Chemical Peeling Skin Treatment

Peeling implies to remove the outer covering. In the Chemical peeling technique, the skin is peeled by applying certain chemicals. This is a process to damage the skin in a controlled way.

Chemical Peeling is a treatment that is used in cases like premature age, fine wrinkles on facial skin, and skin damage due to sun rays. It involves the application of an acid. It is a brief procedure that can easily be performed in the clinic. This procedure does not require any admission to the hospital and the patient can return home after the procedure is over.

It is one of the oldest cosmetic procedures in the world. It was also performed in ancient Egypt, Greece, and Rome. The aim of this procedure is to achieve smoother and more beautiful skin. The acid works by removing damaged outer layers and is sometimes also used on the neck and hands.

Types of Chemical Peels

There are two types of chemical peels – Superficial Facial Peel and Medium Depth Peel.

Superficial Peel

Superficial Peel or Freshening peel: It is done by use of some mile agents like glycolic acid, Jessner’s solution, etc. Jessner’s solution contains resorcinol, salicylic acid, lactic acid, ethanol, salicylic acid, Trichloroacetic Acid(TCA).

The main objective is that this mild acid acts on the upper layer of skin. So, they cause little irritation and little redness. It should be kept in mind that result of doing one peel is not very drastic and the required result is obtained only after a series of 3-6 peels be done at 2-4 weeks intervals. It should be kept in mind that special care at home is also necessary.

Salicylic Acid Peel

It is basically Beta Hydroxy acid(BHA). This is used to start up the peel. It helps to unclog pores and kills the acne causing bacteria.
It also helps with blemishes left behind by acne.
It is suitable for mild to moderate acne.

Glycolic Acid Peel

Glycolic acid is commonly found in face washes and acne creams (mainly Glyco 6, Glyco A, Keracnyl, Avene Diacneal/Triacneal). Glycolic acid is an Alpha Hydroxy acid( also known as AHA).

It is suitable for all kinds of acne.

TCA Peel (Trichloroacetic acid)

It is one of the strongest peels for acne. It contains a high concentration of acid which ranges between 20%-50%. This peel cannot be left on the skin for a long time because of the high concentration. If left for a longer time it can lead to scarring and burning of the skin. It is kept on the skin for a minute or two maximum. It is suitable for moderate to severe skin.

Phenol peel

The penetration of this peel is the highest at the skin level. It is one of the most effective peel. It is suitable for severe acne.

Fruit acid peel

It involves mainly Citric Acid, Lactic acid, Malic acid. It is used along with salicylic and glycolic acid.

Benefits– It produces a smoother texture of the skin and makes skin tone even.

It treats irregular pigmentation and brown spots are also lightened.
Wrinkling of skin is also improved.
It gives youthful skin.

How Superficial Peel is done?

A full-face chemical peel usually takes 1-2 hours to perform. Treatment for wrinkling above the lips takes only less than 30 minutes. After the peel solution is applied, it is neutralized with water. About an hour later, a thick coating of petroleum jelly is layered over the face and covers the protective crust left by the acid solutions. This crusty layer stays in place for one to two days.

For heavy wrinkling– a mask is made of adhesive tape which covers the patient’s face during the early stages of the healing process.

The procedure starts by cleaning the skin to remove any traces of grease with rubbing alcohol or acetone. The peeling solutions are left on the face for a few minutes then removed.

First of all peeling agent is applied to the entire face. This peeling agent produces a mild burning sensation or sensation as if needles are being pierced is felt. But this discomfort is for a very short duration. This mild discomfort may be present for a few hours after the peel and is easily cured by cold application.

The doctor cleanses the patient’s skin and, if necessary, applies a topical anesthetic to the treatment area.

The doctor then applies the chemical peel solution. This solution is formulated according to each patient’s specific needs and goals. It is common for the patient to feel a tingling or stinging sensation as the chemical peel is applied.

After the skin peel solution has been on the skin for the prescribed amount of time, it is washed off with water. A soothing ointment is then applied; a thick coating of petroleum jelly is often used after deep chemical peels.

The doctor then instructs the patient on aftercare, and the doctor may also prescribe a mild pain reliever for discomfort after the procedure, especially if a deep chemical peel was administered.

Depending on the patient’s skin condition and the depth of the chemical peel, multiple treatments may be necessary to achieve the desired results.

The after-effects of this procedure depend upon the sensitivity of the skin of the patient.
Some people may feel mild redness and some amount of swelling.
Some people may also apply makeup and return to work that day.
The entire duration of the procedure is 20-25 minutes.

Medium-Depth Peels

It is a somewhat complex procedure as compared to a superficial one. This procedure involves the superficial and inner layers of skin. Skin specialist uses a combination of acid like Jessner’s solution, followed by Trichloracetic acid.
This procedure takes a longer time than the superficial as it involves a deeper layer.
It is more irritating. It produces more redness and swelling.
It requires 5-10days for healing or may require more time depending on the depth of the peel and sensitivity of the patient.
The healing procedure involves peeling the upper layer of skin and new fresh skin takes the place of old skin.
Healing sometimes takes a week.
A repeat peel may be performed anytime after 6 months.
The procedure is somewhat similar to a superficial one. The peeling agent is applied to the face and mild to moderated burning is felt by the patient.

After-effects of the procedure–

Redness, swelling, and tightness are experienced by some for several hours to days after the procedure.
Within 3-5 days, scaling and brown crusting develops.
Within 7-10, this crust disappears.
The only pink appearance takes a longer time to go.
Medium peels usually do not require anesthesia but deeper peels usually required anesthesia which is given through intravenous mode.

Complications/Risks of Medium-Depth Peels

Deeper peels cause more complications.

It can result in:

Changes in skin pigmentation (It may vary from skin lightening to darkening of the skin)
The patient may have prolonged redness.
Sometimes tiny white cysts can appear on the skin.
There can be increased prominence of small blood vessels on the face.
If the patient has a medical history of herpes simplex it may worsen the condition. Recurrent herpes
simplex is also seen.
Scars may have formed.
Darkening of skin appears 4-6 weeks after the peel. So at this time bleaching creams and sunscreens are prescribed.

There are three common types of chemical peels-

For light to medium uses-

Doctors used AHA (alpha hydroxy acid)- which includes glycolic, lactic, or fruit acid.
TCA (trichloroacetic acid)- is a stronger acid. It acts more deeply in the skin. Phenol is the strongest acid. It is used for the deepest peels and is most commonly used to treat skin wrinkling around the lips and chin.
The contradiction of using phenol– It should not be used in patients with heart disease. Phenol is not to apply to darker skins.
It is said that TAC peels are more effective in dark skin people. It has a shorter recovery time than
with solutions used for lighter peels.
Deep peels are done only once and produce effects that are for a longer duration. This procedure is used for patients who have the deepest wrinkling.

Ideal Patient for Chemical Peeling

A fair-skinned patient, with deep wrinkling of the face.
A person with liver spots and spots on the face due to the sun.
A person who has freckles.
Bad effects of taking birth control pills on the face.
Who are unhappy with the appearance of their skin.
Those who have realistic expectations of the procedure
Those who do not smoke. Patients should not smoke for a few weeks before and after a chemical peel.
Those who have good physical health.
It is said that the best result is achieved who are not taking the acne medication Accutane, have not taken it for the previous year and a half, and who are free of active skin infections.

Precaution for Chemical Peeling

Try to avoid sunlight. Use of sunscreen (with SPF 30 or higher) is very necessary for 3-
6months following facial peels. Precautions to be taken for chemical peeling
Acne cream to be discontinued 2 days before and after the peel.
Do not wash your face for 24 hours after the peel.
Use a neutral and mild cleanser to wash your face.
Apply an oil-free moisturizer.
Do not use treatment cleansers (salicylic or glycolic acid cleansers) for 2-3 days after peeling as this could cause more dryness.
You can your acne regimen after 2-3 days.
Avoid swimming for 2-3 days after peeling.
If more irritation is felt then consult your doctor.
Avoid make up for 2-3 days.
Eye make-up only can be resumed after a peel.
Avoid getting parlor procedures like facials, bleaching 3 days before/after Peel.
Men could skip shaving for a day or two before/after a peel.

Facts About Chemical Peels

It is not a permanent cure for acne. It treats acne more quickly.
After acne heals, chemical peeling is to be done once.
It is a safe procedure and good for acne-prone skin.
It treats acne and dark marks.
It works best on dark marks.
It has no effect on pitted scars.
For pitted scars- Micro-Dermabrasion, Fillers, Subcision, and Laser are good options.
When chemical peel should not be done?
It cannot be done on pregnant and lactating mothers.
It is very important that a patient should mention any medications like thyroid. PCOS(Polycystic ovarian disease), isotretinoin.

How much Chemical Peel costs in Delhi?

Approximately costs Rs 800- Rs 1500 per session. Cost varies as per peeling agent used and clinic.