FOR REVITALIZED AND RENEWED SKIN IN BOSTON
Dr. Katherine Hein is among the top cosmetic surgeons in the Boston, MetroWest, Wellesley, and Sudbury area. She and her aesthetician and skincare professionals offer chemical peel treatments for healthier and renewed skin.
A chemical peel uses a chemical solution to improve and smooth the texture of the facial skin by removing its damaged outer layers. It is helpful for those individuals with facial blemishes, wrinkles and uneven skin pigmentation and sun damage.
Chemical peels are most commonly performed for cosmetic reasons — to enhance your appearance and your self-confidence. A chemical peel also may remove pre-cancerous skin growths, soften acne facial scars and even control acne. If you are concerned about uneven skin pigmentation, sun damage, leathery texture of your facial skin, fine wrinkles, and blemishes, a medical chemical peel may be a good procedure to renew and revitalize your skin.
This website provides basic information about certain types of chemical peel treatments and the results you might expect. It won’t answer all your questions, since a lot depends on your individual circumstances. Once you and Dr. Hein have decided on a specific peel program, be sure to ask her about any details that you do not understand.
WHAT ARE CHEMICAL PEELS?
Phenol, trichloroacetic acid (TCA) and alpha hydroxy acids (AHAs) are the primary acids used in a medical grade chemical peel. Dr. Hein will customize the precise formula to meet each patient’s needs. Although a chemical peel may be performed in conjunction with a facelift, it is neither a substitute for such surgery, nor will it prevent or slow the aging process.
Chemical peel is especially useful to reduce the appearance of fine wrinkles on cheeks, forehead, around the eyes and the vertical wrinkles around the mouth.
Alpha hydroxy acids (AHAs), such as glycolic, lactic or fruit acids, are the mildest of the peel formulas and produce light peels. These types of peels can provide smoother, brighter-looking skin for people who can’t spare the time to recover from a phenol or TCA peel. AHA peels may be used to treat fine wrinkling, areas of dryness, uneven pigmentation, and acne. Various concentrations of an AHA may be applied weekly or at longer intervals to obtain the best result. Your doctor will make this decision during your consultation and as the treatment proceeds. An alpha hydroxy acid, such as glycolic acid, also can be mixed with a facial wash or cream in lesser concentrations as part of a daily skin-care regimen to improve the skin’s texture.
Trichloroacetic acid (TCA) can be used in many concentrations, but it is most commonly used for medium-depth peeling. Fine surface wrinkles, superficial blemishes and pigment problems are commonly treated with TCA. The results of TCA peel are usually less dramatic than and not as long-lasting as those of a phenol peel. In fact, more than one TCA peel may be needed to achieve the desired result. The recovery from a TCA peel is usually shorter than with a phenol peel.
Phenol is the strongest of the chemical solutions and produces a deep peel. It is used mainly to treat patients with coarse facial wrinkles, areas of blotchy or damaged skin caused by sun exposure, or pre-cancerous growths. Since phenol sometimes lightens the treated areas, your skin pigmentation may be a determining factor as to whether or not this is an appropriate treatment for you. Phenol is primarily used on the face; scarring may result if it’s applied to the neck or other body areas.
ARE CHEMICAL PEELS SAFE?
All chemical peels carry some uncertainty and risk. A chemical peel is normally a safe procedure when a qualified, experienced plastic surgeon performs it. However, some unpredictability and risks, such as infection and scarring, while infrequent, are possible.
AHA peels may cause stinging, redness, irritation, and crusting. However, as the skin adjusts to the treatment regimen, these problems will subside.
With a TCA peel, your healed skin will be able to produce pigment as always; the peel will not bleach the skin. However, TCA-peel patients are advised to avoid sun exposure for several months after treatment to protect the newly formed layers of skin. Even though TCA is milder than phenol, it also may produce some unintended color changes in the skin.
With a phenol peel, the new skin frequently loses its ability to make pigment (that is, tan). This means that not only will the skin be lighter in color, but you’ll always have to protect it from the sun. Phenol may pose a special risk for patients with a history of heart disease. It’s important that you make Dr. Hein aware of any heart problems when your medical history is taken.
It also is possible that phenol will cause some undesired cosmetic results, such as uneven pigment changes. Certain modified phenol peels are gentler and may be preferred in some circumstances.
PEEL FORMULAS AT A GLANCE
Dr. Katherine Hein explains to her patients what the major chemical peel ingredients are used for and the considerations as follows:
|Alpha Hydroxy Acids
WHAT ARE THE STEPS TO PLAN FOR A CHEMICAL PEEL?
In some states, no medical degree is required to perform a chemical peel — even the strongest phenol peels. Many states have laws that permit non-physicians to administer certain peel solutions but regulate the strengths that they are permitted to apply. You should be warned that phenol and TCA peels have been offered by inadequately trained practitioners claiming “miracle techniques” to rejuvenate the skin.
It is especially important that you find a physician like Dr. Hein who has adequate training and experience in skin resurfacing. Your plastic surgeon may offer you a choice of peel techniques or suggest a combination of peels to obtain the best result for you.
During your initial consultation, it is important that you discuss your expectations with Dr. Hein. Don’t hesitate to ask any questions or express any concerns that you may have. Dr. Hein and her professional staff will thoroughly explain the specifics of your chemical peel, including its risks and benefits, the recovery period, and the costs. If you have a history of herpes, you should inform Dr. Hein prior to the procedure.
CHEMICAL PEEL CONSIDERATIONS
Dr. Hein and her staff will instruct you on how to prepare for your peel treatment.
Sometimes Retin A – a prescription medication derived from Vitamin A – is used to pre-treat the skin. This thins out the skin’s surface layer, allowing the TCA solution to penetrate more deeply and evenly. If your skin won’t tolerate Retin-A pre-treatment, an AHA cream may be used instead. Hydroquinone, a bleaching agent, is sometimes used in conjunction with Retin-A or AHA pre-treatment, especially if you have blotchy skin areas or pigmentation problems. You may have to spend a month or more in the pre-treatment phase before the doctor will schedule your actual peel.
You will need to arrange for someone to drive you home and help you out for a day or two if you are having a phenol or deeper TCA peel. You probably won’t need any extra assistance if you’re having an AHA peel or superficial TCA peel.
WHERE WILL YOUR CHEMICAL PEEL BE PERFORMED?
Dr. Hein safely performs her patient’s chemical peels in her office.
IS ANESTHESIA REQUIRED FOR A CHEMICAL PEEL?
Anesthesia isn’t required for phenol or TCA peels because the chemical solution acts as an anesthetic. However, sedation may be used before and during the procedure to relax you and keep you comfortable.*
No anesthesia is needed for AHA peels since they cause only a slight stinging sensation during application.*
WHAT IS THE CHEMICAL PEEL PROCESS?
AHA Peels/Treatments: Your doctor will apply the AHA solution to your cleansed facial skin. No “after-peel” ointment or covering is required. Depending on the strength of the peel, periodic treatments may be necessary until the desired effects are achieved.
For some patients, the application of an AHA-based face wash or cream, once or twice a day at home, will be sufficient to accomplish the desired goal. Your plastic surgeon may add Retin-A or a bleaching agent to your at-home treatment schedule. After several weeks of at-home use, your doctor will examine your skin to determine if your regimen needs adjustment.
After an AHA peel, it is common to experience some temporary flaking or scaling, redness, and dryness of the skin. However, these conditions will disappear as the skin adjusts to treatment.*
Phenol and TCA Peels: Typically, the skin is first thoroughly cleansed. Then, the surgeon will carefully apply the phenol or TCA solution. You may feel a stinging sensation as the peel solution is applied, but this feeling will quickly pass.
Two or more TCA peels may be needed to obtain the desired result, and those may be spaced out over several months. Mild TCA peels may be repeated as often as every month.*
If phenol solution has been used, your plastic surgeon may coat the treated area with petroleum jelly or a waterproof adhesive tape. With lighter peels, no covering is necessary.
A full-face phenol peel generally sees optimal results in a single treatment.*
The chemical solution can be applied to the entire face, or to a specific area – for example, around the mouth – sometimes in conjunction with a facelift.
At the end of a phenol peel, a thick layer of petroleum jelly may be applied to the treated area. A protective crust may be allowed to form over the new skin. When it’s removed, the skin underneath will be a bright pink.
After a phenol or TCA peel, your doctor may prescribe a mild pain medication to relieve any tingling or throbbing you may feel. If tape was used to cover your face it will be removed after a day, or two.* A crust or scab will form on the treated area. To help your face heal properly, it is essential that you follow your doctor’s specific post-operative instructions.
A TCA peel may also cause significant swelling depending on the strength of the peel used.*
If you’ve had a phenol peel, your face may become quite swollen. Your eyes may even be swollen shut temporarily. You will need someone to help care for you for a day or two. You may also be limited to a liquid diet and advised not to talk very much during the first few days of recovery.*
GETTING BACK TO NORMAL
With an AHA peel, the temporary redness, flaking and dryness that you experience will not prevent you from working or engaging in your normal activities.* A fresher and improved skin texture will result with continued AHA treatments. Remember, protecting your skin from the sun is also important following these mild acid peels. Ask your doctor to recommend a sunblock with adequate UVA and UVB protection and use it every day.
With a TCA peel, the moderate discomfort and mild swelling you may experience will subside within the first week. In about a week to ten days, your new skin will be apparent, and you should be healed sufficiently to return to your normal activities.* It is best to avoid sun exposure unless you are adequately protected. After healing, the skin is lighter in color, tighter, smoother, and younger looking.
With a phenol peel, new skin will begin to form in about seven to ten days. Your face will be very red at first, gradually fading to a pinkish color over the following weeks to months.* During this time, it is especially important that you use a sunblock or blotchy, irregular skin coloring may result.
About two weeks after treatment, you may return to work and resume some of your normal activities. Your skin will be healed enough for you to wear makeup.* If you need it, special camouflage makeup (we recommend Jane Iredale) can mask most discoloration that remains.
YOUR NEW LOOK
Improvements from AHA peels may be very subtle at first. You may detect a healthier glow to your skin. With continued treatments, you will notice a general improvement in the texture of your skin.
The results of a TCA peel are usually not as long-lasting as those of phenol peel.* However, your skin will be noticeably smoother and fresher looking.
If you’re planning a phenol peel, you can expect dramatic improvement in the surface of your skin – fewer fine wrinkles, fewer blemishes, and more even-toned skin. Your results will be long-lasting, although not immune to the effects of aging and sun exposure.*
When you select Accurate Aesthetics Plastic Surgery for your chemical peel treatment, you can be reassured of a close personal relationship with Dr. Katherine Hein and her professional staff.
To schedule your personal consultation, please contact Accurate Aesthetics by calling (877) 603-7874 toll-free today.
*Results may vary and are not guaranteed. Consult with the medical professionals at Accurate Aesthetics Plastic Surgery to see if you are a candidate.