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Chemical Peels
Ricardo L Rodriguez MD
Board Certified Plastic Surgeon
Baltimore, Maryland
What is a chemical peel?The cumulative effects of the sun, age, and smoking make the skin appear wrinkled and thin. In addition, abnormal cells may grow and multiply, creating unsightly spots or in some cases, skin cancers. Luckily for us, the skin is unique in its ability to regenerate itself. The normal pace of regeneration, however, is slow and does not prevent the accumulation of abnormal skin cells. A more efficient way of ridding the body of those abnormal cells and replacing them with ‘new’ skin is to 'peel' off the top layers of skin. The body then replaces these layers with new skin that is healthier and younger looking. What are the different types of chemical peels?Mechanical peels work by 'rubbing off' the top layers of skin. Older methods used a pumice stone. Dermabrasion also enjoyed popularity. More recently even salons have started using systems that 'sandblast' the skin. How well these methods work is highly technician dependent. Chemical peels work by putting a chemical on the skin that reacts with and breaks up the top layers of skin (epidermis). Examples of this are the 'fruit acid' peels, 'TCA' peel, 'Obaji blue peel', etc. Depending on the nature and concentration of the chemicals used these peels can strip off only very superficial layers of skin or they can go deep into the skin. How do chemical peels differ from laser surgery? Laser Resurfacing works by vaporizing layers of skin and can penetrate deeper into the skin. Depending on the type of laser, there can be heating of the tissues underneath the top layers of skin that will also affect how the skin regenerates. Laser resurfacing can yield a longer lasting result. Which chemical peels are better?There is no one peel that is better than the other. Choosing a peel depends on the amount of recovery time you are willing to invest. Peels can be classified as 'superficial' or 'deep' depending on how many layers of skin are eliminated. The more superficial peels have little downtime. Thus the popularity of the 'lunchtime peels'. The deeper peels require medically supervised care during the healing phase for optimal results, and patients may need to be homebound for several days. The visible effects of the superficial peels are subtle, whereas the effects of deeper peels are dramatic. In addition, and VERY important, the patient has to decide first how much downtime she/he can tolerate. In summary, the deeper the peel the more dramatic an effect she/he expects from the procedure. However, the deeper the peel, the longer the downtime.What peel is better for me?If you want just a 'freshening' of the skin with little downtime, a 'lunchtime peel' or 'paris peel' will be adequate. If you have very fine wrinkles and are willing to tolerate several days of redness and minor dry peeling of the skin over a couple of days, a medium depth peel may be of help. For deep wrinkles, the best solution is a deep peel, but you will have about a week downtime, and redness may persist for weeks. This redness can be covered with special cosmetics.
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