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Chemical peels are an excellent, non-invasive, topical alternative to treat and improve the tone and appearance of sun damaged skin. They help improve fine wrinkles, soften the appearance of deeper folds, bleach aging spots, and improve precancerous skin changes.
Chemical peels will not eliminate deeper wrinkles and several treatments may be required to achieve maximal, sustained results.
Individuals with light colored skin that burns easily with the first summer sun exposure are the best candidates for chemical peels. Persons with moderate brown or darker skin that rarely burns and tans easily are at greater risk for post-treatment hyperpigmentation. Olive colored skin has a tendency to form dark patches after chemical peels. The greater the degree of photodamage the deeper the peel required to achieve improvement.
Chemical peels can improve photodamaged skin by stimulating deposition of new collagen above or in place of the sun-damaged dermis (the deeper layer of skin composed of spongy fibrous connective tissue).
If you have been treated with Accutane, you must wait at least 12 months before having a chemical peel. If you have a history of "cold sores" or "fever blisters" (Herpes simplex infections), an oral antiviral will be prescribed 5-7 days prior to your chemical peel. Topical therapy with retinoids ( such as Retin-A 0.025% cream at bedtime) and/or glycolic acid 8-10% (such as Avon's Anew, Estee Lauder's Fruition, NeoStrata, Aquaglyde cleanser) every morning or twice daily may be recommended for two to four weeks prior to beginning chemical peel treatments. A sunscreen with a sun protection factor (SPF) of at least 15 and containing protection against UV-A and UV-B should be used.
Do not wear makeup, moisturizers, oils, or hair preparations for 24 hours prior to your chemical peel.
The area to be treated is cleansed to remove oily debris. If your procedure is performed in the office, a topical anesthetic cream may be applied to the treatment area before the chemical peel. If your procedure is performed in the operating room at the time of other eyelid, forehead, or cosmetic procedures, then a topical anesthetic is not necessary. The eyes are kept closed during the procedure. A cotton-tipped applicator is used to apply the chemical peeling agent. The edges of the treatment zone are "feathered" into the surrounding untreated areas to prevent a sharp demarcation. The skin will burn and sting slightly during the peel. Neutralization of the chemical typically leads to a white, frosted appearance. A thin layer of ointment is applied to the treated areas and cool compresses are placed over the face. The frosting fades quickly and the treated areas will appear red and swollen.
The treated areas should be cleansed with a mild soap or gentle, nondrying cleanser (SkinCeuticals® Gentle Cleanser - available in our office) twice daily during the first 4-7 days until the redness diminishes. Apply a thin layer of petrolatum jelly (Vaseline®) after cleansing to keep red, treated areas from drying. Whitehead or milia may form over healing pores. Topical ointments may need to be discontinued if significant acne develops. Avoid rubbing and picking of flaky, treated areas. Sun avoidance is critical during the first 6 weeks after a chemical peel. Sunscreens should also be restarted 1-2 weeks after the peel to lessen the risk of permanent hyperpigmentation.
Tylenol should control any discomfort following a chemical peel.
Redness may disappear during the first week or last last up to 6-12 weeks.
A blotchy skin appearance may occur. This typically resolves over the first several weeks. Topical therapies may be prescribed to help with any significant pigmentary changes.
You will experience increased sensitivity to windburn and irritants for several weeks after your peel.
More than one treatment session may be necessary to achieve maximal results. Moderate depth chemical peels can be repeat in about 6 months.
Infections and scarring are extremely rare. It is important to follow post-treatment instructions carefully and to continue your close follow-up in our office to monitor for these potentially devastating complications.
Stephen R. Klapper, M.D., F.A.C.S. is a board certified Ophthalmologist and has completed extensive fellowship training in Ophthalmic Plastic and Reconstructive Surgery. In addition to his clinical practice Dr. Klapper has published numerous scientific articles in peer reviewed journals and presented several papers at regional, national, and international meetings on topics related to the field of eyelid and facial plastic surgery. Dr. Klapper's practice is limited to adult and pediatric cosmetic and reconstructive eyelid and facial surgery, tear duct surgery, orbital disease, thyroid eye disease and the anophthalmic patient. Dr. Klapper also has extensive experience performing facial Botox® injections and Restylane® lip and facial fold injections.
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