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Dermatologists pioneered the use of chemical peeling
for therapeutic benefit. In 1882, Dr. Unna - a German dermatologist
- first described salicylic acid, phenol, and trichloracetic acid
peels. In the 1970’s, a dermatologist, Dr. Van Scott, was
the first to investigate alpha-hydroxy acids. The science and art
of peeling was advanced tremendously in the 1980’s and 1990’s,
when several dermatologists developed “medium-depth”
peeling techniques. These combination procedures allow more effective
peeling without the risks formerly associated with “deep”
peeling agents like phenol.
How can a medium-depth
peel benefit me?
In chemical peeling, a solution is applied to the skin to remove
damaged skin cells and stimulate production of new, healthier skin
cells. The greatest benefit of a medium-depth peel is the removal
of severely sun-damaged skin and precancerous lesions (actinic keratoses).
Studies demonstrate a 75% reduction in actinic keratoses post-peel.
These peels also improve irregular or splotchy pigmentation and
reduce fine wrinkling. In other words, medium-depth peels have significant
therapeutic as well as cosmetic benefits for patients with photodamaged
skin.
How is the treatment
performed?
The entire procedure takes approximately 45 minutes. After cleaning
the face, a light coat of Jessner’s solution is applied to
prepare the skin. After several minutes, the second agent - trichloracetic
acid - is carefully applied. Most patients experience moderate discomfort
for 3-5 minutes, but this quickly subsides with cool compresses.
Medication is available to both ease the pain and help you relax.
What can I expect after
the peel?
A severe sunburn-like reaction. Surprisingly, most patients report
little significant pain during the healing process. Water blisters
form and subsequently break, crust, turn brown, and peel over the
next 5-14 days. Some patients experience some swelling for a few
days. Fortunately, with good wound care, most patients heal completely
within 7-10 days. Some pinkness may be present for a few weeks,
but this can be covered with makeup. It is important to limit sun
exposure for several weeks following a medium-depth chemical peel,
to avoid the formation of splotchy pigmentation and/or persistent
redness.
What are the limitations
of chemical peels?
Lax skin and deeper wrinkles do not respond to peels. Also, chemical
peels cannot change pore size, improve deep scarring, or remove
broken blood vessels on the face. A medium-depth chemical peel is
considered a cosmetic procedure, and is not covered by insurance
– even when done for therapeutic benefit. Payment is due at
the time of scheduling.
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