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Chemical peels use a variety of caustic chemicals to destroy several layers of skin. The peeling solutions are painted on section-by-section of the area to be treated. There are three types; superficial (light), medium, and deep. The type of peel depends on the strength of the chemical used, and on how deeply it penetrates. Superficial peels are usually used for wrinkles, sun damage, acne and Rosacea. Superficial peels remove the stratum corneum and can be helpful for acne that is under control. The medium peel is used for more prominent wrinkles, sun damage and also lesions. Deep peels are used for more severe wrinkling and sun damage.
It’s important to note that in some states no medical degree is required to perform a chemical peel, even the strongest phenol. Some states have laws that regulates the strengths at which peels can be applied and by whom. I would say use caution in having a medium or deep chemical peel applied by any one other than a physician.
Patients with fair complexions are better candidates as the chemical peel can remove pigment from the skin creating a line of demarcation between the treated and untreated areas in patients with darker complexions.
Glycolic Acid Peel
This is the mildest or shallowest exfoliating peel available. Glycolic acid is a mild alpha-hydroxy acid that removes dead surface cells from the top layer of skin. Other fruit acids that are sometimes used are malic, and tartaric. For this kind of peel, doctors use a higher concentration of the acid, while milder preparations are used in skincare salons and given to patients to use at home. Often referred to as 'lunchtime peels', these treatments can be performed in about 10 to 15 minutes. Upon application, patients feel a slight stinging, which subsides after a few minutes. Any redness disappears by the end of the day, and glycolic peels can be repeated as needed. Sun block is a must following your peel.
Normally Good for: Smoothing rough, dry and sun-damaged skin, giving it a brighter appearance and fresher texture. Also works on fine lines and age spots on the face and hands. Aids in the control of acne, does not penetrate the dermis so there’s little or no recovery time. Useful for all skin types; very low risk of scarring.
Issues For Some: Results are temporary and treatments must be repeated as needed. This procedure is for superficial skin problems only. May cause irritation, dryness and other negative reactions in some individuals.
TCA Peel
This peel uses trichloroacetic acids or TCAs (which are stronger than glycolic acids and penetrate deeper) to gently remove the outer layers of the skin. Because it penetrates the dermis, or middle skin layer, this peel actually restores the lower collagen and elastin layers of the skin. During the 15-minute procedure, the patient feels a burning sensation. There will be moderate discomfort and swelling for about a week, and minimal scabbing and some oozing which will last for a few days. Healing and toughening of the 'renewed' layer of skin takes place for a few weeks following a TCA peel, but most patients look presentable enough to return to their normal activities after about a week.
Normally Good for: Early wrinkling, mild scarring, and age spots on the face and hands. It also helps counteract moderate sun damage, uneven pigmentation and weathered skin.
Issues For Some: While new skin is noticeably fresher and smoother following a TCA peel, anyone considering this procedure must be prepared for some discomfort and a week or more of hibernation. Because of penetration to the papillary dermis, there is swelling, redness, drainage and crusting this usually heals in 7 to 10 days. As with any strong acid or laser peel, there's a risk of scarring and the treated areas of the face may turn a whitish color.
Jessner’s Peel
This peel consist of a mixture of lactic acid, salicylic acid, alcohol and resorcinol with the occasional addition of other agents such as hydroquinone or kojic acid. The Jessner’s peel and its variants have been used reliably for over a century for skin freshening and acne treatment, with a minimal recovery time.
Obagi (Blue) Peel
Per a noted dermatologist the blue peel also known as the Obagi peel, is recommended for patients with darker skin. This is a superficial (light) peel which combines trichloroacetic acid (TCA) with blue coloring to improve visibility. Unlike other TCA peels which can be hard to control, the blue-peel kit is standardized, reducing operator error in controlling the depth of the peel. He also noted that complications such as hyperpigmentation, uneven skin tone, and scarring can still occur if the peel is done too aggressively. Deep peels, CO2 lasers, and other deep-penetrating methods of skin resurfacing are not recommended for darker skin types as they can cause scarring and discoloration.
Phenol peel
The strongest kind of chemical peel, this method uses carbolic acid for deep exfoliation of the face. In fact, it's rarely used because it penetrates so deeply. In addition, mild sedation with a local anesthetic is given and there are many risks. Recovery time is around one to three weeks or longer and your skin will be very red after the procedure. You will need someone to care for you for a couple of days after this peel. You will also be on a liquid diet and asked not to talk very much. Over the next six to eight weeks, it will turn from pink to a more normal color. This kind of peel takes at least two hours for a full-face treatment.
Normally Good for: Deep wrinkles, scars and sun-damaged skin. Removes pre-cancerous growths and corrects blotches.
Issues For Some: While your skin will become smoother and tighter after this kind of peel, the procedure is very uncomfortable. The face becomes swollen and most patients won't feel comfortable in public for two weeks after the procedure. Other problems may include scarring, permanent skin lightening and differences in pigmentation between the peeled and unpeeled areas. This kind of peel is not recommended for people with dark skin. Recovery may be slow, complete healing may take several months.
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