Lidlift Kenneth D. Steinsapir, M.D.
Cosmetic, Facial & Eye Plastic Surgery

There are a number of effective, safe chemical peels available that can do wonders in restoring your face to a healthier, more youthful appearance.  These peels can be applied in a variety of strengths, concentrations, and combinations depending on your skin type and the extent of damage your skin has incurred over the years.  Your cosmetic surgeon can determine the best one for you by examining your skin type, condition, and goals.  This way you can agree on the best chemical peel that will rejuvenate your skin without damaging it.

Chemical Peel Before and After Photo

When Do I Need a Chemical Peel?

Your doctor will go over this with you at your consultation.  Some general indications are:

•    acne with or without scaring
•    dark spots that have developed over time
•    aging skin from sun exposure
•    intrinsic skin aging
•    fine lines
•    creases and deep furrows
•    loss of skin elasticity
•    scaly dry skin with irregular brown spots
•    premalignant lesions
•    an overall yellowish hue to the skin due to chronic sun damage

Some patients may benefit from other procedures, like a facelift or facial filler, which can only be determined by an experienced surgeon at an individual consultation.

Which Chemical Peel Should I Get?

This depends on factors like the condition of your skin and what kinds of problems it has, your treatment goals, your skin color as classified by the clinical Fitzpatrick scale (which factors in how easily you sunburn), and other individual conditions.  To give you an idea of available chemical peels, here are some that are effective depending on the personal circumstances:

Alpha Hydroxy Agents

This peel is usually delivered in a series of treatments to improve mild brown spots and freshen the skin tone.  We derive alpha hydroxy acids (AHA) from fruit and dairy products, most commonly using glycolic acid to smooth the skin.  If your skin is suffering from discoloration and darkening from damage, skin bleachers combine synergistically with AHA to lighten the skin nicely.  Repeated treatments yield new collagen and elastin, which is thought to reduce skin sagging.  AHA can be used in an acne facial peel to improve your complexion, too.  Very low concentrations of about 2-15% are available over-the-counter, which generally are not concentrated enough to cause dramatic improvement on their own, but can be used as an effective at-home treatment in conjunction with stronger treatments from a cosmetic physician.

Jessner’s Solution

This balance of resorcinol, salicylic acid, and lactic acid is a mild treatment that can be combined with TCA to treat the skin more deeply.  When combined with TCA, which by itself is a mild to moderate peeling agent, Jessner’s Solution is a mild peel with increased skin effects.  Generally, those being treated with Jessner’s peel alone need frequent treatments (perhaps monthly) and would likely benefit from a stronger peel performed two or three times per year, which would create similar or better results.

Trichloroacetic Acid

Depending on your needs, your doctor can apply trichloroacetic acid (TCA) in any number of strengths to achieve your desired results.  Depending on the concentration strength, your doctor may administer a regional anesthesia and oral or intravenous sedation to ensure your complete comfort.  After TCA treatment, your skin will be fresher and smoother.  Generally the maximum concentration of TCA used is 35%.   TCA solutions of 50% are less predictable and can sometimes result in scaring.  The better option is to opt for an effective but less concentrated treatment that will provide predictable benefits without unwanted scars or use phenol which will safely peel deeper into the skin.  The exception to this is the so-called Cross method using 95% TCA for acne scar pits.

Phenol

This peel, when made into an 89% solution, creates a medium-deep chemical peel used to peel the face.  Phenol formula is remarkably effective at addressing problem lines, improving all but the deepest ones.  The tightening of the facial skin achieved with this treatment can, in some cases, rival facelift results without the need for surgery.  This peel can address sun damage, sun-spots, pre-malignant actinic keratosis, which left untreated can progress to in-situ squamous cell carcinomas. Since this agent is both strong and effective, your doctor must be cautious in its application.  Conservative applications are best because, when overdone, phenol can contribute to scaring, but in lower quantities it is a reliable, powerful treatment.  Very few patients require treatment of this depth on their whole face.  Instead, your doctor should use phenol to treat only small areas of the face where problems are most severe.  It may take 10 to 12 days to heal from a phenol peel while your skin rejuvenates.  Because the skin can stay red up to four to six months, some patients wear coverup and love their results, while many men find that this subtle hue readily blends into their complexion without concern.

Are Fruit Peels Safer Than Chemical Peels?

It’s important to understand that fruit peels are chemical peels, but milder and usually less effective than the chemical peels outlined above.  The word “chemical” scares a lot of people, but it’s important to understand that everything is a chemical, scientifically speaking, and chemical peels have a safe track record.  Fruit peels are generally made of mild alpha hydroxy acids and citric acids extracted from fruits.  Some may think it’s better simply because they hear the word “fruit” instead of “chemical,” but this peel is superficial with minimal benefits.

Should I Get the New Melange Peel?

This peel, which you receive at an office and then leave on for several hours at home, does receive a lot of internet hype.  There have been fantastic claims made about the Melange Peel. It is important to separate marketing hyperbole from reality: while you can expect mild improvement in skin tone, the real issue is do you get real value for what you have been asked to pay?

Expert Treatment

Chemical peels are not something a doctor can learn in a weekend seminar, but something a doctor must perfect by treating hundreds of faces.  The peel is an art form and your physician will assess the best peel or combination of peels for your unique situation.  Find a board certified surgeon with actual fellowship training in cosmetic surgery who has a long history performing facial peels for satisfied patients.

Dr. Steinsapir demonstrates his face peel expertise through years of experience, and his chemical peel before and after photos demonstrate his skill as both a cosmetic surgeon and an artist.  Call us today to schedule your consultation and find out which peel is most suitable to your needs.