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What is a chemical peel?

A chemical peel is the process of applying a chemical solution to your skin to address your concerns and to improve the appearance of your skin. During the process, a chemical solution is applied to your skin, which creates localized, controlled damage to the skin. The treated skin may eventually peel off leaving an improved complexion. We typically consider chemical peels to be in-office treatments due to the strength and expertise needed to optimize the treatment. Mild peeling agents such as glycolic acid, lactic acid and salicylic acid can be found in products that can be used more regularly as part of an at-home routine to maximize the effectiveness of your in-office treatment.

What conditions respond to chemical peels?

Chemical can be used in many parts of the body, and the face, neck and hands are treated most frequently. Peels can target:

  • Fine lines and crepey skin 
  • Acne
  • Mild scarring
  • Brown spots such as sun spots, age spots, liver spots, freckles
  • Precancerous spots (actinic keratoses)
  • Rough skin, scaly patches, dull complexion
  • Uneven pigmentation such as melasma or hypopigmentation

At CLARA, we recommend a consultation so that we can accurately evaluate your skin and make the appropriate treatment recommendations based on your skin and preferences. During the 20 minute visit, we will review your full health and skin history and make a personalized treatment plan to optimize your outcomes.

What is the treatment like?

Your skin will be thoroughly cleansed while your eyes and hair are protected. Next, a degreasing solution is applied to your skin to removes excess oils and allow even penetration of the peeling solution. A customized chemical cocktail is then applied to your skin. The peel may contain glycolic acid, trichloroacetic acid, salicylic acid, lactic acid or carbolic acid (phenol). The “strength” of the peel depends on how deep the chemicals penetrate the skin, how many passes are made on the surface of the skin and the concentration of the acid or mixture of acids. 

Different chemical solutions provide different results. The choice of chemical depends on your goal. You will work with your dermatologist to determine the depth of your peel.

  • superficial peel provides subtle improvement over time and is often done in a series. The outermost layer of skin is removed. This choice may be best if you have fine wrinkling, acne, uneven skin coloring or dry, rough sun-damaged skin to help promote a healthy glow. Recovery from this type of peel may be within hours to a few days but with little to no down time.
  • medium-depth peel gives your skin a smooth, fresh look. The outermost layer and the upper part of your middle skin layer are removed. This choice may be best if you have uneven or moderate skin discoloring, age spots, acne scarring or fine-to-moderate wrinkles. Recovery from this type of peel may take a week or more and require some down time.
  • deep chemical peel produces the most dramatic results. This chemical penetrates down to the lower middle layer of your skin. Recovery time is longer with a deep peel. This choice may be best if you have moderate lines and wrinkles, extensive sun-damaged skin, deep acne scars, blotchy skin, and/or precancerous growths called actinic keratosis. A deep chemical peel requires pretreatment for up to eight weeks. Your doctor will provide specific instructions. A deep chemical peel is a one-time only treatment if applied to your face and does have significant down time.

How should I prepare for a peel at CLARA?

At CLARA, we curate a selection of superficial and medium-depth peels. To prepare for your chemical peel, some general instructions include:

  • Avoid tanning and direct sun exposure for two weeks before each treatment.
  • Apply topical products (such as hydroquinone) as instructed before treatment to prepare your skin.
  • Don’t use any products containing retinoids (such as tretinoin) one to two weeks before treatment, unless your physician tells you differently.
  • If you have been prescribed oral antibiotics or an oral antiviral medicine, start taking it at least 24 hours before your chemical peel.
  • Peel areas must be free of any open sores, lesions or skin infections.

Your doctor will give you specific instructions for your peel type and your unique skin condition.

What is the treatment like?

Acetone is typically used as the degreasing agent during the first step and has a strong odor, but does not create any discomfort. Next, as the peeling solution is applied to your skin, you may feel warmth and/or stinging. This will build depending on the level of the peel and the number of passes that are applied to the skin. Your dermatologist will monitor the level of warmth you are feeling and also the amount of redness and frosting that develops on the skin as the peel is affecting the skin. Cool air and a hand-held fan are used to help during the active phase of the peel. The burning sensation usually peaks and improves within a couple of minutes. Cool compresses are then applied to the skin. The final step depends on the peel and may either be a layer of retinol that is left on the skin for 7 hours or a thin layer of post-procedure ointment. Once the peel is finished you may feel normal or slightly more sensitive in the treated area with a superficial peel or you may feel warm and tight after a medium-depth peel.  

What are the possible complications of chemical peels?

Darker skin types and a history of melasma may increase the risk of hyperpigmentation with certain peels. Superficial and medium-depth peels have a low risk of scarring in certain areas of your face and certain individuals may be more prone to scarring. Tell your dermatologist if you have a history of keloids or any unusual scarring tendencies. If scarring does occur, it can usually be treated with good results.

If you’ve had a history of cold sores (herpes outbreaks), your dermatologist may prescribe medication to reduce the chance of a flare and they may also prescribe antibiotics as prophylaxis to infection (which is rare). 

What should I expect after the chemical peel?

What to expect varies depending on the depth of your chemical peel.

If you’ve had a light chemical peel:

  • Expect some pink-light redness after your peel and you may experience fine scaling or peeling 3-7 days after the peel. 
  • Apply lotion or cream as directed until your skin heals. After your skin heals, apply daily sunscreen.
  • You can wear makeup immediately after treatment or the next day.
  • Additional peels may be repeated every two to five weeks until you achieve your desired results. Typically three to five peels are needed to achieve your goal.

If you’ve had a medium chemical peel:

  • Expect redness, warmth, and swelling for the first 24-72 hours. Your skin may also feel tight. Blisters can develop and will break open. Skin will crust and peel off over seven to 14 days.
  • Perform daily soaks with distilled water or diluted vinegar as directed by your doctor. Apply ointment after each soak. Apply lotion or cream daily. Don’t expose your skin to sunlight until completely healed or at least 14 days and robust sun protection should continue for 1 month following the peel. 
  • Antivirals and antibiotics are typically taken for 7 days following a facial peel. 
  • You can wear makeup after five to seven days.
  • Additional medium-depth peels may be repeated at six to 12 months intervals, if needed, to maintain results.

A highly effective skincare routine can also maximize results and help maintain them over time. At CLARA, we build this into each of our consultations – book yours today.

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