A chemical peel is one of the least invasive ways to improve the appearance of your skin. Sun exposure, acne, or just getting older can leave your skin tone uneven, wrinkled, spotted, or scarred. A chemical peel can help your skin look smoother and younger. It uses a chemical solution to smooth the texture of your skin by removing the damaged outer layers. Although chemical peels are used mostly on the face, they can also be used to improve the skin on your neck and hands.

A chemical peel can help improve:

• Acne or acne scars
• Age and liver spots
• Fine lines and wrinkles
• Freckles
• Irregular skin pigmentation
• Rough skin and scaly patches
• Scars
• Sun-damaged skin

A chemical peel cannot:

• Treat deep facial lines
• Tighten loose or sagging skin
• Remove broken capillaries
• Change pore size
• Remove deep scars

You may not be a good candidate for chemical peeling if you have:

• A history of abnormal skin scarring
• Abnormal pigmentation
• Afro-Caribbean or Asian skin
• Facial warts
• Red hair and pale freckled skin
• Used certain acne treatments within the last year

Chemical solutions are carefully applied to your skin to improve the texture by removing damaged outer layers. The chemicals used are phenol, trichloroacetic acid, and alphahydroxy acids. The formula used by your doctor will be adjusted to meet your particular needs.

Light chemical peel:

Subtle improvements at first, but that healthy glow will increase with more treatments. If you have uneven pigment, dryness, acne, or fine wrinkling, a light chemical peel might be the right choice. This kind of peel removes just the outer layer of skin (epidermis) in a light exfoliation and results in a healthier glow. Your health care provider will use a combination of alphahydroxy acids and beta hydroxy acids, such as glycolic acid, lactic acid, salicylic acid, and maleic acid. All of these chemicals are the mildest choices. You can repeat these treatments to achieve your desired results.

Procedural Steps:

• Your face will be cleansed.
• The chemical solution is brushed onto your skin and left on for a few minutes. You may feel some mild stinging.
• The chemical peel is then washed off and neutralized.

Medium chemical peel:

Your skin will be noticeably smoother and fresher-looking. Acne scars, deeper wrinkles and uneven skin color can all be treated with a medium chemical peel. The chemicals used for this type of peel will remove skin cells from both the outer layer of skin (epidermis) and upper part of your middle layer of skin (dermis). Your health care provider will use trichloroacetic acid, sometimes used in combination with glycolic acid.

Procedural Steps:

• Your face will be cleansed.
• The chemical solution is brushed onto your skin and left for just a few minutes. You may feel some burning or stinging.
• The treated area may turn a whitish grey color.
• The chemicals are neutralized with a cool saline compress.
• Your skin may turn red or brown in the days just after the peel. It may take up to six weeks for your skin to look normal.

You may repeat a medium chemical peel every few months to maintain your new glowing skin.

Deep chemical peel:

Results are dramatic, but recovery takes the longest. If you have deeper facial wrinkles, skin that’s damaged by the sun, scars, areas that appear blotchy, or even pre-cancerous growths, deep facial chemical peels might be the right choice for you. Your physician will use the strongest chemical called phenol to penetrate down to the lower dermal layer of your skin. For this type of peel, you may need a local anesthetic and a sedative to manage any discomfort.

A deep chemical peel usually involves some sort of pretreatment for up to eight weeks. This will prepare your skin for the peel and speed the healing process. Pretreatment may include use of a retinoic acid cream or gel – a prescription medication that’s derived from vitamin A. This works to thin out the skin’s surface layer, allowing the chemical solution to penetrate more evenly and deeply.

Procedural Steps:

• You will be given a sedative to relax along with a local anesthetic to numb your face.
• Your face will be cleansed.
• Phenol is brushed onto the area after an appropriate time interval.
• The chemical is neutralized with water.
• A thick coat of ointment is smoothed over your skin, to prevent dryness and pain. The ointment must stay in place. Sometimes your surgeon will cover your skin with strips of tape or medicated gauze rather than ointment.

Deep chemical facial peels will result in peeling, crusting, skin redness, and discomfort for several days. Your doctor will provide painkillers to keep you comfortable. Although the swelling is likely to disappear in about two weeks, your skin may remain red for up to three months. One treatment with a deep chemical peel will produce long-lasting and dramatic results that can last up to 10 years.

You should understand that all chemical peels carry some risks and uncertainties. It’s usually a very safe procedure when performed by a qualified and experienced plastic surgeon. It happens infrequently, but you could develop an infection or scarring from chemical peels.

For people with certain skin types, there is a risk of developing a temporary or permanent color change in the skin either lightening or darkening. Use of hormone medications or a family history of brownish discoloration on the face may increase the possibility of developing abnormal pigmentation.

If you have suffered from cold sores (herpes) in the past, there is a risk of reactivation. Be sure to ask your doctor to prescribe medication to try and avoid an outbreak.

Inform your physician if you have a history of keloids (scar tissue overgrowth) or any unusual scarring tendencies.

Prices for elective procedures can vary. The cost for a chemical peel may be based on the expertise and qualifications of the person performing the procedure, type of chemical peel performed, time and effort the procedure or treatment requires, and the geographic location of the office. Many plastic surgeons offer patient financing plans, so be sure to ask. Additional fees may include:

• Anesthesia fees
• Prescriptions for medication
• Facility costs

Use this checklist as a guide during your consultation

• Am I a good candidate for a chemical peel?
• What will be expected of me to get the best results?
• Who will perform the chemical peel?
• Have they been specifically trained in this procedure?
• Where and how will you perform my procedure or treatment?
• How long of a recovery period can I expect?
• What are the risks and possible complications associated with my procedure?
• How can I expect to look over time?
• Do you have before-and-after photos I can look at for this procedure?
• What results are reasonable for me?