Types of chemical peels

There are three general categories of chemical solutions used as acne chemical peel treatments: alphahydroxy acid (AHA) or glycolic acid peels, trichloroacetic acid (TCA) peels, and phenol peels.

Alpha and beta hydroxyl acid peels

Mild or light forms of peels for acne are alphahydroxy acid peel and betahydroxy acid peel. AHAs, such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels. Salicylic acid chemical peels are the most common type of betahydroxy acid peel. Betahydroxy acids are helpful because they can exfoliate oily skin and deeply penetrate the skin with no irritation.

AHAs are derived from fruit, sugar, sour milk, and other natural sources. AHA chemical peels often contain:

  • Glycolic acid (extracted from sugar cane)
  • Lactic acid (extracted from milk)
  • Malic acid (extracted from pears and apples)
  • Citric acid (extracted from oranges and lemons)
  • Tartaric acid (extracted from grapes)

Lighter chemical peels for acne do not require much recovery time, although it is normal for people to experience slight redness and irritation and may also experience some crusting which will eventually subside as the body adjusts to the treatment. The peeling is similar to sunburn. Most people can continue their normal activities. Make-up can be applied a few hours after the procedure. These lighter chemical peel treatments are usually repeated every six weeks and patients generally undergo five to eight light chemical peels to achieve optimal results.

Trichloroacetic acid peels

Medium chemical peels, also known as TCA chemical peels, provide more dramatic results than light chemical peels, and they don’t require the extended recovery time of deep (phenol) peels. A medium chemical peel can be used to treat any area of the body and take only minutes to complete. Depending on the size of the area being treated, a medium chemical peel may take from 15 to 60 minutes to complete, though most treatments can be completed within 30 minutes.

TCA can be used in many concentrations, but it is most commonly used for medium-depth peeling. A 15 percent concentration may be suitable in some cases; for a slightly deeper penetration, the physician may use a concentration as high as 50 percent. Fine surface wrinkles, superficial blemishes and pigment problems are commonly treated with TCA. It is ideal for the removal of acne scars, and for removing shallow tattoos and age spots. It is also recommended for large pores but not for deep furrows.

It helps remove the layers of dead skin that can cause acne infection to get blocked and releases the impurities allowing the skin to heal with a much healthier look. TCA chemical peel also helps increase the blood flow and circulation, which in turn stimulates your skin cells allowing them to rejuvenate and build up collagen and elastic fibers which strengthen the skin.

It is advised to wear sunscreen after having a TCA chemical peel. The treatment is painful and treated areas are swollen, red and crusted for the next week or so. The results of TCA chemical peels are usually less dramatic than and not as long-lasting as those of a phenol peel. More than one TCA chemical peel may be needed to achieve the desired result. The recovery from a TCA chemical peel is usually shorter than with a phenol peel.

Other chemical peels

Phenol peels

Phenol is the strongest of the chemical solutions and produces a deep peel. It is used mainly to treat patients with coarse facial wrinkles, areas of blotchy or damaged skin caused by sun exposure, or pre-cancerous growths. Compared to light chemical peels and medium chemical peels, deep chemical peels have more dramatic results, and only a single treatment is required. Since phenol sometimes lightens the treated areas, the level of skin pigmentation may be a determining factor as to whether or not it is an appropriate treatment for the patient. Phenol is primarily used on the face; scarring may result if it’s applied to the neck or other body areas. Some physicians prefer general anesthesia or local anesthetics combined with intravenous sedatives.

The main disadvantage of phenol chemical peel is permanent skin pallor; therefore, deep peel is not recommended for darker skinned individuals such Hispanics, East Indians, Asians and African Americans.

The initial recovery period with a deep acne chemical peel scar is approximately 10 days to two weeks. As the new skin cells emerge, the face is very red at first, gradually fading to a pinkish color over the next few weeks. The face may become very swollen, even to the point that the eyes are temporarily swollen shut. This sunburned appearance takes two to three months to improve. Thereafter, the skin would appear extremely pale. A sunblock must be used to protect the delicate new skin.

Jessner’s peel

It is a technique which combines the use of resorcinol, lactic, and salicylic acids. It is a mild peeling agent that can be used to lighten areas of hyper pigmentation and to treat aged sun-damaged skin. Before using the Jessner’s solution to do a chemical peel, Retin-A (tretinoin) is applied to the skin each night for 2-3 weeks.

Blue peel

This chemical peel is TCA blended with a blue dye, which allows the physician to accurately determine where and how evenly the chemical has been applied. This chemical peel has the same benefits as any TCA chemical peel; however, it is often recommended as a treatment for skin discoloration. This peel is accompanied by home treatment with hydroquinone and tretinoin.

Getting the most from chemical peel

  • It is always better to get a dermatologist’s OK before having a light chemical peel in case you are using any prescription medication.
  • Remember to wear sunscreen daily. The skin becomes more prone to sunburn and sun damage for some time after the chemical peel treatment. Choose a non-comedogenic brand that doesn’t clog pores.
  • Medicated cleansers, such as those containing benzoyl peroxide or salicylic acid, can sting if used after a chemical peel. Instead, use a gentle cleanser like Cetaphil or Dove for a few days, or until the skin gets healed.
  • Although skin begins to feel softer and smoother after just one session, the best results however appear with a series of treatments. To treat acne, the sessions are usually spaced one to two weeks apart.
  • Ask the doctor what acne treatment medications, if any, should be used while having a series of light chemical peels done.

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