Chemical Peels

Types of chemical peels:

1. Superficial or lunchtime peel: Alpha-hydroxy acid or another mild acid is used to penetrate only the outer layer of skin to gently exfoliate it. The treatment is used to improve the appearance of mild skin discoloration and rough skin as well as to refresh the face, neck, chest or hands.
2. Medium peel: Glycolic or trichloroacetic acid is applied to penetrate the out and middle layers of skin to remove damaged skin cells. The treatment is used to improve age spots, fine lines and wrinkles, freckles and moderate skin discoloration. It also can be used to smooth rough skin and treat some precancerous skin growths, i.e. actinic keratosis.
3. Deep peel: Trichloroacetic acid or phenol is applied to deeply penetrate the middle layer of skin to remove damaged skin cells. The treatment removes moderate lines, age spots, freckles and shallow scars. Patients will see a dramatic improvement in skin appearance. The procedure is used on the face and only can be performed once.

Determining if you’re a candidate

Before you have a chemical peel, your doctor will likely:

1. Review your medical history. Be prepared to answer questions about current and past medical conditions — especially any heart, kidney or liver conditions if you’re considering a deep chemical peel. Tell your doctor about any medications you’re taking or have taken recently — particularly those that might make your skin sensitive to the sun — as well as any cosmetic procedures you’ve had in the past. Be sure to tell your doctor if you’ve been using a retinoid cream such as tretinoin (Renova, Retin-A, others), which can enhance the penetration of some chemical peels.
2. Do a physical exam. Your doctor will inspect your skin and the area to be treated. This will help him or her determine what type of chemical peel you might benefit from most and how your physical features — for example, the tone and thickness of your skin — might affect your results.
3. Discuss your expectations. Talk with your doctor about your motivations and expectations, as well as the potential risks. Make sure you understand how many treatments you might need, how long it will take to heal and what your results might be.

Before the procedure

A chemical peel is typically done in an office-based procedure room or outpatient surgical facility. Before the procedure, your doctor will clean your face and might cover your eyes with ointment, gauze, tape or goggles. He or she might also protect your hair.

Pain relief isn't typically needed for a light chemical peel. If you're having a medium chemical peel, you might have the option of taking a sedative and a painkiller.

If you're having a deep chemical peel, your doctor will likely numb your skin with a local anesthetic and give you a sedative or use regional anesthesia — which numbs a certain part of your body.