Cosmetic and Plastic Surgery Center of Houston, Texas

If you've ever overdone tanning on the beach and peeled afterward, you're halfway to understanding the cosmetic surgery principle used in chemical peeling. However, it’s not rays of the sun, but an acid solution which is painted on the skin of the face and, depending how deep you want the peel to go, you can choose from a 30 percent or 70 percent strength glycolic acid peel.

Chemical peels use several types of acid solutions to improve and smooth the texture of your facial skin. The acid works by removing damaged outer layers and are sometimes also used on the neck and hands. Chemical peels have been proven to be among the most popular nonsurgical cosmetic procedures chosen by patients. For instance, The American Academy of Facial Plastic Surgery estimates nearly 74,000 (UPDATE) patients underwent chemical peels in 2003, (the most recent year for which the academy has statistics) making it the third most popular among surgical and non-surgical cosmetic procedures.

Chemical peels vary according to their specific ingredients and strength. The actual depth of the peeling can also depend on other considerations such as how long the solutions remain on the skin and if they are lightly, heavily or vigorously applied. The most commonly performed peel procedures are lightly applied to smooth rough dry skin and aids in control of acne.

There are three common types of chemical peels: For light to medium uses, physicians use a solution known as AHA (alpha hydroxyl acid,) which include glycolic, lactic or fruit acid. AHA treatments may require a series of multiple applications.

TCA (trichloroacetic acid) is stronger and flays the skin down to a greater depth while Phenol, the strongest acid, is used for the deepest peels and is most commonly used to treat skin wrinkling around the lips and chin. However, Phenol may pose a special risk for patients with a history of heart disease so it’s important you make your surgeon aware of your condition. Moreover, Phenol is not usually applied to darker skins.

TCA peels are more effective in treating patients with darker skin and offer a shorter recovery time than with solutions used for lighter peels. A TCA peel may also require pretreatment with AHA or a Retin-A cream.

According to the American Academy of Facial and Plastic Surgery, there was a 30 percent increase over the previous year for a total of Deep peels are usually done once and provide longer-lasting results. The deep peel is usually used on patients who have the deepest wrinkling.

Although chemical peels may be done in conjunction with a facelift, the peel is not a substitute for that surgery, nor will it stop aging. A chemical peel is most useful for fine wrinkles on cheeks, forehead and around the eyes and the vertical wrinkles around the mouth.

Chemical Peel Benefits:

After the top layer of skin is peeled away, new, fresh skin regenerates without imperfections, lines and wrinkles. Deeper chemical peels are an effective treatment for the extreme wrinkling caused by spending too much time in the sun.

If your surgeon has selected an AHA peel, no anesthesia or sedation is needed. Sometimes, a single treatment can produce that radiant look of younger skin. Additionally, time off from your job and regular activities is not usually required with an AHA peel.

How are chemical Peels performed?

A full face chemical peel usually takes one to two hours to perform and is safely done in the physician’s office. Your physician may ask you to eliminate certain drugs from your system before doing the procedure. But a more limited procedure -- like treating only the wrinkling above the lip -- will generally take less than 30 minutes. Overall, your surgeon decides which solution is right for your case and applies it to the treatment area, avoiding eyes, brows and lips. After the peel solution has worked on the skin, it is neutralized with water. About an hour later, a thick coating of petroleum jelly is layered over the face and covers the protective crust left by the acid solutions. That crusty layer stays in place for one to two days. Some physicians use another technique for cases of severe wrinkling, whereby a mask made of adhesive tape, covers the patient’s face during the early stages of the healing process.

The solution is applied using a sponge, cotton pad, swab or brush. The treatment begins with a thorough cleaning of the skin to remove any traces of grease with rubbing alcohol or acetone. The peeling solution is left on the face for a few minutes then removed.

The deeper a peel penetrates, the more visible will be the results. However, the recovery time may be longer. A full face chemical peel usually takes one to two hours to perform and is safely done in the physician’s office. Your physician may ask you to eliminate certain drugs from your system before doing the procedure. But a more limited procedure -- like treating only the wrinkling above the lip -- will generally take less than 30 minutes. Overall, your surgeon decides which solution is right for your case and applies it to the treatment area, avoiding eyes, brows and lips. After the peel solution has worked on the skin, it is neutralized with water. About an hour later, a thick coating of petroleum jelly is layered over the face and covers the protective crust left by the acid solutions. That crusty layer stays in place for one to two days. Some physicians use another technique for cases of severe wrinkling, whereby a mask made of adhesive tape, covers the patient’s face during the early stages of the healing process.

The deeper a peel penetrates, the more visible will be the results. However, the recovery time may be longer.

How much pain is associated with chemical peels?

With AHA, the patient only feels some stinging or irritation and sees some redness on the face.

All three procedures can cause puffiness in the face which subsides after several days. Medium peels usually do not require anesthesia while the deep peels usually require intravenous sedation. Temporary flaking or scaling, redness and dryness are normal after effects. Ointments, used for seven to ten days following surgery, keep the skin supple. Some deep chemical peels require a break from normal activities for one to two weeks. With the deeper peel, the patient is usually monitored with an EKG.

Who would be an ideal candidate for chemical peels?

The fair skinned, light haired patient who has a very wrinkled face or who has a face dotted with liver, age and sun spots, freckles or splotching due to taking birth control pills – and wants a looker, fresher look -- would be a good candidate for a chemical peel. The face that has a dull texture and color may be improved with chemical peeling. Precancerous keratoses or scaling patches may improve after chemical peeling. However, the procedure does not correct sags, bulges and deep furrows. Those conditions are often better treated by face, brow and eye lifts or soft tissue fillers.

What are the risks and limitations of chemical peels?

Experts say not everyone may be a suitable candidate for a chemical facial peel. Before surgery, your physician must evaluate the solutions’ effect on ethnic background, age, skin type and color. But because there can be serious consequences and unforeseen complications, the American Society for the Aesthetic Plastic Surgery says Phenol chemical peels should only be performed by a qualified physician. (In some states, non-physicians can apply chemical peels. Some inadequately trained practitioners claim in advertisements they have “miracle treatments” to rejuvenate the skin.) Overall, you must be free of skin infections, including acne and any type cold sore, especially herpes simplex sores. You must have not taken Acutance for twelve to 18 months before treatment, depending on your doctor’s specifications. And, you will be asked to limit your exposure to the sun for at least a month before undergoing the peel.

What are the typical costs associated with chemical peels?

While the American Society of Plastic Surgeons says the average cost of a chemical peel in the U.S. is $607, prices vary widely depending on the procedure and overall economic conditions where you live. For instance, one mild face peel costs around $100 per application but a Phenol full face peel can cost $3000 to $4000. And those are doctor’s fees. Be sure and check what other associated fees are involved before proceeding. Click here for our chemical peel pricing.

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