Chemical Peels

The skin is a living organ made up of millions of cells organized in several layers. Everyday thousands of cells are sloughed off, and new cells from deeper layers of the skin replace them. As part of aging, this process becomes slower and more disorderly causing the skin to appear more dull, blotchy and "sun damaged". The goal of a superficial chemical peel is to create controlled shedding of the cornified (outer) layer of cells. This exposes a new fresh layer of skin with resultant more even, pink and pleasing color, increased luster and soft, smoother texture. In addition, the peel stimulates new collagen synthesis (formation) in the dermis (deeper skin layer) thereby tightening the skin surface and decreasing wrinkling.

Various chemical solutions are used for peeling of the skin depending on the goal and desires of the patient. Glycolic (fruity acid, alpha hydroxy peels), ranging from 30 to 70%, superficially exfoliate and refresh the skin and allow for improved penetration of skin care products.  Other similar (beta-hydroxy) acids such as lactic and polybionic acids may be used.  Series of mild, superficial chemical peels further augments the results and also improve superficial brown spots such as "liver" spots and sun lentigenes. These peels may be successfully combined with microdermabrasion for even nicer, quicker results (see our microdermabrasion page). Salacylic peels are useful for treatment of active acne and may be combined with retinoid for control of this common facial problem. The superficial chemical peels cause mild burning and tingling of the skin for a few minutes during and following the treatment but there is essentially no real recovery time required. Patients return to normal activities the same or next day.

Medium depth peels are useful for bleaching of brown pigmentary changes (liver spots, sun spots), for treatment of very mild wrinkling and for removal of precancerous skin lesions such as actinic keratoses. Most people have similar aging and sun damage changes not only on the face but also on the neck, chest and hands. Fortunately, medium depth peels are safe to be performed on these non-facial areas.  Dr. Zemplenyi usually uses trichloroacetic acid (TCA) up to 35% in concentration sometimes further augmented with a Jessner's solution (Resorcinol). Healing time varies with the depth of the peel and takes about 7 to 10 days prior to application of cover-up make up, and therefore, most patients choose to at stay home during the healing time following a medium depth TCA peel. For maximum comfort, at the Bel-Red Center we perform medium depth peels using oral pre-medication, cooling of the skin surface and sometimes conscious sedation ("twilight sleep") anesthesia.

In Dr. Zemplenyi's practice, deep phenol chemical peels have been partially replaced by CO2 laser resurfacing, but he feels that phenol peels are still very satisfactory for patients with facial wrinkling and Fitzpatrick type I (very fair) skin.  As with laser resurfacing anti-viral (herpetic) medications are used in the period immediately before and after the procedure. Post-operative occlusive treatment and anti-inflammatory steroids shorten the recovery time, but cover-up makeup is necessary for several weeks to months while the pink discoloration resolves. Cover-up makeup is available from the esthetician services available at the Bel-Red Center for Aesthetic Surgery. 

Use of sunscreens to protect the fresh, new skin is necessary for at least three to six months following medium depth chemical peeling, and proper on-going skin care program enhances the results. (See SKIN CARE).