling agents for decades and are experts in performing all types of this chemical surgery. Today, with the public's increasing interest in rejuvenation skin and slowing the effects of the aging process, chemical peeling has emerged as an exciting anti-aging procedure. Results of chemical peels may also be enhanced by new laser/light-based rejuvenation techniques. A thorough evaluation by your dermatologist is necessary before choosing a chemical peel program.

What can a chemical peel do?
Chemical peeling is used to treat fine lines, especially under the eyes and sround the mouth. Wrinkles caused by sun damage, aging, and hereditary factors can be reduced or even eliminated with this procedure. However, sags, bulges, and more severe wrinkles do not respond to peeling and may require other kinds of cosmetic surgical procedures. A dermatologist can help determine the most appropriate type of treatment for each individual case.

Mild scarring and certain tyes of acne may also be treated with chemical peels. In addition , pigmentation of the skin in the form of sun spots, age spots, liver spots, freckls, blotchiness due to taking birth control pills, and skin that is dull in texture and color may be improved with chemical peeling. Areas of sun-damaged skin and scaling patches may improve after chemical peeling as well. Sunscreens and sun blocks must be used in conjunction with chemical peels in order to decrease the chance of the reappearance of leasions.

How are chemical peels performed?
The procedure may be performed on the face, neck, chest, hands, arms, and legs. Superficial, medium, or deep chemical peels may be used to improve damaged skin. As a rule, the deeper the peel, the longer the recovery time. Your dermatologist will recomment the best peel for your skin problems.

Prior to treatment, instructions may include stopping certain medications and preparing the skin with pre-conditioning creams.

A chemical peel is usually performed in a dermatologist's office. The skin is thoroughly cleansed with an agent that removes excess oils, and the eyes and hair are protected. One or more chemical solutions such as glycolic acid, trichloroacetic acid, salicylic acid, lactid acid, or carcolic acid (phenol) are used. Your dermatologist will suggest the proper peeling agent based upon the type of skin damage present and desired results.

During a chemical peel, the physician applies the solution to various areas of the skin. These applications produce separation and eventually peel off layers of skin, enabling rejuvenized skin to appear

During the procedure, most patients experience a warm to hot sensation that may last about five to ten minutes, followed by a stinging sensation, A deeper peel may be more painful and require medication during or after the procedure. 

What should be expected after treatment?
Depending upon the type of peel, there may be a mild to severe sun burning sensations. Superficial peeling usually involves redness, followed by scaling that lasts three to five days.

Medium-depth and deep peeling can sometimes result in swelling and blisters that may break, crust, turn brown, and peel off over a period of 7 to 14 days or longer. Some peels may require surgical tape to be placed on part or all of the skin that is treated.

It is important to avoid overexposure to the sun immediately after a chemical peel since the new skin is fragile and more susceptible to injury. Your dermatologist will prescribe appropriate follow-up care to help the skin heal. 

What are the possible complications?
In certain skin types, there is a risk of developing a temporary or permanent color change. Birth control pills, pregnancy, or a family history of brownish discoloration on the face may increase the possibility of developing abnormal pigmentation. Persistent redness may also occur and can last for months.

Although very low, there is a risk of scarring after chemical peels. If scarring does occur, it can usually be treated with good results. There is a small incidence of the reactivation of cold sores or herpes simplex infection in patients with a history of fever blisters. Prior to a chemical peel, it is important for a patient to inform the dermatologist of any past history of keloids, unusual scarring tendencies, extensive X-rays or radiation to the face, or recurring cold sores, for proper precautions to be taken.

What are the limitations of chemical peels?
Chemical peels cannot remove loose or sagging skin since they cannot eliminate the gravitational forces which produce the loose skin. A facelift, brow lift, laser/light-based skin rejuvenation, or other procedures may be required.

Chemical peeling does not remove deep scars. Dermabrasion, laser resurfacing or non-ablative laser therapy, punch grafting, punch elevation, scar excision, or soft tissue fillers may be much more effective for scars and should be discussed with Dr. B.

While chemical peels cannot change pore size or remove broken blood vessels on the face, the procedure may improve the appearance of these conditions.

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