Despite the appearance of several new types of lasers each year, plastic and cosmetic surgeons report doing over one million chemical peels in 2004. Chemical peels, which have been a popular skin rejuvenation procedure form more than 50years helps rejuvenate facial skin and is favored by many, patients who may not wish to undergo more invasive procedures such as laser resurfacing.  

Well Worth It: Skin peeling techniques work because old, damaged skin is taken off in one of three ways. The outer layer of skin can be ground off by dermabrasion, dissolved by acid or vaporized with a laser. However, lasers and chemical peels remove the old skin in vastly different ways. A laser vaporizes skin fluid, leaving behind dead cells and other debris which must be immediately cleaned away to prevent infection. That leaves an open wound which requires care for three to five days. In addition, a laser may redden the face anywhere from several months to a year. But a chemical peel works differently. Depending on how extensive a rejuvenation the patient wants, the peel causes a slow loss of skin over 24 to 72 hours. In about seven to ten days, healthy, beautiful new skin appears.

Healthier Radiant Look: The skin is gently cleansed, and the surgeon applies the solution with a sponge, cotton pad, cotton swab or brush. Usually, no anesthesia or sedation is needed for the light peel because the patient feels only a mild tingling or stinging. Often, one treatment provides a healthier, radiant look for the patient who can immediately resume normal activities. But a light peel requires the patient to return to her surgeon to maintain the look.

Medium peels penetrate more deeply and remove sufficient skin to cause a sunburned appearance. Medium peels treat mild to moderate wrinkles, moderate sun damage, pigment changes and precancerous lesions. Stronger acids, such as TCA (trichloroacetic acid) are usually used. Medium peels can also require return treatments for freshness.

Phenol is primarily used for deep peels and requires monitoring during its application. On the other hand, TCA can be used for light, medium or deep peels depending on the concentration and technique used for its application.

“The strongest peel uses phenol with croton oil, a chemical which is designed for light-eyed, fair-skinned people who have deeper wrinkles, acne scars, rosacea or a lot of sun damage. The deep peel is one of the best techniques plastic surgeons have for removing deep wrinkling and can last a lifetime.”

However, phenol is not used to treat patients with dark, oily complexions and those who may be at risk for heart conditions. Deep peel patients are always given IV fluids and  monitored with an EKG because phenol is dangerous to the heart in higher doses, if applied too quickly or over too large an area at once. Experts say an area about the size of a palm is treated every fifteen minutes or so minimize the risk or irregular heart beats, one of the possible adverse side effects.

Have a plastic surgery question for Dr. Dickie?   If so, e-mail us at info@BahamasInstituteOfPlasticSurgery.com .   Dr. Kenneth Dickie is certified by the Royal College of Physicians and Surgeons of Canada in Plastic Surgery.   He specializes in Cosmetic Plastic Surgery as well as Plastic, Reconstructive, and Hand Surgery.   Dr. Dickie has been in clinical practice since 1984, and is currently a member of the Canadian and American Societies of Plastic Surgery, and the Canadian and American Societies of Aesthetic Plastic Surgery.   For a consultation, please contact the Bahamas Institute of Plastic Surgery at (242) 351-1234 or toll-free 1(242)300-1235.