What is a Chemical Peel?
A chemical peel is a technique used to improve and smooth the texture of the facial skin using a chemical solution that causes the dead skin to slough and eventually peel off. The regenerated skin is usually smoother and less wrinkled than the old skin. Some types of chemical peels can be bought ‘over-the-counter’ and administered without being medically qualified, however people are advised to seek professional help from a specialist, preferably a facial plastic surgeon on a specific type of chemical peel before a procedure is performed. This is because different skin types react in vastly different ways to the same peel, sometimes causing over- or under-pigmentation or scarring if performed incorrectly.
A variety of different types of peel agents exist:
- glycolic acid
- Retinoic acid
- TCA (trichloroacetic acid)
Many of the chemical peels require pre-treatment with creams which condition and prepare the skin. These also include sun blocks and vitamin complexes. In addition, these creams will often be recommended after the course of chemical peels is completed.
Light chemical peels like AHA and glycolic acid peels are usually done in an outpatient setting. There is minimal discomfort so usually no anesthetic is given because the patient feels only a slight stinging when the solution is applied. If analgesia was requested, a painkiller such as paracetamol would be appropriate.
Medium depth peels like TCA (which peel to a deeper level in the skin) are also performed as an outpatient procedure and tend to be a bit more painful. Frequently, the combination of a sedative and a painkiller usually suffices. TCA peels often do not require anesthesia because the solution itself has a numbing effect on the skin. The patient usually feels a warm or burning sensation.
Phenol is the classic deep chemical peel. The application is very painful, therefore the procedure usually requires a general anesthetic. These peels have a higher incidence of possible adverse influences upon the heart. Also if a deep peel is required, similar results can usually be obtained with a carefully planned and well-executed course of medium depth peels over a period of time. For these reasons, phenol peels are not performed by our clinic.