Chemical Peels - NYC Dermatologist Dr. Anetta Reszko

Unclog the pores, diminish colonization of the skin with acne-causing Propionibacterium acnes. They can address skin irregularities like discolorations and acne scarring. The area to be treated is thoroughly cleansed and the appropriate chemical solution is carefully applied. Both the solution and the length of time it is left on the skin will vary with skin type and whether a mild or moderate chemical peel treatment has been selected.

Glycolic Acid/Alpha Hydroxy Acid Peel

Glycolic acid is a member of the alpha hydroxy acid (AHA) family of carboxylic acids. Glycolic acid is ideal for improvement of wrinkles, sun-related damage, uneven pigmentation, and acne. Once applied, glycolic acid chemically exfoliates the outer layer of skin (epidermis), revealing the underlying new skin and giving your skin an even, dewy texture. In addition, glycolic acid stimulates synthesis of new collagen and elastic fibers that strengthen the skin.

Glycolic acid and other alpha hydroxy acids (AHAs) are the mildest of the chemical peel formulas and produce light superficial peels. These types of peels provide smoother, brighter-looking skin for people who desire gradual improvement without associated side effects and long recovery periods. Concentrations can range from 20% to 70%. Optimal results are achieved after four to six sessions.

Candidates for glycolic acid peels include individuals with superficial lines and fine wrinkles of the face, neck, upper chest, arms, etc.; uneven pigmentation; enlarged facial pores; superficial acne scars; lentigines, age (liver) spots.

Indications for chemical peels:

Pigmentary disorders

Melasma
Post-inflammatory hyperpigmentation
Freckles
Lentigines
Facial melanoses

Acne

Superficial acne scars
Post acne pigmentation
Comedonal acne
Acne excoriée
Acne vulgaris – mild to moderately severe acne

Aesthetic

Photoaging
Fine superficial wrinkling
Dilated pores
Superficial scars

Epidermal growths

Seborrheic keratoses
Actinic keratoses
Warts
Milia
Sebaceous hyperplasia
Dermatosis papulosa nigra

Preparation for a Chemical Peel

For two weeks prior to chemical peel start washing your face with the glycolic or salicylic acid cleanser to prepare your skin for the procedure.
Avoid excessive sun exposure. Apply a sunscreen with SPF 30 and higher as part of your daily regimen
One week prior to the peel stop the use of following treatments and products. The use of these products/treatments prior to your peel may increase the reactivity of the skin to the peel
Retin-A or Renova (Tretinoin), Tazorac or Avage (Tazorotene), Differin (Alapalene, Epiduo) and any other retinoinds such as retinol
Microdermabrasion or other resurfacing treatments, electrolysis, depilatories, waxing, bleaching agents for at least 2 weeks prior to treatment
Please update your medical history, including the following allergies, history of atopic dermatitis, eczema, seborrheic dermatitis, viral infection, collagen vascular disease, autoimmune disease.
On the day of your appointment, do not apply makeup, aftershave, or cologne. Avoid shaving on the day of the peel.
Wear loose clothing
Limit your sun exposure at least a month before the peel and practice strict sun protection measures for 2-3 months after the peel.

You may be prescribed medication to take prior to the treatment to prevent a bacterial and/or viral infection and topical medication to prepare the skin and decrease the risk of pigmentary changes. Your skin must be free of active infections, including active cold sores (herpes simplex virus, herpes labialis, HSV). If you have a history of cold sores systemic anti-viral medication may be recommended for several days prior to the peel. You must also not have taken Accutane for a period of 12-18 months before a treatment.

Post-Peel Instructions

Mild redness is expected for several days after the peel. For the next 7 to 10 days or so your skin will shed its dead, damaged layer. You may not be able to see the peeling, but, when visible, the peeling begins 2-4 days after the chemical peel and usually lasts 3-7 days. In addition, you may feel some mild tingling or itching. Mild swelling is normal and may occur for up to 3 days.

To achieve the best results and minimize the risk of complications:

Apply non-comedogenic moisturizer at least 2 times a day or as often as needed when your skin feels dry.
If you plan to be outdoors, driving or in close proximity to windows, apply sunscreen with SPF 30 and higher. Avoid prolonged sun exposure between 10 AM and 3 PM.
In carrying for the treated areas, use a gentle soapless cleanser like CeraVe, Cetaphil. Avoid scrubbing or using a wash cloth.
DO NOT PICK OR PEEL OR SCRATCH the treated area as permanent scarring may result
Do not undergo any other facial treatments for at least 14 days after the peel.
You may apply cosmetics a day after the chemical peel unless a blister or a superficial ulcer develops. If a blister, a superficial ulceration or a scab develops, apply an antibiotic ointment Bactroban until the blister dries or new skin forms. Do not pick the blister or a scab because a scar may form.
To limit post-peel swelling, sleep on your back with your head elevated on a few pillows for the first few days.
Ice packs, cool compresses can help to reduce post-procedural discomfort and swelling.
Call our office if any problems, questions, or concerns arise.

Frequently Asked Questions about Chemical Peels

Can chemical peels be performed on any type of skin?

Yes. Chemical peels can be safely performedon all skin types and tones. Moderate and deep chemical peels, however, should be used cautiously if you have skin type III-VI to avoid temporary hyperpigmentation.

What areas of the body are treated with chemical peels?

Chemical peels can be performed on the face, neck, chest, arms and hands.

What is the difference between a mild and amoderate chemical peel?

Mild peels are performed using fruit acids such as mandelic, salicylic, lactic or glycolic acids. Moderate peels are performed using trichloracetic (TCA) acid and Jessner’s solution.

Mild peels produce minimal redness, some late peeling and no downtime. Multiple mild peels performed over several months will greatly enhance the radiance, tone, textureand color of the skin. When used in series every 3-4 weeks, mild peels may correct pigmentary problems (dark spots), superficial blemishes, sun damage, fine lines and wrinkles.

Moderate peels require one to two weeks of recovery, but will usually produce more dramatic results in just one treatment than multiple mild peels. Moderate peels are used to correct pigmentary problems, superficial blemishes, moderate sun damage, fine lines and wrinkles.

How much improvement can I expect from a chemical peel?

Mild chemical peels show noticeable improvementin texture, tone, softness, clarity,pores, age spots, fine lines and skin brightness.

Moderate chemical peels show dramatic improvement of age spots, freckles fine wrinkles, mild scars, skin tone, texture, melasma, sun damage and uneven pigmentation.

Can chemical peels be repeated?

Yes. Mild chemical peels are considered a maintenance treatment and can be performed as often as every two weeks.

Moderate chemical peels can be repeated after six months to one year depending on the goal of the procedure. For example, melasma, characterized by abnormal facial pigment, may respond to repeated moderate and deep chemical peels, as will some other skin conditions.

What are the risks?

Mild chemical peels are considered extremely safe. On rare occasions, side effects may include minimal scarring, blisters, and uneven pigmentation.

Moderate chemical peels are also considered safe but should be performed by those who have extensive experience. Rarely, can cause permanent scarring, skin whitening or darkening, infections, redness and other complications.

How painful are chemical peels?

The sensation will vary depending on the type of the peel.

Mild chemical peels produce a tingling or stinging of the skin but very little discomfort.

Moderate chemical peels produce an intense stinging and burning for two to three minutes until the chemical is neutralized, followed by a feeling of numbness. Topical anesthesia and/or mild oral sedation may used to ease discomfort during the procedure.