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Chemical peel uses a
chemical solution to improve and smooth the texture of the facial
skin by removing its damaged outer layers. It is helpful for those
individuals with facial blemishes, wrinkles and uneven skin
pigmentation. Phenol, trichloroacetic acid (TCA) and alphahydroxy
acids (AHAs) are used for this purpose. The precise formula used may
be adjusted to meet each patient's needs. Although chemical peel may
be performed in conjunction with a facelift, it is not a substitute
for such surgery, nor will it prevent or slow the ageing process.
Chemical peel may also
soften acne facial scars and even control acne.
Types of chemicals
Alphahydroxy acids (AHAs),
such as glycolic, lactic, or fruit acids are the mildest of the peel
formulas and produce light peels. These types of peels can provide
smoother, brighter-looking skin for people who can't spare the time
to recover from a phenol or TCA peel. AHA peels may be used to treat
fine wrinkling, areas of dryness, uneven pigmentation and acne.
Various concentrations of an AHA may be applied weekly or at longer
intervals to obtain the best result. Your doctor will make this
decision during your consultation and as the treatment proceeds. An
alphahydroxy acid, such as glycolic acid, can also be mixed with a
facial wash or cream in lesser concentrations as part of a daily
skin-care regimen to improve the skin's texture.
Trichloroacetic acid (TCA)
can be used in many concentrations, but it is most commonly used for
medium-depth peeling. Fine surface wrinkles, superficial blemishes
and pigment problems are commonly treated with TCA. The results of
TCA peel are usually less dramatic than and not as long-lasting as
those of a phenol peel. In fact, more than one TCA peel may be
needed to achieve the desired result. The recovery from a TCA peel
is usually shorter than with a phenol peel.
Phenol is the strongest of
the chemical solutions and produces a deep peel. It is used mainly
to treat patients with coarse facial wrinkles, areas of blotchy or
damaged skin caused by sun exposure, or pre-cancerous growths. Since
phenol sometimes lightens the treated areas, your skin pigmentation
may be a determining factor as to whether or not this is an
appropriate treatment for you. Phenol is primarily used on the face;
scarring may result if it's applied to the neck or other body areas.
Risks
Chemical peel is normally a
safe procedure. However, some unpredictability and risks such as
infection and scarring, while infrequent, are possible.
AHA peels may cause
stinging, redness, irritation and crusting. However, as the skin
adjusts to the treatment regimen, these problems will subside.
With a TCA peel, your healed
skin will be able to produce pigment as always; the peel will not
bleach the skin. However, TCA-peel patients are advised to avoid sun
exposure for several months after treatment to protect the newly
formed layers of skin. Even though TCA is milder than phenol, it may
also produce some unintended colour changes in the skin.
With a phenol peel, the new
skin frequently loses its ability to make pigment (that is, tan).
This means that not only will the skin be lighter in colour, but
you'll always have to protect it from the sun. Phenol may pose a
special risk for patients with a history of heart disease. It's
important that you make your surgeon aware of any heart problems
when your medical history is taken.
It is also possible that
phenol will cause some undesired cosmetic results, such as uneven
pigment changes. Certain modified phenol peels are gentler and may
be preferred in some circumstances.
Before and after
chemical peel
In some states in the USA,
no medical degree is required to perform a chemical peel - even the
strongest phenol peels. Many states have laws that permit
non-physicians to administer certain peel solutions, but regulate
the strengths which they are permitted to apply. You should be
warned that phenol and TCA peels have been offered by inadequately
trained practitioners claiming "miracletechniques" to rejuvenate the
skin.
It is very important that
you find a physician who has adequate training and experience in
skin resurfacing. Your plastic surgeon may offer you a choice of
peel techniques or suggest a combination of peels to obtain the best
result for you.
During your initial
consultation, it is important that you discuss your expectations
with your plastic surgeon. Don't hesitate to ask any questions or
express any concerns that you may have. Expect your plastic surgeon
to explain the planned procedure in detail, including its risks and
benefits, the recovery period and the costs. If you have a history
of herpes, you should inform your physician prior to the procedure.
Chemical peel
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