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This
procedure can restore sun-damaged, wrinkled, blemished, acne
scarred or blotchy skin to its original youthful appearance.
The results are normally a smoother more even toned textured
skin. The skin will look younger, tighter and fresher
than before although it cannot remove all facial flaws.
Deeper lines, wrinkles and other flaws may require
additional treatments or techniques. The chemicals
normally used are Trichloracetic acid (TCA) for more
superficial lines and blemishes or Phenol (a much deeper and
more serious peel) for deeper wrinkles, flaws or
discolorations. Regardless, the down time can be
considerable so be prepared to take time off for recovery.
Your
Options in Chemical Peels
There are very minor peels and there are deeper, more serious,
peels requiring sedation and extensive recovery time. We
will discuss the available options today so that you may make a
well-rounded, informed decision. These peels can be used
not only on the face, but on the neck, chest, back, arms, hands,
etc. Anywhere you wish to rejuvenate or improve your
skin. -
Alphahydroxy Acid:
These peels help with fine, superficial wrinkles, sun
damage, unevenness, white and black heads, pimples and
splotchiness. These peels can also improve dryness and
dehydrated skins. They aren't very invasive and
provide mild resurfacing results. T hey produce a mild
rejuvenation without the extended downtime of a more
invasive peel. -
Fruit Acids:
There are five main fruit acids: citric acids
(citrus-derived), glycolic (derived from sugar
cane), lactic acid (although derived from milk,
this is still considered a fruit acid), malic
(derived from apples) and tartaric (derived from
grapes). -
Citric Acid peels:
Usually derived from lemons, oranges, limes and
pineapples. These peels are simple and effective,
although not incredibly invasive or capable of
significant improvement with one treatment. -
Glycolic Acid Peels:
formulated from sugar cane, this peel creates a mild
exfoliating action. Glycolic acid peels work by
loosening up the horny layer and exfoliating the
superficial top layer. This peel also stimulates
collagen growth. -
Lactic Acid Peel:
An in-office 70%or less alphahydroxy facial peel to
remove dead skin cells, and promote healthier,
softer and more radiant skin. This peel is derived
from either sour milk or bilberries. Cleopatra was
said to bathe in asses' milk. -
Malic Acid Peel:
This peel is the same type of mildly invasive peel
derived from the extracts of apples. It can open up
the pores, allow the pores to expel their sebum and
reduce acne. -
Tartaric Acid Peels:
This peel is derived from grape extract and is
capable of delivering the same benefits as the above
peels. Have your skin technician determine which is
best for your individual needs.
For the above peels, do NOT pick or pull at the flaking or
peeling skin. Also moisturizing will lessen the
benefits of the peel. Although extensive cracking an
bleeding will not help either, moisturize these areas or
apply a calming serum such as
Neova Calming Green Tea Serum with Copper Peptide.
This will heal these areas and lessen cracking and bleeding
which can scar your newly uncovered skin. Peeling or
exfoliating your sensitive skin at this time can
significantly scar your skin. These peels may be
reapplied at 2 week intervals.
Jessner's Peel: This is a medium depth peel designed for
more extensive damage than AHA's can improve. It is
made from salicylic acid (a beta hydroxy acid), lactic acid
(an alpha hydroxy acid) and resorcinol. Your
surgeon or skin technician will apply a glycolic cleanser
over your face to fully remove the oils and horny layer so
that your Jessner's solution will penetrate properly.
Then he or she will apply the Jessner's solution to your
face, it will then burn slightly (although this
uncomfortable sensation can be relieved by a fan blowing
cool air on your treatment area). you may have several
layers applied depending. You may develop a whitened
look, known as frosting that will dissipate within a few
hours. Then your skin technician will neutralize the
acid and remove your solution with cool water. Your
technician may apply a calming mask and you will be sent
home. You will peel and flake for about 7 days and
turn pink or brown afterwards. After you heal nice,
smooth skin will be revealed.
For the above peels, do NOT pick or pull at the flaking or
peeling skin. Also moisturizing will lessen the
benefits of the peel. Although extensive cracking an
bleeding will not help. Moisturize these areas or
apply a calming serum such as
Neova Calming Green Tea Serum with Copper Peptide.
This will heal these areas and lessen cracking and bleeding
which can scar your newly uncovered skin. Peeling or
exfoliating your sensitive skin at this time can
significantly scar your skin. This peel may be
reapplied at 2-3 week intervals.
The Obagi Blue Peel:
This type of peel is relatively new. Developed by Dr. Zein
E. Obagi, this peel is an in-office trichloracetic acid
(TCA) peel to correct fine lines, superficial scars, minimal
laxity and pigmentation problems.
It is performed in 1-4 steps and is very beneficial to
persons of all skin types.
Usually more invasive peels are unfortunately suitable to
only those of European Caucasian descent.
With the Blue peel, persons of ethnic skin tones such Asian,
African-America, Italian and other darker skins tones can
safely undergo beneficial resurfacing.
The solution
is applied in 1 to 4 layers and left on the skin for 25-30
minutes.
You may feel a slight burning or stinging sensation as each
layer is applied which may last from 2-5 minutes.
A gain a fan will help you tolerate the stinging sensation -
so request if this is used.
The blue tint will darken and advise the skin technician
when the peel is complete.
The blue tinge that you get from this peel may last for up
to 3-10 days, depending.
So prepare to take off a few days for this one as well. This
peel may be reapplied at 4 week intervals.
Phenol:
Chemical peeling with phenol is used to improve significant
actinic damage as well as moderate wrinkling of the skin. It
provides a relatively deep and predictable injury to the
dermis. “Pure” phenol is 88%. The solution most commonly
used was developed by Baker and Gordon and contains 3 ml USP
liquid, phenol 88%, 2-ml water; 8 drops liquid soap (Septisol);
and 3 drops croton oil.
It has been shown through histologic studies that the
Baker/Gordon formula penetrates deeper than pure phenol.
This is a serious peel, requires sedation and monitoring of
your vital statistics.
Unfortunately, there is usually blanching of the skin and a
distinct resulting demarcation line. It is very
possible that your skin will never regain its ability to tan
after a very deep phenol peel so consider this before
committing to such a procedure.
Also this peel is usually reserved for the face - and not
the neck, arms, etc. It is reported that scarring can result
when used on these non-facial areas.
Refinity Medical Skin Solutions®:
This peel and the accompanying skin care is a medical
strength AHA without the high known to occur with this
type of peel. Refinity goes by the belief that in
order to produce maximum results, a high level of acid must
be made available to the skin. The higher the level of
Exfoliation or skin renewal. However, increasing acid
strength also increases the potential for skin irritation.
They report that in order to obtain the best result, one
begins using a mild solution then works up to a higher
concentration - but without the intense irritation seen with
high concentrations of acid or Retin A use. Refinity
allows this to happen with the addition of COSMODERM-7™.
The peel itself takes about 5-15 minutes and the entire
treatment lasts about 30 minutes. You will be a little pink
or even slightly red afterwards but smoother skin is a
definite benefit. The Refinity Peel helps improve
Crow's feet wrinkles about 35%, whereas age spots,
superficial facial lines and uneven skin town can be
improved from a little over 50% to 70%.
The smoothness of the skin and moisturization properties can
be improved by as much as 98%. -
BioMedic MicroPeel®: This procedure is a three step
process which is a combination of a manual exfoliation, a
chemical peel and a Cryogenic Therapy session - together. It
outcome is extraordinary. The first step is a five
minute manual or enzymatic exfoliation treatment. This
step allows the removal of the skin's "horny" layer, known
as the stratum corneum. This allows the acids
to penetrate more deeply and also to improve the look of
hyperpigmentations.
The optional second step is a 15 - 30% Alpha Hydroxy
Peel. Your skin specialist will leave this on your
skin anywhere from 15 seconds to 2 minutes, and no longer.
You will feel a slight burning or stinging which can be
lessened by a cool breeze from a small fan although this
step is very short and may not be needed. If you
choose to add this step BioMedic recommends that you have no
more than 4-6 treatments WITH the AHA peel.
The third step is very beneficial and the main component of
the entire treatment. This step is performed with what is
called cryotherapy. Cryogenic Therapy is the act of using a
very cold substance to freeze a layer of skin.
You may have heard of sun damage and precancerous cells
being removed with Cryogenic Therapy. The substance
used is Carbon Dioxide and it is applied to the face in
circular motions, freezes the surface cells, helps deliver
an anti-inflammatory response and smoothes the skin.
The result is a smoother, clearer, healthier complexion.
Are You a Candidate for a Chemical
Peel?
Depending upon the peel, you may be a candidate for one if you
have slight wrinkles, hyperpigmentations, splotchiness,
unevenness, acne, acne scars, black heads or sun damaged skin.
You may not be a candidate if you have herpes as this can spread
to your healing skin and cause great, weeping sores which will
damage and scar your skin. Ask your primary physician for
a release and perhaps a prescription for a oral medications such
as Zovirax. This will decrease your risk of an outbreak.
If your primary care physician does not release you or opposes
to your having a peel - DON'T take that chance! Also,
deeper peels may not be suitable for you if you are prone to
keloids or hyper- and hypopigmentation.
For
deeper peels which require sedation or extensive recovery, first
and foremost, you must be in good health, not have any active
diseases or pre-existing medical conditions and must have
realistic expectations of the outcome of your procedure.
Communication is crucial in reaching one's goals. You must
be able to voice your desires to your surgeon if he/she is to
understand what your desired results are. Discuss you
goals with your surgeon so that you may reach an understanding
with what can realistically be achieved.
You must be mentally and emotionally stable to undergo an
cosmetic procedure such as this. This is an operation which
requires patience and stability in dealing with the healing
period. There is sometimes a lull or depression after a
deeper peel and if there is already a pre-existing emotional
condition, this low period can develop into a more serious
issue.
Please consider this before committing to this procedure.
What to Expect at Your Consultation
After checking a few dermatologists', surgeons' or skin
technicians' backgrounds and credentials, you will make an
appointment for a consultation. You will meet with these
possibles and discuss your goals and you will disclose all
information regarding your health; if you smoke, what
medications or vitamins you presently take, etc. - this is very
important. Visit the Medication & Supplements List for more information.
You will discuss your complaints and concerns and discuss the
various results one can achieve, the amount that can improved,
etc.
Your doctor will explain the technique and options that may be
most appropriate for you and should discuss the risks
associated with chemical peel with you, as well.
You will also discuss the available anesthesia, if applicable,
that will be used for your procedure. Most deeper chemical
procedures are performed under either Oral Sedation or
Light Sleep Sedation. However, lighter peels pay need no
more than an electric fan blowing cool air on you.
Either way, discuss this beforehand as many people are not aware
of the risks of Anesthesia.
If you would like more information on Consultations or a list of
questions to ask your doctor please visit the
Consultation Help Page. If you should choose to book or
reserve a procedure date you will usually give a deposit to hold
your date. Most times if you cancel a few days beforehand, this
amount is non-refundable. After paying your deposit and
scheduling a surgery date, you will also schedule a
pre-operative appointment...
Your Preoperative Appointment
Although usually not necessary for lighter peels, this
appointment addresses more questions you may not have thought to
ask at the initial consultation, such as more procedure details,
concerns and even ascertaining that your doctor is aware of what
you desire from your procedure. Just as your doctor
will make certain that you know what it realistically possible
from this procedure.
You will also discuss your pre-operative instructions and speak
about the recovery period instructions and what to expect in the
weeks or months ahead. If for deep peels, you may be given
prescriptions for antibiotics, pain relievers, perhaps blood
pressure medicines, prescription anti-inflammatory drugs.
Remember, always ask your doctor before taking any of these
products.
Please do not hesitate to address any concerns that you may have
during this time and even after your pre-operative appointment.
If you remember something when you get home or the next day or
even the day of surgery - don't be afraid to ask.
Preparing for Your Chemical Peel
You will more than likely be asked to closely follow a skin care
regimen which may include the use of AHAs, Retin A, Kojic Acid,
Hydroquinone, etc. to prepare your skin and even out the skin
tone itself. This will make the peel more effective as
well as lessens the pigment and fades a tan by prohibiting
melanin production and skin cell turn over. This way you
are less likely you hyperpigment after the procedure.
You
will be instructed to buy or given a high quality moisturizer,
skin preparation lotions and sunblock which you will use as you
heal afterwards to protect the newly uncovered skin from the
harmful UV rays. The skin will crack and depending upon
your instructions, peel depth and skin type you will either be
asked to cover it with a thin layer of lotion or antibacterial
ointment or allow it to dry, crack and fall away NATURALLY.
So please adhere to your own physician's or skin care
specialist's instructions. These steps are very important.
How This Procedure Is Performed
Depending upon the peel, peel depth and the skin type - you may
be anesthetized. If so please
read the anesthesia section.
If not, you will have
your skin cleansed and prepared either by exfoliation,
sterilized or whatever is needed. The layers of acid will
be applied and the timer set for your treatment protocol.
You may experience a warm or tingling sensation and depending
upon the strength of the peel - a stinging sensation. Your
physician may place a fan on low speed to help with any type of
discomfort.
The acid will be removed with a neutralizing lotion abs you will
then have a moisturizer applied to your face. You may or
may not have a "second skin" type of dressing placed on your
face then gauze - unless of course this is a superficial peel.
Please consult with your physician for specific details of your
procedure as many treatments are carried out differently and are
entirely individual-dependent.
The Road to Recovery
You will feel as though your skin has a windburn or sunburn and
will find that your skin is tight. Do not make excessive
or widely exaggerated facial expressions. This can tearing
of the skin and bleeding, hence - scarring. Just let your
skin heal naturally and do not peel or tug on ANY skin that may
peel from the face. You can cause excessive damage
resulting in severe scarring if you do this. Below is a
typical after care instruction sheet, please ask your physician
or skin care specialist for your own specific instruction sheet.
Typical Post-Peel Instructions -
You will cleanse your face as usual but be
instructed to use a gentle-formulated cleanser.
-
You may be instructed to use a special moisturizing
cream or lotion.
-
Do not apply any type if glycolic acid or
exfoliation products as this can severely damage or
irritate the skin
during the entire time of healing or the skin will
become irritated. -
Avoid sun exposure if you can. Use a high SPF
sunblock to help block the harmful UV rays.
-
Do NOT peel, rub or scratch your skin at anytime,
whatsoever. This WILL cause damage and compromise
your results as well as possibly severely scar you.
-
Let your surgeon or skin care specialist know
immediately if you have a herpes break out. This can
also result in severe and permanent scarring.
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You will start noticing pink, fresh skin emerging from under the
peeling , damaged skin. Remember not to "help" the peel
along by pulling or rubbing this "old" skin off. Within a
few weeks the pinkness will fade for most, light peels.
Depending upon the depth of the peel you may have lingering
pinkness which may look like a mild sunburn or flushed
appearance. Your physician will go over what to expect for
the depth of the peel you undergo.
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Important Contraindications of Chemical Peels
You should not have a
chemical peel if you will continue to have excessive sun
exposure. Active Herpes Simplex, Warts, history of
Keloidal scarring (excessive ropey scarring where the
collagen grows outside of the incision or cut area, Any
type of recent facial surgical procedures. You should
not have a chemical peel if you've used Accutane in the
last year (which increases your chances of excessive
scarring), or if you are pregnant or lactating (although
simple, superficial fruit acids may be acceptable, ask
your physician). If you have any auto immune diseases,
have had any recent radioactive or Chemotherapy
treatments -- have sunburn, windburn or broken skin or
have recently waxed or have recently used a depilatory
such as Nair or use Vaniqua. |
Risks & Complications of Chemical
Peels
If you have oral herpes. You MUST gain the approval of
your primary physician and seek a prescription for oral
acyclovir - one brand name is Zovirax. This is very
important! Zovirax can significantly decrease your chances
of a break out. If you have a break out during your
healing period, it can spread to your entire face and result in
severe and permanent scarring.
Be careful of crusting or excessive weeping. In AHA peels
you may think this is normal but there is a borderline
appearances that you must watch out for. Ask your skin
care specialist for specifics regarding what to look for.
If for a typical AHA peel, you should feel and look normal
within 3-4 days. For deeper peels your downtime may take
weeks and then months for complete recovery.
If you experience painful areas
of the face, contact your surgeon or skin care specialist
immediately - ESPECIALLY if you are prone to cold sores.
Blisters that form will need to be reported immediately!
Hyperpigmentations (excessive coloration) and hypopigmentation
(lack of pigmentation) can be problematic of misdiagnosed skin
types, failure to reveal any skin problems or ethnicity and
improper post-peel care. Infection is uncommon but
possible so keep an eye out for redness and pain.
Scarring is a problem if the above is experienced so please
adhere to your post-peel instructions to decrease your chances
of long term or permanent, visible signs of damage.
The Average Prices
of Chemical Peels
The average prices for the common chemical peels are as follows:
|
Type of Peel or Brand Name |
Cost | |
AHA peel (low strength) |
$30 (or $5. if added on to European full facials) | |
AHA (50% - 70% concentration) |
$1,000 + up | |
BHA (8 - 13 % concentration) |
$1,000 + up | |
Phase IV Jessner's Peel (mild) |
approximately $100 + up | |
Phase IV Jessner's Peel (moderate) |
approximately $150 + up | |
Phase IV Jessner's Peel (aggressive) |
approximately $200 + up | |
Phase V Method 40 Jessner's Peel (mild, moderate,
aggressive) |
approximately $250 + up | |
Phenol (around mouth) |
approximately $2,000. + up | |
Phenol (full face) |
approximately $3,000. - $4,000. + up | |
Obagi Blue Peel (recovery 7 - 10 days) |
approximately $200. + up per layer/15% solution;
$400 + up per layer/ 20% solution - up to $1,000. | |
Standard TCA Peel |
approximately $1,500. - $3,000. + up | |
Light TCA Peel |
$200. to $500. + up | |
Spot Peels |
$100. + up | |
BioMedic MicroPeel |
$100. - $480. for a series of six treatments + up | |
BioMedic MicroPeel Plus |
$125. to $600. for a series of six treatments + up | |
Refinity AHA Peel |
$135. to $660. for a series of six treatments + up | |
Weekend Peel (recovery 4 - 6 days) |
$750. + up |
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