Chemical peeling, also known as chemical exfoliation, is a procedure where a chemical substance applied to the skin causing a controlled destruction of the epidermis with or without part of the dermis, leading to skin regeneration and remodeling. Chemical peels are used for facial rejuvenation, restoring a more youthful and rested appearance to the aging face. It addresses issues such as enlarged pores and rhytides, inflammatory disorders including acne vulgaris, pseudofolliculitis barbae, rosacea, and post-acne scarring. Pigmentary disorders such as melasma, ephelides or freckles, lentigines, and post-inflammatory pigmentation. Chemical peels ae also indicated for epidermal proliferation and pre-cancerous lesions including sebaceous and actinic keratosis.

Chemical peels work due to acids within the solution that raise the acidity of the skin. Changing the skin’s normal pH level chemically loosens the cells that form the “glue” between dead skin cells and healthy skin cells. When that bond is chemically loosened, exfoliation occurs and the dead skin cells are removed to reveal healthy skin underneath. This process promotes the growth of new, healthy skin cells.

A light, or superficial, peel produces results that usually last between one and two months. A medium peel's results will last between two and six months, and the results of a deep peel last forever.

Before your peel, take antiviral medication if you have a history of cold sores for preventative measures. Use a bleaching agent (hydroquinone) if you have a history of hyperpigmentation. Avoid unprotected sun exposure. Avoid cosmetic hair treatments 1 week before your peel (electrolysis, permanent hair treatments, facial masks/scrubs). You may use a retinoid cream a few weeks before treatment to help with healing.

In the office, we will gather a complete medical history, assess your skin and create a comprehensive treatment plan to produce safe, reliable and satisfactory results. Wether your goal is to have facial rejuvenation, address inflammatory disorders such as acne, pigmentation or lesions- we will provide you with the options within our practice. We will dsicuss expectations and educate you on post care. After selecting the appropriate chemical peel and plan of care, we will take before pictures for comparison.

For the treatment, we will cleanse the skin and then degrease it with alcohol or acetone for the removal of any residue or makeup. You will wear a head cap and vaseline will be applied around the eyes, lips, nasolabial folds and lateral canthi to avoid potential pooling of the chemical.eyes will be covereed with an appropriate shield. You may take an oral analgesic for comfort if needed. the peeling will be applied with a 2x2 woven gauze and a pass will be made on the thicker skin of the face(chin, nose, cheeks, forehead) and then followed by the thinner regions (around eyes, mouth). A fan or neckfan may be provided for comfort. We will look for erythema and frosting, a visible white coat on the skin indicating protein denaturation.

After a peel, cool saline compresses can be applied to neutralize the solution and provide comfort. After 24 hours, you may shower and uses a gentle (non-detergent) cleanser. Protect yourself against sun exposure and let the face peel on its own, do not tear or pull skin that peels off the skin, you may use scissors to trim. Do not use makeup until the skin is fully healed( 2 weeks later). It is imperative that you avoid the sun and wear SPF for the next months. Peeling lasts 5-10 days. “Vingar soaks” (0.25% acetic acid) facilitates healing as well as petroleum jelly applications (3-5 times a day) until area finishes peeling. Post treatment pictures shoudl be taken 2-3 months post peel.

-Pregnancy or breastfeeding

-History of of an allergic reaction to a chemical peel, ongoing infection, open lacerations or wounds in the area of the peel.

-Recent isotretinon use in the last 6. months (relevant to medium and deep peels).

-Psoriasis, connective tissue disease, atopic dermatitis, exposure to radiation therapy, recent facial surgery.

-Keloid scarring, poor wound healing (uncontrolled diabetes or immunosuppression), patients with Fitzpatrick III-VI (prone to aberrant pigmentation or dyschromia) unless chemical peel otherwise states it is safe for these skin types.

-Heart, kidney or liver damage. A deep chemical peel uses carbonic acid (phenol), which can damage heart muscles and cause the heart to beat irregularly. Phenol can also harm the kidneys and liver. To limit exposure to phenol, the peel is done a portion at a time 10-20 minutes apart.