Chemical Peeling

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Text C. Methods of Dermatologic Surgical Skin Rejuvenation

Chemical peeling, also called chemexfoliation or dermapeeling, is a facial skin rejuvenation procedure that does what its name implies—it peels the skin. Its use is usually in the treatment of superficial to moderate photoaging skin damage. Mild chemical peels can be applied to people in their 20s, to prevent effects of aging from becoming apparent too early in life.

In a chemical peeling treatment, a chemical solution is applied to facial skin, causing the skin to blister and peel off over a period of days. As the treated skin blisters and peels, new skin forms to take its place. The new skin is usually smoother and less wrinkled than the old skin.

A mild chemical peel is usually all that is necessary to treat fine lines and wrinkles around the eyes and mouth. Patients with minimal skin damage often respond best to a series of light peels in combination with a skin care program including retinoids and a sunscreen protection program. A medium-depth peel is often more effective for patients with moderate skin damage, including age spots, freckles and actinic keratoses. A medium-depth peel may be combined with another treatment such as laser resurfacing to achieve maximum effectiveness.

Depending on the objectives of the treatment as determined jointly by the patient and dermatologist, the condition and type of the patient’s skin, and the degree of skin damage, the dermatologist by performing dermatologic surgery individualizes the strength of the chemical solution and the depth of the peel. Peeling solution may include one or more chemicals such as alpha-hydroxy acids, trichloroacetic acid, or carbolic acid. The procedure can be performed in the dermatologist’s office, or in an outpatient surgery center. In addition to skin rejuvenation, chemical peeling is effective in reduction of some acne scars. Peeling does not remove deep scars.

The immediate after-effect of a chemical peel is similar to a sunburn. After a mild or superficial peel, redness and scaling of the skin last 3 to 5 days. Medium-depth or deep peeling can result in redness, swelling, blistering and peeling for 7 to 14 days. Medications are prescribed to alleviate discomfort. Overexposure to sun must be avoided for a period of time to prevent sun damage while the new skin is susceptible to injury.

Chemical peeling is effective only for surface skin damage. Effects of aging in deeper tissues, such as sagging jowls and drooping eyelids, must be addressed by other procedures that can be recommended by your dermatologic surgeon.