CHEMICAL PEELS: 
What can a chemical peel do?
Chemical peeling is often used to treat fine lines under the eyes and around the mouth. Wrinkles caused by sun damage, aging, and hereditary factors can often be reduced or even eliminated with this procedure. Sags, bulges, and more severe wrinkles do not respond well to peeling and may require other kinds of cosmetic surgical procedures such as a face lift, brow lift, eyelid lift, or soft tissue filler.
Mild scarring and certain types of acne can also be treated with chemical peels. In addition, pigmentation of the skin in the form of sunspots, age spots, liver spots, freckles, splotching due to taking birth control pills, and skin that is dull in texture and color may be improved with chemical peeling.
Chemical peeling may be combined with microdermabrasion, Botox injections, or tissue fillers such as Restylane, Juvederm, Radiesse, or Sculptra to optimize skin rejuvenation based on the needs of the individual patient. Sun damage, precancerous growths, or rough skin may improve after chemical peeling. After a chemical peel, new lesions or patches are less likely to appear.
How are chemical peels performed?
A chemical peel is performed in our office as an out-patient procedure. At the time of treatment, the skin is thoroughly cleansed to remove excess oils. A chemical solution such as glycolic acid for superficial peels or trichloracetic acid (TCA) for deeper peels is used. The proper peeling agent is selected based upon the type of skin damage present. During a chemical peel, the solution is applied to the skin, producing a “controlled wound”, enabling new, refreshed skin to appear. Most patients experience a warm to somewhat hot sensation which lasts about five to ten minutes followed by a stinging sensation. Deeper peels may require pain medication during or after the procedure.
• Glycolic Acid – This has become the standard alpha-hydroxy acid used for superficial peeling. Glycolic acid stimulates the dermal collagen layer to thicken, which is believed to be the primary reason for the “freshening” of the skin. The healing time of the glycolic acid peel is dependent on its strength, ranging from no time at all for the lower strength formulations to three to five days of peeling for the higher strength solutions. Glycolic acid peels are used for treating acne as well as conditions associated with mild photodamage including fine lines and wrinkles, sun-derived keratoses (scaly spots), and increased pigmentation. Many over-the-counter creams contain milder concentrations of alpha-hydroxy acids which produce little or no change.
• TCA (Trichloracetic acid) – The strength usually ranges from 20% to 35%. During a TCA peel, most patients experience a warm to hot sensation that may last about five to 10 minutes, followed by a stinging sensation. Skin peeling can last for one to three weeks. Redness is normal and usually lasts 7 to 10 days. The ideal candidate for a TCA peel has mild to moderate photodamage or acne scarring. TCA peels are used to lighten sunspots, roughness, and fine lines. TCA peels are considered safe and have highly favorable benefits relative to the risks involved.
What should be expected after treatment?
Depending on the type of peel, a reaction similar to sunburn occurs. Superficial peeling usually involves redness followed by scaling that ends in several days. Deeper peeling may result in swelling and the presence of water blisters that will break, crust, and peel over a period of seven to fourteen days. It is important to avoid overexposure to the sun after a chemical peel since the new skin is fragile and more susceptible to burning and to reduce the potential to develop abnormal skin color. Depending on the type of peel and the degree of sun damage that is present, this treatment can be repeated at regular intervals to optimize results.
MICRODERMABRASION: 
Over the past few years, microdermabrasion has become a popular skin rejuvenation procedure in the United States. Microdermabrasion has been used in Europe and Asia for the past decade. Microdermabrasion provides an alternative for patients who desire to conservatively improve their skin’s appearance without a prolonged recovery time. Microdermabrasion is non-invasive, produces no discomfort, does not require topical or local anesthesia, and has no recovery or down-time.
What to expect from Microdermabrasion?
Exfoliation with the Vibraderm Skin Station produces significant tone and texture improvement. Microdermabrasion reduces fine lines and wrinkles, age spots and dullness, acne scars and pore size. Compared to original forms of microdermabrasion in which aluminum oxide particles are blown across the skin, “vibradermabrasion” causes less trauma to the epidermis than that seen with other systems and therefore causes little if any inflammation or swelling. Treatment sessions last 20-30 minutes. Vibradermabrasion may also be used on the chest, neck, arms, and hands with virtually no complications. Patient satisfaction with microdermabrasion has been consistently and overwhelmingly positive. Patients enjoy the treatment and are pleased with the results. Changes in the skin can be seen after only three treatments. Skin biopsies have demonstrated stimulation of the basal (growth) layer with thickening of the skin as well as formation of new collagen and elastic fibers. Vibradermabrasion treatments are very comfortable and produce consistent results. Combinations of microdermabrasion and superficial peels have given good results because it allows the peel to penetrate into the skin in a controlled manner. Healing time is very short as only mild redness is usually seen. A patient with mild to medium photodamage would be an excellent candidate for repeated microdermabrasion and/or superficial peel combination treatments.
Indications for treatment
A minimum of five initial treatment visits, usually seven to ten days apart, is recommended to achieve optimal results. Follow-up maintenance is optional. Vibradermabrasion is effective for the following conditions:
- Greatly enhances poor, dull skin texture by gently resurfacing the superficial skin layers.
- Softens and modifies fine 'expression' lines typically seen on the forehead and around the mouth.
- Polishes and reduces fine lines on the cheeks generally caused by aging and sun damage.
- Improves changes seen from chronic photodamage.
- Smoothes pigment changes or skin discoloration.
- Polishes and smoothes the margins of acne scars as well as other scars on the face. This usually requires ten initial treatment visits.
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