New York Facial FAQ > More Information about Chemical Peels
How Chemical Peels are Performed at SHIZUKA new york Spa
Immediately before a Superficial Peel , the skin is cleaned. The chemical (usually a liquid or paste) is applied to the skin with care using a small brush, gauze, or cotton-tipped applicators. The chemical is left on the skin for 2 to 7 minutes, depending on the type of chemical used. Water is often used to neutralize the acid and end the chemical reaction. It is then wiped off. You may feel a small burning sensation while the chemical is on your skin. A handheld fan can help cool the skin and relieve any discomfort.
The technique used to do a Medium Peel is similar to that used for a superficial facial peel, but the chemical is either in a slightly higher concentration or may be left on for a longer period of time. A medium chemical peel is more painful than a superficial peel, as the chemicals are stronger and penetrate deeper into the skin. You may be given a pain reliever and/or oral sedative to reduce any pain and anxiety during the procedure. Cool compresses and fans can be used to cool the stinging sensation caused by the chemical. The procedure takes approximately 20 minutes at our New York Day Spa in Manhattan. There is little or no pain once the peel is finished.
Deep Peels take the most time and are the most painful type of chemical peel. The procedure for a deep peel using phenol is also more complicated than for other types of peels. You may be given an oral sedative and pain relievers. General anesthesia is occasionally used but runs increased risk of possible complications.
During this procedure, you may be put on a heart monitor and receive IV (intravenous) fluids, because phenol is toxic when absorbed into the body's system in large doses. These measures may not be necessary if only a single, small area is being peeled.
After the skin has been thoroughly cleansed, the chemical will be applied and allowed to penetrate. After one area of the face is treated, there will be a 15-minute break before the next area is treated to avoid getting too much phenol in your system.
Tape or ointment is often applied to the area after the peel to increase its effectiveness. When tape is used, it is removed after 2 days. Ointment is washed off with water after 24 hours and then reapplied as needed. Depending on how large an area is being treated, the entire facial peel may take 60 to 90 minutes at our New York Spa in NYC.
Before the Peel
The depth of the peel you would require and the type of chemical solution that would be most appropriate is based on several factors including your skin type, the area(s) you would like peeled, your goals, any risk factors involved, and other issues. In some cases, a small “test spot” may be peeled to get a better idea of the results, especially for people with darker skin.
Two to three weeks before the peel, you will need to begin preparing your skin. Among other things, you will be asked to cleanse the skin twice per day, apply a special moisturizer or cream once or twice per day, and use sunscreen every day. In some cases, daily use of tretinoin (Retin-A) will also be recommended and may speed healing. This skin care regimen will help the skin peel more evenly, will speed healing after the peel, and may reduce the chance of infection and other complications, especially uneven color changes in the skin.
the mouth or eyes, you may be given a short course of medication before the peel to prevent viral infection.
After Your Procedure
Recovery time after a chemical peel depends on the depth, duration and type of chemical used. In order to speed healing, ensure longer lasting results, prevent infection and avoid color changes in the treated area caused by sun exposure, proper care of the skin after the peel is very important
Post-Peel Care:
- Cleanse the skin frequently with water.
- Change the dressing or ointment on the wound (for medium and deep peels).
- Moisturize the skin daily.
- Avoid sun exposure until peel has stopped and sunscreen can be used. Once peeling has stopped, sunscreen should be used every day as new skin is more susceptible to sun damage.
- Some doctors may also recommend using retinoid (Retin-A) cream nightly, usually starting 2 to 3 weeks after the peel.
Possible Risks associated with Chemical Peels
In general, the deeper the peel, the greater the risk of side effects and complications. Chemical peels can result in:
- Redness (erythema). Expect some redness of the skin after a chemical peel. With deeper peels or with certain skin types, redness can be severe. It may fade within a few weeks, or it may last several months.
- Color changes in the skin. Treated areas may be darker or lighter than the surrounding skin.
- Crusting and scaling.
- Swelling (edema). This can occur especially around the eyes.
- Scarring.
- Allergic reaction to the chemical.
- Infection. People who have a history of herpes outbreaks are especially prone to infection after a chemical peel.
- Increased sensitivity to sunlight.
A chemical peel (except for a superficial type) may not be done if you have:
- Recently used isotretinoin (Accutane, a drug used to treat acne).
- Had recent facial surgery or facial radiation therapy. This can make re-growth of the skin more difficult.
- An active herpes infection affecting the area to be treated.
- An impaired immune system. This can delay healing and increase the risk of infection and skin color changes after the peel.
- Known allergies to certain medications.
- Impaired immune system*
There is a special concern with deep peels. Although rare, the use of phenol can potentially cause more severe complications during the procedure, including heart, liver, or kidney failure (phenol peels are not used in our practice).
Other Issues
Expectations
Chemical peels are designed to wound and remove the upper layers of the skin. You need to prepare yourself for how your skin will look immediately after the peel and throughout the healing process. You also need to be prepared to use cosmetics to blend skin tones between treated and untreated areas, such as between the face and jaw line.
Be sure that your doctor understands what you hope to achieve and that you understand what results you can realistically expect. Even with realistic expectations, you may not see results for several weeks or months after a chemical peel.
Sun protection
During the early healing period after a chemical peel (before the skin has finished peeling), you will need to avoid sun exposure. Once the early healing period has passed, you will need to wear sunscreen every day and limit sun exposure as much as possible. New skin is more susceptible to damage and discoloration from sunlight.
Options for skin resurfacing
Chemical peeling, dermabrasion, and laser resurfacing are the most commonly used techniques for improving the texture and appearance of the skin. Although these techniques use different methods, they have basically the same effect on the skin. They destroy and remove the upper layers of skin to allow for skin re-growth.
No one technique is necessarily better than another. When performed by an experienced surgeon, laser resurfacing may be slightly more precise than chemical peeling or dermabrasion. However, the choice of technique is based on the site you want to treat, your skin type and condition, the doctor's experience, your preferences, and other factors. Some people may get the best results using a combination of techniques.
References:
- www.webmd.com
- Drake LA, et al. (1995). Guidelines of care for chemical peeling. Journal of the American Academy of Dermatology, 33(3): 497–503.
- Branham GH, Thomas JR (1996). Rejuvenation of the skin surface: Chemical peel and dermabrasion. Facial Plastic Surgery, 12(2): 125–133.
- Matarasso SL, et al. (1997). Cutaneous resurfacing. Dermatologic Clinics, 15(4): 569–581.
- Sherris DA, et al. (1998). Comprehensive treatment of the aging face—Cutaneous and structural rejuvenation. Mayo Clinic Proceedings, 73: 139–146.
- Brody HJ (1999). Skin resurfacing: Chemical peels. In IM Freedberg et al., eds., Fitzpatrick's Dermatology in General Medicine, 5th ed., pp. 2937–2946. New York: McGraw-Hill.
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