FACIAL PLASTIC &
RECONSTRUCTIVE SURGERY
Michael C. Neuenschwander, MD

Chemical Peel Information 

Your skin is a living organ, made up of millions of cells. Everyday, thousands of cells die, fall off, and are replaced by new cells from below. This is a slow and haphazard process that does not allow your skin to shed dark spots, sun damage, or a dull, lifeless complexion.

The purpose of a facial peel is to cause the even, controlled shedding of several layers of damaged cells, so you are left with a new fresh layer of skin, with a more even texture and color. This process is similar to a snake shedding its skin.

Many types of facial peels have been performed in this country during the past 20 to 30 years. The most common peel, called a chemical peel, uses the chemical phenol as its peeling agent. This potentially toxic chemical creates a deep peel and usually caused the skin to become permanently lighter in color and often rather blotchy. In addition, the texture of the skin often becomes waxy and masklike.

The facial peel performed in my office does not use phenol. The main ingredient is trichloroacetic acid (TCA). This creates a peel that offers less risk of scarring and pigmentation changes than the phenol chemical peel. Because the peel I perform is not as deep as a phenol peel, it is not as effective in improving deep wrinkles, but it can make marked improvements in blotchy pigmentation, freckling, sun damage, fine wrinkles, and some types of acne scars. When you have healed after a TCA peel, you should have skin that is your own natural color and texture.


How you will feel
The peel is an outpatient procedure performed in my office. It consists of the application of one or several layers of medication to your skin to create a controlled chemical burn. There is normally a few minutes of stinging and burning after the medication is applied. This usually stops within 2 or 3 minutes, and there is no more discomfort during the rest of the time you are peeling, although most people experience itching during the healing process. During the next several days, your skin turns darker, feels tight, then cracks and peels off, leaving you with a new fresh layer of skin. There are no scabs, bleeding, or bandages.

During healing, you should have no pain. Most people look strange during peeling, but if you don’t mind your appearance, you are able to go out and even go to work. However, you will not be able to be in the sun or do anything that would cause you to perspire heavily.


After the peel
The average peel takes 5 to 6 days to complete. Deeper peels, for heavily sun-damaged and wrinkled skin, may take 8 or 10 days. There are specific medicated creams you will need to use during peeling. You will be supplied all of this information on another sheet.

Most patients require more than one peel to achieve their best improvement. For most skin types, two peels are needed to give the best results, but some skin problems, such as excessive pigmentation from pregnancy or birth control pills, may require multiple peels for maximum improvement.