There are many types of chemical peels, with differences based on how deeply the chemical penetrates and what type of chemical solution is used. Factors that affect the depth of a peel include the preparation of the patient's skin before the procedure, the acid concentration in the peeling agent, the number of coats that are applied, and the amount of time allowed before the acid is neutralized.
Chemical peels are used to create an injury of a specific skin depth with the goal of stimulating new skin growth and improving surface texture and appearance. The exfoliative nature of chemical peels stimulates new epidermal growth and collagen with more evenly distributed melanin. There are three basic types of peels:
- Deep peels
The deeper the peel, the better the result. However, with deeper treatments expect more cost, more discomfort, a longer downtime, and more potential risk. Superficial peels have no downtime and are comfortably performed in the office or spa setting.
To find out which chemical peel might be best for your complexion, please call Desert Hills Plastic Surgery Center at 702-260-7707 today. Dr. Hayley Brown and her team serve patients in Las Vegas and throughout the United States.
AHAs are the mildest peels and work for all skin types. The most common are glycolic and lactic acid peels, but citric acid, malic acid and tartaric acid peels are also available.
Concentrations of each peel solution can vary to improve fine wrinkles, areas of dryness, uneven pigmentation and acne. They do not tighten the skin. Lower concentration alpha hydroxy acids are often key ingredients in skin care products and have proven benefit to improve the skin’s texture and appearance over time.
Beta Hydroxy Acid Peels
Salicylic acid peels are milder than AHA peels, however, they tend to get deeper into the pores than the AHA peels. A derivative of salicylic acid, ß-lipohydroxy acid (LHA) is a peel that not only provides efficient exfoliation at low concentrations, it possesses antibacterial, anti-inflammatory, antifungal, and anti comedogenic properties. Studies show that beta hydroxy acid peels control sebum excretion and remove dead skin cells better than AHAs, so they work best in treating acne.
Other Superficial to Medium Depth Peels
Most of these are combinations of peel solutions in low concentration. The Vi Peel is a formulation of TCA, Tretinoic Acid, Salicylic Acid, Phenol, Vitamin C and a mineral blend in relatively low concentration. It is safe in patients with darker skin types.
The Jessner peel contains 14% salicylic acid, lactic acid, and resorcinol in an ethanol base.
Retinoic acid peels are used to treat melasma and postinflammatory hyperpigmentation. It is usually performed in conjunction with a superficial peel or exfoliative procedure immediately before to open up the skin, so the retinoic acid can penetrate on a deeper level. The patient leaves with the chemical peel solution on their face. The peeling process takes place on the third day. More dramatic changes to the skin require multiple peels over time.
TCA peels are medium depth peels that cause a second degree burn of the skin. Strengths of TCA range from 20-50%. Higher strength TCA peels need to be performed by a physician. Depth of penetration is increased as concentration increases, with 50% TCA penetrating into the reticular dermis. Concentrations higher than 40% are not recommended because of the high risk of scarring.
TCA peels work well to smooth fine surface wrinkles, remove superficial blemishes, actinic damage, and correct pigment problems. The depth of penetration can be slightly unpredictable and based on many factors including a patient’s pretreatment regimen, the type of gauze used to apply the solution, the hand pressure used to apply the solution, the evenness of application, and the amount of passes per area. It can work in darker skin types with caution, although pre-treatment with Retin-A and bleaching creams (hydroquinone) is recommended to decrease risks of increased pigmentation while healing.
Downtime is usually 5-7 days. The procedure is well-tolerated in the office, but expect burning discomfort relieved by a fan for about 5-10 minutes during the application of the solution. Results can be variable from person to person. Repeat treatments can be performed every 6 months in order to maintain results. Many skin care companies have their own TCA peel formulations. They usually contain lower concentrations of TCA solution.
The Obagi blue peel and the Biomedic Pigment Peel Plus are examples.
Phenol Peels are the strongest of the chemical solutions and phenol produces a deep skin peel. Effects of a phenol chemical peel are long lasting, and in some cases are still readily apparent up to 20 years following the procedure. Improvements in the patient’s skin can be quite dramatic. A single treatment usually achieves the desired result.
Deep peels penetrate several layers of skin and cause a deep second-degree burn of the skin. They can only be used on the face. Deep peels may not be used on darker skin types because they tend to bleach the skin and cause permanent hypopigmentation, similar to deep, aggressive laser treatments. Even in lighter-skinned people, phenol peels or any type of deep resurfacing may bleach the skin. A deep peel can be done only once in most cases.
Phenol peels can correct blotches caused by sun exposure or aging, smooth out coarse deep wrinkles, remove facial freckles and improve surface texture. Only experienced physicians should perform these peels, as they pose additional risks of arrhythmias during the procedure without strict safety protocols in place. Patients who have phenol peels require increased protection from the sun permanently.
If you'd like to find out which chemical peel can revitalize your skin most effectively, please contact Desert Hills Plastic Surgery Center online or call 702-260-7707 to learn about our skin resurfacing treatments in the Las Vegas area.