Preparing for the procedure
Your plastic surgeon will
instruct you on how to prepare for your peel treatment.
Sometimes Retin A - a
prescription medication derived from Vitamin A - is used to
pre-treat the skin. This thins out the skin's surface layer,
allowing the TCA solution to penetrate more deeply and evenly. If
your skin won't tolerate Retin-A pre-treatment, an AHA cream may be
used instead. Hydroquinone, a bleaching agent, is sometimes used in
conjunction with Retin-A or AHA pre-treatment, especially if you
have blotchy skin areas or pigmentation problems. You may have to
spend a month or more in the pre-treatment phase before the doctor
will schedule your actual peel.
You will need to arrange for
someone to drive you home and help you out for a day or two if you
are having a phenol or deeper TCA peel. You probably won't need any
extra assistance if you're having an AHA peel or superficial TCA
peel.
Anaesthesia isn't required
for phenol or TCA peels because the chemical solution acts as an
anaesthetic. However, sedation may be used before and during the
procedure to relax you and keep you comfortable.
No anaesthesia is needed for
AHA peels since they cause only a slight stinging sensation during
application.
The procedure
AHA peels/treatments: Your
doctor will apply the AHA solution to your cleansed facial skin, a
process that usually takes no more than 10 minutes. No "after-peel"
ointment or covering is required. Depending on the strength of the
peel, periodic treatments may be necessary until the desired effects
are achieved.
For some patients, the
application of an AHA-based face wash or cream once or twice a day
at home will be sufficient to accomplish the desired goal. Your
plastic surgeon may add Retin-A or a bleaching agent to your at-home
treatment schedule. After several weeks of at-home use, your doctor
will examine your skin to determine if your regimen needs
adjustment.
Phenol and TCA peels:
Typically, the skin is first thoroughly cleansed. Then, the surgeon
will carefully apply the phenol or TCA solution. You may feel a
stinging sensation as the peel solution is applied, but this feeling
will quickly pass.
A full-face TCA peel usually
takes no more than 15 minutes. Two or more TCA peels may be needed
to obtain the desired result, and those may be spaced out over
several months. Mild TCA peels may be repeated as often as every
month.
If phenol solution has been
used, your plastic surgeon may coat the treated area with petroleum
jelly or a waterproof adhesive tape. With lighter peels, no covering
is necessary.
A full-face phenol peel
generally takes one or two hours to perform, while a phenol peel to
a smaller facial region (perhaps the skin above the upper lip) may
take only 10 or 15 minutes. A single treatment usually suffices.
After the peel
After an AHA peel, it is
common to experience some temporary flaking or scaling, redness and
dryness of the skin. However, these conditions will disappear as the
skin adjusts to treatment.
After a phenol or TCA peel,
your doctor may prescribe a mild pain medication to relieve any
tingling or throbbing you may feel. If tape was used to cover your
face, it will be removed after a day or two. A crust or scab will
form on the treated area. To help your face heal properly, it is
essential that you follow your doctor's specific post-operative
instructions.
A TCA peel may also cause
significant swelling, depending on the strength of the peel used.
If you've had a phenol peel,
your face may become quite swollen. Your eyes may even be swollen
shut temporarily. You will need someone to help care for you for a
day or two. You may also be limited to a liquid diet and advised not
to talk very much during the first few days of recovery.
With an AHA peel, the
temporary redness, flaking and dryness that you experience will not
prevent you from working or engaging in your normal activities. A
fresher and improved skin texture will result with continued AHA
treatments. Remember, protecting your skin from the sun is also
important following these mild acid peels. Ask your doctor to
recommend a sunblock with adequate UVA and UVB protection and use it
every day.
With a TCA peel, the
moderate discomfort and mild swelling you may experience will
subside within the first week. In about a week to ten days, your new
skin will be apparent and you should be healed sufficiently to
return to your normal activities. It is best to avoid sun exposure
unless you are adequately protected.
With a phenol peel,
new skin will begin to form in about seven to ten days. Your face
will be very red at first, gradually fading to a pinkish colour over
the following weeks to months. During this time, it is especially
important that you use a sunblock or blotchy, irregular skin
colouring may result.
About two weeks after
treatment, you may return to work and resume some of your normal
activities. Your skin will be healed enough for you to wear makeup.
The results of a TCA peel
are usually not as long-lasting as those of phenol peel. However,
your skin will be noticeably smoother and fresher-looking.
If you're planning a phenol
peel, you can expect dramatic improvement in the surface of your
skin - fewer fine wrinkles, fewer blemishes and more even-toned
skin. Your results will be long-lasting, although not immune to the
effects of ageing and sun exposure.
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