Chemical peel uses a chemical solution to improve and smooth the texture of the facial skin by removing its damaged outer layers. It is helpful for those individuals with facial blemishes, wrinkles and uneven skin pigmentation. Trichloroacetic acid (TCA) and alphahydroxy acids (AHA) are used for this purpose. The precise regimen used is adjusted to meet each patient's needs.

Chemical peels are not a substitute for facelift surgery, nor will they prevent or slow the subsequent aging process. This web site provides basic information about certain types of chemical peel treatments and the results you might expect. It won't answer all your questions, since a lot depends on your individual circumstances.

If you have further questions, write them down and ask your surgeon and his helpful staff at your consultation.

Deciding if chemical peel is right for you

Chemical peel is most commonly performed for cosmetic reasons -- to enhance your appearance and your self confidence. Chemical peel may also remove pre-cancerous skin growths, soften acne facial scars and even control acne.

Your private health insurance and medicare may cover some of the cost of TCA peels. Be sure to check your policy and contact your insurance company before the procedure is performed. Our staff can also advise if your claim is within Medicare guidelines.

Alphahydroxy acids (AHAs), such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels. These types of peels can provide smoother, brighter-looking skin for people who can't spare the time to recover from a TCA peel. AHA peels can be performed within our center.

AHA peels may be used to treat fine wrinkling, areas of dryness, uneven pigmentation and acne. High concentrations of an AHA applied regularly on a monthly basis obtain the best result. An alphahydroxy acid, such as glycolic acid, is also mixed with a facial wash or cream in lesser concentrations, as part of a daily skin-care regimen to improve the skin's texture. This maintenance programme can continue indefinitely. For more information, click on skin care, in the main menu.

Trichloroacetic acid (TCA) can be used in many concentrations, but it is most commonly used for medium-depth peeling. Fine surface wrinkles, superficial blemishes and pigment problems are commonly treated with TCA. The results of TCA peel are usually more dramatic and long-lasting than those of AHA Peels. However more than one TCA peel may still be needed to achieve the desired result. The recovery from a TCA peel typically takes 7 - 10 days.

All chemical peels carry some uncertainty and risk

TCA peel is normally a safe procedure when it is performed by a qualified, experienced plastic surgeon. However, some unpredictability and risks such as infection and scarring, while infrequent, are possible.

AHA peels may cause stinging, redness, irritation and crusting. However, as the skin adjusts to the treatment regimen, these problems will subside.

With a TCA peel, your healed skin should be able to produce pigment as always; the peel should not markedly bleach the skin. However, TCA-peel patients are advised to avoid sun exposure for several months after treatment to protect the newly formed skin.
Failure to heed this advice may result in patchy hyperpigmentation (darker than normal colour to the skin). Slight lightening of the skin colour normally results from removal of sun damaged layers of the skin - very rarely, more marked lightening has occurred.

Peel formulas at a glance

Alphahydroxy acids (AHA's)

Uses:

• Smoothes rough, dry skin
• Improves texture of sun-damaged skin
• Aids in control of acne
• Can help correct pigment problems
• Used as TCA pre-treatment

Considerations:

• A series of peels may be needed
• As with most peel treatments, sunblock use is recommended

Trichloroacetic acid (TCA)

• Smoothes out fine surface wrinkles
• Removes superficial blemishes
• Corrects pigment problems

Considerations:

• Can be used on neck or other body areas
• Requires pre-treatment with Stieva -A and AHA's
• Treatment takes only half an hour
• Peel depth can be adjusted
• Repeat treatment may be needed to attain desired results
• Sunblock must be used for several months
• Healing is usually quick

Planning for a chemical peel

AHA's
Australian laws permit non-physicians to administer certain peel solutions, but regulate the strengths which they are permitted to apply. Beauticians may offer AHA or fruit acid peels, but may only use low and generally less effective strengths of AHA. Plastic Surgeons commonly use strengths up to 70%. Your surgeon and his staff currently offer a revolutionary type of AHA peel called Refinity. This very powerful 70% AHA peel causes little discomfort due to a proprietary strontium salt included in the formulation, which acts like a local anaesthetic. Other 70% AHA peels cause considerable pain, and many less concentrated peels are first required , slowly building up to the 70% strength.

TCA

It is very important that you find a plastic surgeon who has adequate training and experience in skin resurfacing, with all available modalities. your surgeon can offer you a choice of peel techniques or may suggest other resurfacing treatments such as dermabrasion or laser resurfacing to help you achieve your desired outcome.

During your initial consultation, it is important that you discuss your expectations. Don't hesitate to ask any questions or express any concerns that you may have.

your surgeon will explain the planned procedure in detail, including its risks and benefits, the recovery period and the costs. If you have a history of herpes (cold sores), inform him prior to the procedure. Remember, chemical peel treatments are usually not covered by medical insurance unless they are performed for medically related problems.

Preparing for your chemical peel

We will give you complete instruction on how to prepare for your peel treatment. Often, Stieva A (a prescription medication also marketed as Retin A and derived from Vitamin A ) is used to pre-treat the skin. This thins out the skin's surface layer, allowing the peel solution to penetrate more deeply and evenly. An AHA maintenance cream will be used in addition. Hydroquinone, a bleaching agent, is sometimes used in conjunction with Retin-A or AHA pre-treatment, especially if you have blotchy skin areas or pigmentation problems. You may have to spend a month in the pre-treatment phase before the doctor will schedule your TCA peel.

You will require time off work after TCA peel, a few days to a week is sufficient. If you are having your TCA peel in a hospital setting, you will need to arrange for someone to drive you home and help you out for a day or two.

Where your peel will be performed

TCA peels can be performed in an outpatient surgical centre, or in our rooms, depending upon the strength of the peel. Your surgeon may want you to stay overnight in a hospital if other cosmetic procedures are performed simultaneously.

AHA peels are performed in the Sunshine Coast Plastic Surgery Centre.

Types of Anesthesia

If a high strength TCA peel is required, your peel will be performed in an outpatient setting in a hospital. General anesthesia isn't required for TCA peels, however, sedation will be used during the procedure to relax you and keep you comfortable.

TCA peels performed in our rooms at Sunshine Coast Plastic Surgery require no anaesthesia at all.

No anesthesia is needed for AHA peels since they cause only a slight to moderate stinging sensation during application.

The Peel

AHA Peel:

Your skin will be cleansed to remove all trace of oil and then the AHA applied, a process that usually takes no more than 10 - 15 minutes. You will be given a moisturiser to use for the following 48 hours and you may need to alter your skin care programme in this time. Periodic treatments will be necessary until the desired effects are achieved. Typically, a course of 3 to 6 peels are employed.

A maintenance home programme of an AHA facial cleanser and moisturiser twice a day can help to keep your skin looking its best. Your surgeon may recommend the addition of Stieva-A or Cellex-C to your skin care regime to help reverse the effects of environmental damage, and prevent further damage . After several months of use of this skin care , your doctor will examine your skin to determine if your regimen needs adjustment. See Skin Care in the main menu for more information.

TCA peels:

Initially,the skin is thoroughly cleansed to remove all trace of oils.Then the TCA solution is applied, this is left in place until the desired level of "frosting" has occured, the peel is then neutralised with water and a thick moisturiser applied. A full-face TCA peel usually takes no more than 30 minutes. Two or more TCA peels may be needed to obtain the desired result, and these may be spaced out over several months.

After the surgery

After an AHA peel, it is common to experience some temporary flaking or scaling, redness and dryness of the skin. However, these conditions will disappear as the skin adjusts to treatment.

After a TCA peel, your doctor may prescribe a mild pain medication to relieve any tingling or throbbing you may feel. A crust or scab will form on the treated area. To help your face heal properly, it is essential that you follow your surgeon's specific post-operative instructions.

A TCA peel may also cause significant swelling, depending on the strength of the peel used.

Getting back to normal

With an AHA peel, the temporary redness, flaking and dryness that you experience will not prevent you from working or engaging in your normal activities. A fresher and improved skin texture will result with continued AHA treatments. Remember, protecting your skin from the sun is also important following these mild acid peels. Ask your surgeon to recommend a sunblock with adequate UVA and UVB protection and use it everyday. Click on skin care and sun protection for more information.

With a TCA peel, the moderate discomfort and mild swelling you may experience will subside within the first week. In about a week to ten days, your new skin will be apparent and you should be healed sufficiently to return to your normal activities. It is best to avoid sun exposure for some months, even if you are adequately protected. If you wish to use them, specialist camouflage cosmetic kits are available. Simply ask our friendly staff.

Your new look

Improvements from AHA peels may be subtle at first. You may detect a healthier glow to your skin. With continued treatments, you will notice a general improvement in the texture of your skin. The results of a TCA peel are reasonably long lasting and your skin will be noticeably smoother and fresher-looking.

If you have further questions, write them down and ask your surgeon and his friendly staff at your consultation.