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Chemical Peel
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Overview
Chemical peeling
is a way of rejuvenating facial skin (sometimes arms and chest)
by applying a chemical that essentially destroys the top layers
of the skin. When the skin heals it does so by reforming collagen
that is thicker, better vascularized and more youthful. It
is most effective in treating sun damaged skin. It effectively
eliminates or reduces age spots and skin discoloration. It
also helps with fine wrinkles as well as improving skin texture. Chemical peeling is very effective in recapturing the healthy,
glowing texture seen in youthful skin.
The most common chemical used for peeling
by Dr. Cruise is trichloroacetic acid or TCA. TCA is the most
common chemical used for peeling because it combines safety
with effectiveness better than other agents. There are other
chemicals such as phenol and fruit acids, but they do
not have the same combination of effectiveness and safety
as TCA. They are, however, useful for certain skin problems.
Chemical peeling is particularly useful
within the armamentarium of rejuvenation because it is very
effective, does not need general anesthesia, and is relatively
low-cost. Effectively, a chemical peel causes a controlled
burn. Dr. Cruise can predict the depth of the burn so that
it goes down to a certain depth within the skin but no further. The
skin heals with collagen that is more abundant and youthful. Obviously, you need to make sure that whoever is performing
this procedure has the proper credentials and is well-trained
because too deep of a burn can result in serious scarring.
Normally, the entire face is peeled at
once. This includes the eyelids, forehead, and onto the neck. The
procedure is performed within Dr. Cruise's surgical suite under
local anesthesia. Some plastic surgeons and dermatologists
perform peels with no anesthesia at all. While this is acceptable,
Dr. Cruise prefers to be as painless as possible. After the
peel, the skin of your face becomes leathery and appears burned
until the skin peels off uncovering the new skin below. This
takes about 7 to 10 days.
After your skin has peeled, your face
is pink for 1 to 2 months depending on the depth of the peel. It is important that you stay out of the sun for at least
6 months. Exposure to sun may cause hyper-pigmentation and/or
irritation of the face.
Chemical peeling is extremely useful
both in facial rejuvenation and as part of an anti-aging protocol
that can be repeated every 4 years after the age of 30.
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 Dr. Cruise's philosophy regarding Chemical Peel
 Chemical peeling is a very effective tool within my armamentarium for skin care. Because it is less likely to cause prolonged redness it is often a better treatment choice than laser skin resurfacing. I feel so strongly about the merits of peeling that I, personally, have a peel every 4 years as part of my anti-aging protocol. By doing this, collagen within the dermis is forced to re-create itself in a more youthful fashion. It also enhances the blood supply to the dermis which creates a healthy, glowing appearance.
Carefully read over the benefits of chemical peeling because they apply to just about everyone. The downside to chemical peeling is that you must be careful to stay out of the sun. This is something you should do anyway. This will require using sunscreens more often as well as wearing hats. The benefits to your skin, however, are well worth it.
I encourage you to incorporate chemical peeling as part of your skin care management program as I have. If you do not have a program or would like to learn state-of-the-art skin care, I would love to discuss this with you because skin care and anti-aging is as important, if not more so, then rejuvenation.
Someone considering chemical peeling must understand that in order to get the desired improvement it is necessary to peel down to the deeper levels of the skin. This will leave you looking not presentable to the public for about a week. Surprisingly, it is not painful despite what it may look like.
In my practice, I find it extremely important to undergo a pre-peel protocol consisting of Retin-A and glycolic acid for at least 6 weeks prior to the procedure. Ideally, you should continue this forever.
Proper skin care is the most cost effective, simplest way to keep your skin looking its best. I encourage you to consult with me. I will go over your options. You will be surprised at how easy and effective it is. I will clarify issues that the cosmetic industry purposely makes confusing in order to sell its products.
Benefits
Chemical peeling has many benefits. Outlined below are the most notable.
- Very effective at removing age spots
and skin discoloration.
- Treats fine wrinkles and skin irregularities.
- Improves texture of skin creating
a more youthful, glowing skin.
- Improves skin texture and some scarring
in patients with acne scars.
- Can be used on face, hands, arms, chest,
and shoulders.
- Is relatively inexpensive.
- Can be done as an office procedure
under local anesthesia.
- Depth of peel can be controlled to
obtain the desired results.
- The most superficial of peels can
be done as a "lunchtime" peel.
Possible complications
The risks of chemical peeling in the hands of a competent plastic surgeon such as Dr. Cruise are very low and satisfaction is extremely high. The most significant complication is scarring. This is avoided by proper skin pretreatment as well as controlling the depth of the peel. Dr. Cruise has the experience to adjust the depth of peel precisely depending on skin type and patient wishes. Another complication unique to chemical peeling is hyper or hypo-pigmentation. This can occur if early sun exposure occurs or if the peel is too deep for a particular skin type. Other possible complications are prolonged redness and whiteheads. Whiteheads, otherwise know as milia, are not uncommon as the sebaceous glands become blocked by the newly formed skin. They go away and are not usually a problem.
A particular concern is the patient with a history of facial herpes. A chemical peel may cause a reactivation of the herpes. Dr. Cruise addresses this by prescribing the medication, Valtrex which is quite effective.
Are
you a good candidate?
People who
could benefit most from chemical peeling are those with sun
damaged skin. If you feel that your skin would be improved
by any of the reasons mentioned above in the benefits section then you are a good candidate.
People who have been on Accutane within
the last 2 years should not have chemical peeling as this
drug prevents adequate healing after the peel. Patients with
a history of herpes should notify Dr. Cruise so that proper
prevention is instituted. Herpes reactivation can occur after
a peel.
Another consideration for those thinking
of chemical peeling is that it is important to stay out of
intense sun exposure for at least 6 months. Ultra-violet rays
can cause undesirable darkening or redness in patients who had a recent chemical peel. Dr. Cruise will discuss ways to avoid sun exposure. He will
also go over a simple, effective skin care program that he
follows. This program includes daily glycolic acid moisturizers
and Retin-A as a minimum.
Prior to chemical peeling
The procedure takes about 45 minutes.
BEFORE SURGERY
- Let the doctor know of all medications taken daily.
- Avoid sunbathing for 2 weeks prior to surgery.
- Arrange for someone to drive you to and from surgery if you take Xanax.
- Be prepared for your face to be red and peeling for the first 7 to 10 days.
- Please make sure to let Dr. Cruise know if you have ever taken Accutane or have had oral herpes.
- Six - week pre-treatment with OBAGI skin care line, Ratin-A and Hydroquinone yields optimal results and decreases risk of hyper pigmentation. It is a requirement on darker skin patients.
THINGS TO PURCHASE BEFORE SURGERY
- Xanax
- Bacitracin or Neosporin - drug store
- Hydroquinone - at our office.
- Hydrocortisone Cream 1% - drug store.
- Wide brimmed hat to protect yourself from the sun on the way home. You might consider a shawl to cover your face. You will not want people to see your face.
THE DAY OF SURGERY
- Shower and clean your face aggressively with soap to remove facial oils. Do not apply anything to your face including moisturizers or make up.
- Shave facial hair (men).
- Do not bring any jewelry or valuables with you on the day of surgery.
- Bring a hat and a shawl so you can cover your face before you leave.
After
the procedure
AFTER SURGERY
- No bandages are necessary.
- Apply thin layer of Bacitracin to peeled area twice a day or more if peeled area becomes dry. After the peeling has stopped you may stop using it.
- Do not scratch area as bleeding will cause prolonged healing and possible hyper pigmentation.
- Stay out of prolonged exposure to sun for at least 4 months or use sun protection.
- You may start applying make up when peeling has stopped and skin is no longer irritated.
- Post peel splotchy redness is common. It will fade away over time. It may persist for up to 6 months. Hydrocortisone is helpful to clear up this redness.
- Begin Hydroquinone when peeling is finished. This will help prevent hyper pigmentation. Finish entire bottle.
- After 10 days continue with adequate skin care to maintain your results.
WHAT TO EXPECT AS YOU RECOVER
- Your face will be purplish right after the procedure and then will gradually turn brown and leathery. When the skin peels the underlying new skin will be pinkish.
- You might swell and if you do use hydrocortisone cream. Also use hydrocortisone to diminish itching and redness. Use Bacitracin if your face becomes dry.
WHEN TO CALL US
Post surgical complications are rare and are often easily solved by the doctor if you notify us. Call us if you experience any of the following: a temperature of 101 F or higher, your face becomes painful, you notice blistering or if you think that anything is wrong. Please call the office during regular business hours @ 949-644-4808 after hours page Dr. Cruise @ 714-304-8050.
YOUR FOLLOW UP APPOINTMENTS
Please make sure to attend all follow up appointments to ensure the best result.
Normally, Dr. Cruise will perform a complete
facial sensory block using local anesthesia. This provides
excellent anesthesia without the side effects of general anesthesia.
Recovery
time
Surprisingly, you will feel much better
than you look after a chemical peel. If you work at home
you could easily return to work the next day. Most people,
however, are self-conscious until their skin peels and their
new skin is revealed. This takes about 7 to 14 days. This
is when most people return to work.
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