What is a chemical peel?
A chemical peel involves precisely placing specific chemicals on the skin of the face, neck or chest. Depending upon the chemical composition of the peel, the number of layers applied to the skin and other technical factors, chemical peels can target a variety of skin conditions.
Chemical peels are typically described as superficial, medium or deep in depth. Downtime is highly correlated with the depth of the peel. The deeper the peel, the longer the period of downtime. While the deepest peels tend to create the most dramatic improvement they also involve the longest downtime and the highest risk of complications. For this reason, at Weber Facial Plastic Surgery we tend to focus on superficial and medium depth peels most often as they have the best balance between results, risk and downtime.
What results can be expected following a chemical peel?
Chemical peels can be performed to target fine lines and facial wrinkles, excessive skin pigment, irregular skin texture and facial scarring resulting from acne and skin conditions. With all but the most aggressive treatments, chemical peels are designed to smooth the existing skin pigmentation and texture without overly lightening the face and neck skin.
What is the downtime following a chemical peel?
The simple answer is that downtime varies by the type and intensity of the peel performed. We offer “lunchtime” glycolic peels that result in mild redness and flaking resulting in NO downtime. That’s right zero downtime for a skin treatment that will create long term improvement in the skin.
“Middle of the road” peels such as the VI or Perfect Derma peel offer a more aggressive solution that results in about 3 days of intense peeling but minimal redness and no disruption of the deeper skin layers. The peeling can be well managed with facial moisturizers and gentle facial cleansing. The fact that the skin itself is not red or raw means that most of our VI peel or Perfect Derma peel patients will continue to work and not experience any isolation from work or social activities.
The most aggressive peel that Dr. Weber offers is the Monheit combination peel. This peel was conceived and published in 1995 by Dr. Gary Monheit, Dermatologist, who sought to create a safe and reproducible medium depth chemical peel with minimal risk of skin lightening or scarring. This peel is most often employed by Dr. Weber for tightening of significant wrinkles around the undereye area and or improvement in the imprinted lines around the mouth. As mentioned earlier, the amount of benefit from the peel is correlated with the amount of downtime experienced. Thus, our Monheit peel patients can expect five to seven days of downtime.
Can chemical peels be combined with other treatments?
Absolutely! One of our favorite combinations is to combine a Monheit peel to the undereye and mouth area with eyelid surgery, facelifts and neck lifts. In many cases, a Monheit peel will work as well or better than the traditional removal of skin from the lower eyelids. An added benefit is that skin tightening with a chemical peel does not damage any of the structural supports of the upper eyelid and avoids the need to make an incision in the delicate lower eyelid skin.
Are chemical peels safe?
Chemical peels, when applied properly, are very safe. Superficial peels (Glycolic, VI peel, Perfect Derma peel) do not damage the dermal layer of the skin meaning that the skin does not become “raw”. Thus, downtime involves only a mild pink color, variable amounts of flaking of the skin and minimal risk of complications. Medium depth peels, such as the Monheit combination peel, do penetrate into the dermal layer and result in a “raw” appearance of the skin that lasts 4-6 days. Once the skin has healed from a medium depth peel, mild redness can last four to six weeks but is easily camouflaged with camouflage makeup, foundation or tinted sunscreen. The chance of infection is very low if you follow the post-procedure instructions that simply involve keep the skin clean and glistening after medium depth peels. Scarring of the skin is even more unusual but patients with a history of abnormal scarring (keloids or hypertrophic scarring) might be at elevated risk.
Are there certain skin types or skin conditions that make chemical peels more risky?
Yes. These are encountered rarely but there exist a handful of factors that make chemical peels risky for certain patients. These include:
Skin type – Patients with darker skin are at higher risk of both loss of pigmentation and darkening (PIH or post-inflammatory hyperpigmentation) following aggressive chemical peels.
Accutane – Accutane is an oral medication most often used to control severe acne in teens and rare adults. This medication reduces the turnover of skin and can raise the risk of prolonged recovery or scarring after a chemical peel. Most experts recommend waiting 6-12 months following the last dose of Accutane before performing aggressive chemical peels or LASER resurfacing. It is typically safe to undergo a chemical peel once your skin begins to produce a normal amount of oil after finishing a course of Accutane.
History of aggressive skin resurfacing with chemical peels, ablative LASERs and dermabrasion – These treatments remove a significant portion of the skin barrier which then must regrow. Aggressively retreating this skin can raise the risk of complications.
History of cold sores – Patients with a history of cold sore outbreaks are typically treated with an antiviral medication before and for a short period after the chemical peel involving the mouth area. In total, patients take 7-10 days of cold sore medication to prevent an outbreak. If the peel does not involve the mouth area this is typically not necessary.
Inflammatory skin problems – Out of an abundance of caution we will often limit the aggressiveness of chemical peels in people who live with excessive inflammation of the skin. In some patients with inflammatory skin conditions like Rosacea, medium and deep chemical peels can result in prolonged redness and downtime.
What can be done to optimize my chemical peel results?
The best advice is to follow a healthy diet and get plenty of sleep and exercise. We also start our chemical peel patients on “Brighten” a combination skincare product containing prescription grade Retin-A and a skin lightening agent such as Arbutin or Hydroquinone. “Brighten” speeds up the turnover of your skin which accelerates healing, reduces the production of irregular skin pigment which lowers the risk of PIH and can slightly thin the skin allowing deeper penetration of the peel into your skin and more dramatic results.
Is there anything that I must do after the chemical peel?
We recommend avoiding prolonged sun exposure for the first three months following your peel treatment which can result in darkening of the peeled skin. Continuing medical-grade skincare including gentle cleanser, Retin-A containing product and sunscreen will enhance and maintain your results. We also strongly recommend using broad spectrum sun protection including sun block, sunglasses and a large brim hat for the first three months following your peel. That is also great advice for long term protection of your skin and maintenance of the chemical peel results.
Where can I learn more?
Please take a look at our website for more information: https://www.weberfps.com/non-invasive/chemical-peels/
You can also schedule an in-person consultation by calling us at (303) 792-2224 or sending an email to [email protected]