Chemical Peel

Chemical peel is the most commonly used cosmetic intervention that improves appearance and hereby helps to gather confidence. During chemical peel a chemical substance is administered to the skin that smoothes skin bumps and removes the outer, damaged layer of the skin that is replaced by a natural, juvenile and smooth skin. The name of the chemical peel depends on the used chemical substance. So if alpha hydroxy acid is used during the intervention it is called AHA chemical peel, if trichloracetic acid is used, the name is TCA chemical peel, if phenol, then the name is phenol chemical peel.

Whom to Recommend Chemical Peel for?

Chemical peel is recommended for those who have bumpy skin with wrinkles or have uneven pigmentation, damaged by the sun.

• Those who’d like better result quickly – are fed up with inefficient creams
• Those who feel as if more and more wrinkles come every day
• Those who look tired after sunbathing or brown spots occur on them
• Whose acne does not cease (to say nothing of scars)
• Men: ingrown hair in beard
• Women: folliculitis after waxing, ingrown hair

A personal consultation is needed with every patient to choose the optimal kind of chemical peel.

How is the suitable substance for chemical peel chosen?

Alpha hydroxy acids (AHA), like glycolic acid, lactic acid or fruit acid are weakest chemical peels, so these are used for superficial peel. Glycolic acid is found in the nature in cane sugar, pineapple, grape and other fruits. The result of the chemical peel performed with it is a smoother, shinier skin and you can go back to your everyday routine right after the intervention. AHA chemical peel smoothes superficial wrinkles, smoothes the dehydrated, bumpy skin, fades away pigment spots, has a beneficial effect on acne.

These acids with superficial effect are used regularly every week, in every 2 weeks, or monthly. The medical treatment may be complemented with home care products to achieve an even better result. These personalized home care products are recommended during the consultation.

Trichloroacetic acid can be used in different dilutions. The 15% concentration is used for a superficial chemical peel, while the 35% and 45% concentration is for a medium depth peel.

Whom to recommend TCA chemical peel for?

Those who want to get rid of their superficial wrinkles or pigment spots. It fades away age spots and able to smooth superficial bumps. Chemical peel should be repeated to achieve the required effect. The recovery time at home is 3-4 days after a medium depth chemical peel (35%-45% concentration). Sun protection is required for months after the treatment to protect the new skin from damaging sunrays.

Phenol is the strongest chemical peel and it is used for the deepest medical peel. It fades away the wrinkles around the eyes, mouth and pigment spots. In case of wrinkles around the eyes it is recommended for those who are afraid of surgery (eyelid plastic surgery). This is one of the most effective solutions without operation to smooth the wrinkles around the mouth. It is recommended for sun-damaged skin to remove precancerous skin symptoms. The skin might have a lighter color following the phenol peel. Hereinafter the use of sun protection is always recommended. This therapy is not recommended for people with a history of heart disease.

Every chemical peel (just like any cosmetic intervention) may have side effects. The risk is minimal in case of superficial chemical peel. Scarring or pigment problems may develop following a deeper peel.

Summary: Chemical peels and their effect

Alpha hydroxy acids (AHA)

• Smoothes rough, dehydrated skin
• Has beneficial effect on sun damaged skin
• An effective treatment for skin acne
• It fades away or improves superficial pigment spots with the additional use of bleaching cream
• Has a moderate rejuvenating (skin renewal) effect (induces collagen production)

Important

• Peel has to be repeated several times for optimal effect
• Face, neck, décolletage and other regions of the body can be treated
• Treatment lasts for 10-15 minutes
• Sun protection is recommended

Trichloroacetic acid (TCA)

Effect

• Smoothes superficial wrinkles
• Fades away superficial bumps
• Improves pigment problems
• Improves acne scars

Important

• Face, neck, décolletage and other regions of the body can be treated
• Preparatory treatment is recommended at home
• Treatment lasts for 10-15 minutes
• Superficial and medium depth chemical peel may be performed depending on concentration
• Treatment should be repeated from time to time to maintain the attained result
• Sun protection is recommended for months
• Recovery time is 0-5 days (depending on concentration)

Phenol

Recommended

• To treat deep pigment spots
• To smooth deep wrinkles
• To treat precancerous changes

Important

• It can be used on the face only
• For people with pale skin only
• Not recommended for patients with heart problems
• Slow recovery – Full recovery may last for months because of redness
• Fades away wrinkles on face permanently
• Sun protection should be used all the time
• Spectacular and long lasting result
• Your new skin color may stay lighter than the original

What should I do to have chemical peel?

Find a physician who has a decent education and practice in chemical peel. Even the most superficial chemical peel should be performed by a physician or a properly educated assistant with medical attendance. Only a qualified physician should perform a trichloroacetic acid or a phenol chemical peel!

Discuss your expectation with your physician on your first consultation. Don’t be afraid to ask all your questions regarding the process. Your physician will tell you the advantages and disadvantages of the suggested chemical peel, the details and prices of the treatment. If you have recurrent herpes don’t forget to discuss it to be able to employ a suitable preventive treatment.

What are the steps of the treatment?

1. Preparation for chemical peel

We will discuss the proper preparatory treatments before chemical peel during the consultation.

You should use creams containing low concentration of glycolic acid or polyhydroxy acid for two weeks at home before glycolic acid chemical peel.

It is essential to mention if you use any retinoid products (Roaccutan, Sotret, Aknenormin, Isotrex, Differin etc.) on your skin, since the chemical peel will have a deeper effect and crusts may occur on your skin. If your skin is too dry the effect may be deeper.

You should use creams containing low concentration of glycolic acid or polyhydroxy acid for 2 weeks or a month together with a bleaching cream at home before trichloroacetic acid chemical peel.

In case of the phenol chemical peel you need assistance to transfer you home. No extra assistance is needed in case of trichloroacetic acid or glycolic acid chemical peel

2. Anesthesia

Anesthetics are not required in case of a trichloroacetic acid or a phenol chemical peel since the chemical substance itself has anesthetizing effect. If necessary you can get some mild sedative pills to stay in a relaxed, peaceful condition during the treatment.

You don’t need any anesthetics during the alpha hydroxy acid chemical peel since you can feel a mild pinching sensation only.

3. Chemical peel

Alpha hydroxy acid (AHA) chemical peel/treatment: The physician or a qualified assistant cleans and degreases the skin. The skin is covered with AHA for max. 5-10 minutes. The face, neck, décolletage, arm, hand, feet, etc. can be treated. A mild redness may occur for 1-2 hours following the chemical peel, but it doesn’t disturb your everyday routine. Treatment should be repeated to reach or maintain the required effect.

Phenol and trichloroacetic acid (TCA) chemical peel: The physician covers the well cleaned skin with phenol or TCA. A pinching sensation may occur for a short time, but it ceases soon.

Two or more TCA chemical peel is needed to reach the desired effect. Superficial TCA-treatments may be repeated monthly.

A single Phenol chemical peel is usually sufficient. The treatment of a single region of the body lasts for max. 15 minutes.

4. Following chemical peel

Mild exfoliation, redness and dryness may occur following AHA-treatment. These symptoms decrease during the repeated chemical peels.

A mild painkiller may be required following a phenol or TCA chemical peel. Crust may occur on the treated area. You should closely follow your physician’s instructions.

The treated area may swell following the phenol chemical peel. You may need assistance at home for two days.

5.Returning to everyday routine

You can return to work with your temporal skin redness following the AHA chemical peel. The repeated AHA chemical peel results a more juvenile and fresh skin. Don’t forget to use sun protection. We will recommend a proper sun protection product during the consultation.

Moderate exfoliation and swelling may occur on the first week following TCA chemical peel. The new skin is formed within 7-10 days. You can return to your everyday routine then. Sun protection is very important in this case, too.

The new skin is formed in 7-10 days following a phenol chemical peel. In the beginning expressed skin redness will occur than it will slowly become pink in the following weeks or months. Total sun protection is very important during this period. You can use a makeup in two weeks and return to your everyday routine. We will recommend a makeup product to you during the consultation.

6. Final result – Your fresher, more juvenile and smoother skin

First the result is not spectacular following an AHA chemical peel, only your healthier and shinier skin will be apparent. The production of collagen tissue will be induced by the maintaining treatments and your tissues will be more flexible.

TCA chemical peel is not as permanent as phenol peel, so it has to be repeated from time to time. But your skin will be noticeably smoother and livelier.

The rejuvenating ad maintaining therapies should be combined in order to achieve a perfect result. Chemical peel may be combined with botox-treatment, wrinkle fill, mesotherapy rejuvenation and laser therapy.

Comparison of chemical peel substances

Type of chemical peel	AHA chemical peel	Salicylic acid chemical peel	TCA chemical peel – low concentration	TCA chemical peel – high concentration	Phenol chemical peel
Superficial wrinkles	Moderate improvement	Slight improvement	Slight improvement	Moderate improvement	Good improvement
Acne	Good improvement	Good improvement	Slight improvement	Slight improvement	Good improvement
Acne scars	Moderate improvement	Slight improvement	Slight improvement	Moderate improvement	Good improvement
Deep wrinkles	Slight improvement	Slight improvement	Slight improvement	Moderate improvement	Good improvement
Age spots	Moderate improvement	Moderate improvement	Moderate improvement	Good improvement	Good improvement
Effects	1 – 3 months	1 – 3 months	3 – 6 months	Year+	Year+
Risks	Low	Low	Medium	High	High
Recovery time	None or short	None or short	Generally short	Long	Long