Cosmetic Dermatology

Chemical Peels

Chemical peels work by removing the outer layer of skin by applying chemicals that loosen the ‘glue’ that holds dead skin to the surface. The amount of skin removed is determined by the type of chemical that is applied, the strength that is used, and the duration of time it is left on the skin.

How does it work?
Glycolic Acid (AHA) – Superficial Peel
Removes the superficial epidermis, or top layer of skin

Trichloroacetic Acid (TCA) – Medium Depth Peel
Removes the superficial and mid layers of the epidermis, and when it heals a new
smoother layer of skin remains

What do they treat?
Glycolic Acid
  • Gives the skin a healthy glow by smoothing skin texture
  • minimizines flaking and dry skin and balances skin tones
  • reduces very fine lines from sun damage
  • reduces lentigines (brown spots) from sun damage
  • improves melasma (brown discoloration)
  • acne

Trichloroacetic Acid (TCA)
TCA peels offer all of the benefits of glycolic acid and additionally:
  • smooths fine wrinkles caused from sun damage
  • improves superficial acne scars
  • improves or resolves uneven pigment and lentigines (sun spots)

How is a treatment performed?
The skin is gently cleansed and then degreased with alcohol. The chemical is applied with cotton and left on for 3 to 5 minutes for a superficial glycolic acid peel and is then neutralized with water. TCA peels are applied evenly with a fine brush until a frost is achieved, typically within several minutes. Patients are given a hand held fan to help with mild burning or stinging that can occur during the procedure.

How often is the peel repeated?
Glycolic Acid

Typically the dose is gradually titrated with weekly peels for two to three weeks, and then the peel is repeated weekly for 4-6 weeks until the desired result is achieved. Maintenance peels can be done monthly.

Trichloroacetic Acid (TCA)

Monthly peels are recommended until results are achieved, and then every 6 to 12 months for maintenance

How long is the peeling and recovery process?
Glycolic Acid

Due to the titration process most patients can return to normal activities immediately. Patients should expect some facial tightness and redness, and sometimes mild peeling that can last for 2 to 10 days.

Trichloroacetic Acid (TCA)

Swelling and discomfort may occur. The skin will initially redden, and then blister and crust and look like a severe sunburn before it heals. Peeling usually occurs over a 5-6 day period. Healing usually takes 1-2 weeks, during which public activities are often avoided. The skin may remain red for up to six months or longer.

What type of restrictions will be necessary?
Strict sun avoidance should be followed until all peeling has ceased, and sunscreen should be applied daily for at least 3 months following the procedure.