|
Face: Chemical PeelWhat is a Chemical Face Peel?A Chemical Face Peel is the application to the skin of one or a combination of several chemical-exfoliating agents, which causes a resultant injury, and subsequent shedding of the superficial portions of the epidermis and/or dermis layers of the skin. New skin subsequently regenerates and significant restoration of youthful skin is the result. There are other names for Chemical Facial Peeling such as chemosurgery and chemexfoliation. Chemical AgentsThere are quite a number of Chemical Face Peeling agents and these can be combined with other agents to achieve different responses and results depending on the desires of the patient and the experience of the facial plastic surgeon. A short list of exfoliating agents includes the following: trichloroacetic acid (TCA), alpha-hydroxy acids, including glycolic acid, phenol, salicylic acid, lactic acid, alpha-keto acids, tretinoin or retinoic acid, or resorcinol. The Underlying ProblemOver the years, the skin of the neck and face loosens and the overall texture of the skin changes and becomes more weathered. Sun exposure, poor diet, stress, and underlying medical conditions are significant factors accelerating this process. Fine lines develop around the eyes causing crow’s feet; laugh lines around the mouth, and smile wrinkles appear around the upper and lower lips. These are just a few of the unsightly changes that can occur and are improved with Chemical Face Peeling. The goal of Chemical Facial Peeling is rejuvenation and restoration to a more youthful appearance. A Viable SolutionThere is an inevitable and timeless question that has been asked for centuries: how can we restore skin youthfulness after time has weathered one’s facial beauty? Chemical Face Peeling for facial rejuvenation has withstood the test of time and the scrutiny of many facial plastic surgeons. An operation such as a face-lift or blepharoplasty can remove sags and significantly improve the aesthetic appearance of the eyes and face. Specifically, these surgical treatments improve wrinkling. Chemical face peels can supplement surgical treatments, and can significantly smooth out wrinkles in areas where surgery is less effective. Indeed, many surgeons feel that Chemical Face Peeling is the treatment of choice for facial rejuvenation. More specifically, many areas are easily treated with Chemical Facial Peeling techniques and the results are successful. Chemical Face Peels remove age related skin changes such as dark pigmentation spots, (hyperigmentation), melasma, dyschromias, lentigines, bumps, lumps, enlarged moles, and fibromas etc. and scaly raised lesions (solar keratosis, hyperkeratoses, seborrheic keratoses). In addition to these improvements, wrinkles are also reduced. There are many strong proponents who feel that chemical resurfacing achieves removal of pre-cancerous and early cancerous skin lesions. Although Chemical Face Peeling is not recommended treatment for skin cancer, it more than likely reduces the risk of future skin cancer. Types of Chemical Face PeelChemical Face Peeling agents are divided into three categories based on their inherent level of injury and subsequent inherent rejuvenation. These are as follows:
Chemical Face Peel agents exfoliate the skin, which leads to subsequent skin healing, resurfacing, and rejuvenation. Basically, the deeper the wound, the greater the subsequent rejuvenation. Therefore, there is a greater potential risk for side effects and complications with deep Chemical Face Peeling. These agents essentially create a greater injury to the specific layers of skin, instigating subsequent aesthetic rejuvenation affects. Superficial Chemical Facial Peeling“Superficial Chemical Face Peeling” essentially means that a superficial level of injury is delivered to the skin to achieve modest facial rejuvenation. Specifically, these agents provide a resurfacing of the upper layer of skin, keratin, superficial stria, and corium layers of the epidermis. Expectant regeneration of the upper layer of skin quickly ensues four to seven days later, which results in an overall modest improvement. Superficial Chemical Face Peeling can be performed as a “lunchtime facial” without the concern for post-treatment swelling and redness. The treatments take approximately 15 to 20 minutes. First, the face is rigorously cleaned; the Chemical Face Peeling agent is then applied. A small amount of tingling and discomfort is expected. The degree of penetration of the superficial peeling agent is based on the chemical strength (concentration) and the amount of time the agent is left on the face in its active form. Oftentimes, superficial Chemical Face Peeling is performed multiple times in succession over a several week period of time in order to achieve reasonable and identifiable facial rejuvenation. Trichloracetic acid (10 to 25 %) is a very common superficial peeling agent. Jessner’s Solution (resorcinol) in a concentration of 10 to 50% is also commonly employed. Resorcinol paste, at approximately 10 to 30 % concentration is also sometimes used. Solid carbon dioxide ice (solid blocks at –78.5°C) also provides a superficial peel. Alpha-hydroxy acids and alpha-keto acids, such as glycolic acid, are Chemical Face Peeling agents produced naturally from sources such as sugar cane or sour milk. Other fruity acids include mandelic, azelaic, and benzylic acids. Trichoracetic and glycolic acids are the most common agents used today for superficial Chemical Face Peeling. When used for longer than six months, trans-retinoic acid or tretinoin, also known as Retin-A, provides a nice superficial chemical treatment as well. Medium Depth Chemical Face PeelingMedium depth Chemical Face Peels penetrate the deeper layers of the skin (dermis). Thus, greater overall rejuvenation is achieved than with superficial Chemical Face Peeling. Over the years, a medium depth Chemical Face Peel has become one of the most commonly desired facial skin resurfacing options. Typically, medium depth Chemical Face Peels are cheaper than the laser-resurfacing counterpart. The typical agents used in medium depth peels are trichloracetic acid in a 35-50% concentration. Jessner’s solution in combination with trichloracetic acid is an alternative option. Simple trichloracetic acid in a 50% solution combined with full strength unoccluded Phenol (88%) agent is also sometimes used. These medium depth treatment regimens require several days of convalescence. Subsequently, there is a moderate amount of bruising, swelling, and redness that occurs. Topical ointments such as kojic acid and/or hydroquinone ointment can help minimize postoperative pigmentation problems and ensure proper healing. Pain medications and shower regimens are also instituted a few days after the procedure. Deep Chemical Face PeelingA deep Chemical Face Peel requires greater post-operative convalescence, but achieves a greater level of improvement and facial rejuvenation. The traditional deep Chemical Face Peel is that of “Baker and Gordon” formulation, which includes a Phenol component. The technique requires sedation and proper cardiac monitoring. Postoperative convalescence is a prolonged two-week period of time, however the ultimate result is highly satisfactory and successful. What to Expect of Chemical Face PeelingWith any interventional endeavor, including Chemical Face Peeling, possible complications are occasionally seen. Superficial Chemical Face Peeling is rarely associated with complications. With medium and deep Chemical Face Peeling there is a slightly greater risk. Some of the common minor complications include the following:
Rare complications include the following:
Combining experience, service, and specialization is the essence of Dr. Santos’ practice. As a double board certified Facial Plastic and Head and Neck Surgeon, Dr. Santos is dedicated to applying state of the art techniques and technologies. His philosophy is that of commitment and excellence in surgical technique and artistry, as well as creating an environment where the best possible medical care is achieved for each individual.
Also See: Face Lift, Laser Resurfacing, Botox, Restylane, Scar Revision
|
