Chemical peeling gives a predictable result with safety, efficacy, and an excellent cost to benefit ratio. Chemical peeling still remains the most popular and reliable method for skin resurfacing. Lasers cannot produce such results as efficiently and safely as chemical peeling and laser hype has not delivered what it has marketed.
Chemical peeling is an in-office procedure that involves the application of a chemical agent (acid) to the skin to destroy and remove old damaged skin and stimulate new growth with more evenly distributed pigmentation. Using acid on the skin is really nothing new. Cleopatra used tartaric acid, the residue at the bottom of the wine barrel to massage her face. Over the years women have used buttermilk, vinegar, and lemon juice on their skin which all contains weak acids. Both the chemical peeling process and the peeling agents have been refined to minimize potential complications and to further stimulate skin repair.
With proper technique, skin rejuvenation with chemical peels results in high patient satisfaction. The different peeling agents can be used alone or in combinations to provide a tailored treatment fitting the individual patient’s unique needs.
Chemical peels are classified by their depth of penetration. Peel depth is determined by several factors: the chemical chosen and its concentration; patient skin type and thickness; the body site to be peeled; skin preparation; application method; duration of skin contact with the acid; and the season and climate.
Superficial chemical peels penetrate to the bottom layer of the epidermis and will stimulate growth of a new epidermis. They are best suited for mild to moderate textural imperfections, fine lines, pigmentation irregularities, and acne lesions. For optimal results, we recommend a series of four to six treatments. Superficial peels are designed to be repeated weekly or every other week because of their quick re-epithelialization times. There is little discomfort, minimal down-time, and gives noticeable improvement. Superficial peeling agents include glycolic acid, salicylic acid, resorcinol, and lactic acid.
Medium depth chemical peels penetrate down to the upper dermis. For this peel we use trichloroacetic acid (TCA) combined with Jessner’s solution or glycolic acid. The depth of this peel will depend upon the concentration of the acid, the number of coats applied and the application technique, the skin thickness, and whether or not the skin has been “preconditioned” with retinoids or an exfoliant. There is a much greater degree of improvement in fine wrinkle lines and sun-damaged skin with this level peel but has a 7 to 10 day period of “down time”.