Chemical Peeling
"Chemical peel" is a general classification for a number of chemical treatments used to exfoliate and rejuvenate the skin. Typically during a chemical peel nothing actually "peels" off. A chemical solution is applied to the skin, and works by dissolving the upper layers of the skin. As the tissue is dissolved it causes new tissue to emerge. Some chemical peels are so strong as to be able to remove the whole surface of the skin. These are the deepest forms of chemical peeling, which, in my opinion, are not used as often as they had been. These forms of peels have generally been replaced by laser treatment as laser provides a greater and more precise level of control . Most peels today are less destructive and more superficial. Chemical peels have been in use for a number of years and are a highly popular way to improve the texture and look of skin.

The depth and strength of the 'peel' varies based upon the :
  • Strength of the chemicals used and
  • The length of time the solution is applied.
  • Number of coats applied.

This procedure uses a chemical solution, usually an acid, to ‘peel’ away the top layers of the epidermis in order to improve conditions such as
  • Acne
  • Irregular pigmentation or
  • Wrinkles.

Type of Peels
There are a variety of different types of chemical skin peels, as there are a variety of chemicals used, each with their own properties.
Superficial peels : Glycolic acid peels.
Medium depth : TCA
Deep peels : Phenol

With a chemical peel you get some tightening of the skin, you get improvements of pre-cancerous and brown spots, improves texture and a general resurfacing of the skin. Note that patients taking Retin-a may be more sensitive and should notify their doctor.

Glycolic Acid Peel
Glycolic acid, which is derived from sugar cane, is probably the most popular grade of alpha hydroxy acid (AHA) used for facial peels. Glycolic acid peels are effective, yet they tend to produce the minimum of side effects. It is used in various concentrations - 20%, 35%, 50% and 70%.

What does it do?
Like other AHA peels, glycolic acid peels removes the top layer of dead cells on your skin, revealing a new layer that is smoother-textured and more vibrant-looking. These peels help with fine lines, minor skin discolorations (such as "age" spots), and dry patches known as solar keratoses. They’re also useful for treating acne and for removing or minimizing old acne scars. Glycolic acid peels are also believed to stimulate the growth of collagen, a protein that helps give skin its structure. The loss of collagen due to aging and sun exposure is one of the factors involved in the formation of lines and wrinkles. To increase the effectiveness of the peel, your physician may recommend that you combine it with another treatment that removes the top micro-layer of skin: microdermabrasion.

Treatment with Glycolic Acid
In physician offices a glycolic acid peel may be administered in concentrations from 20% to 80%. The stronger the concentration of the peel, the deeper the peel will dissolve tissue. It usually requires 4 to 6 sittings at interval of two weeks each time. It is an office procedure , taking just 15 - 20 minutes. First, your skin will be cleansed and degreased. Then the acid will be applied. As soon as the acid has reached the intended depth, your physician will apply a neutralizing solution. If someone is using Retin-A or Retinoid-like medications it will make a glycolic peel have a stronger effect, so let your practitioner know if you are using such medications.

Side Effects
For a few days after treatment, your skin will look slightly reddened, and it may peel a bit. It will also be dry--a side effect that can be relieved with a moisturizer. You’ll need to wear a sunscreen for several weeks, as your skin will be more vulnerable than usual to sunburn.

TCA Peel (Trichloroacetic Acid Peel)
Trichloracetic Acid (TCA) peels are considered medium-depth peels. They reach slightly deeper into the skin than alpha hydroxy acid (AHA) peels--and thus often produce stronger results. To avoid discoloration, however, people with dark brown skin need to follow a pre-treatment protocol that may include treating the skin with alpha hydroxy acids (AHAs) first.

How Does a TCA Peel Work?
TCA is a skin-resurfacing treatment: it removes dead skin cells, uncovering a "new" layer of skin that appears smoother and more vibrant. As a result, it softens fine lines, minimizes superficial "age" spots and other skin discolorations, and generally improves the tone and texture of your skin. TCA peels are also very popular for diminishing the appearance of acne scars. More than one TCA treatment may be recommended. Treatments are usually spaced 2 to 3 months apart. To increase their effectiveness, these peels are often combined with other skin-rejuvenating treatments, such as microdermabrasion.

The Treatment
TCA peels generally takes 15 to 30 minutes. The exact length of treatment will depend on how many "coats" of the acid are applied to your skin. First, your skin will be cleansed and degreased. Then the acid will be applied. As soon as the acid has reached the intended depth, your physician will apply a neutralizing solution. You’ll experience a slight stinging sensation during the 2 to 3 minutes the solution remains on your skin. Your physician may use ice water or a fan to reduce any discomfort. If a high concentration of acid is being used, you may also be given a medication for pain or anxiety.

Side Effects
You’ll probably want to set aside several days to recover from a TCA treatment. Immediately after the procedure, you can expect some skin irritation, redness and swelling. Within a few days, your skin will tighten and darken--and then begin to crack and peel for the next 4 to 7 days--at which point the tighter, smoother and more youthful-looking layer of skin will emerge. Because your skin’s newly formed layer will be temporarily more susceptible to sunburn, you’ll need to protect it with an effective sunscreen for several weeks. TCA is a strong chemical that can transform the appearance of your skin, but it should be administered only by a skilled and experienced doctor. I use chemical peels for photo-aging, such as age spots and wrinkles , for improving acne and modest acne scarring. They are also very effective at exfoliating and smoothing the skin, as well as improving the texture of the skin. Another benefit of using chemical peels is that they can be used not only on the face, but on the chest and back as well. I almost exclusively use the glycolic acid peels . In few cases I use TCA peel. The recovery time for a patient after a chemical peel will depend on the type and strength of the peel they've had. For example, the common alpha-hydroxy and glycolic acid peels have little or no recovery time. There may be some slight pinkness to the skin, but that usually fades rapidly. With the higher concentration peels, such as TCA or Phenol peels, you can have some peeling and irritation for a few days afterward.
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