Chemical Peeling for Acne Scars
What is a chemical peel? A Chemical Peeling for Acne Scars also known as chemexfoliation or dermapeeling, is used to improve the appearance of the skin. In this treatment, a chemical solution is applied to the skin, which causes it to "blister" and eventually peel off. The new, regenerated skin is usually smoother and less wrinkled than the old skin. The new skin is also temporarily more sensitive to the sun. What conditions does a chemical peel treat? Chemical peels are used to treat certain skin conditions or to improve appearance. Fine lines under the eyes or around the mouth and wrinkles caused by sun damage, aging, and hereditary factors can often be reduced or eliminated with this procedure. Sags, bulges, and more severe wrinkles do not respond well to chemical peels. They may require other cosmetic surgical procedures, such as carbon dioxide laser resurfacing, a face lift, brow lift, eye lift, or soft tissue filler. A dermatologic surgeon can help determine the best treatment for each person. Chemical peels are performed on the face, neck or hands. They can help reduce: Certain types of acne Mild scarring Sun spots Age spots Liver spots Freckles Dark patches (melasma) due to pregnancy or taking birth control pills (melasma) Chemical peels can also help skin that is dull in texture and color. Areas of sun damage, which may contain pre-cancerous keratoses that appear as scaly spots, may improve after chemical peeling. Following treatment, with diligent sun avoidance and sunscreen use, new pre-cancerous lesions are less likely to appear. Who is a good candidate for a chemical peel? Generally, superficial peels can be used in all skin types. However, patients with darker skin types have greater risks of post-inflammatory hyperpigmentation (darkening of the skin). While superficial peels can be used in darker skin types, less aggressive treatments are advised to reduce risks of hyperpigmentation. How are chemical peels performed? A chemical peel can be performed in a doctor's office or in a surgery center as an outpatient procedure. The skin is thoroughly cleansed with an agent that removes excess oils, and the eyes and hair are protected. One or more chemical solutions, such as glycolic acid, trichloroacetic acid, salicylic acid, lactic acid, or carbolic acid (phenol), are applied to the skin. Before the procedure: Avoid tanning and direct sun exposure for 2 weeks before each treatment. Apply topical products (such as hydroquinone) as instructed before treatment to prepare the skin. Do not use any products containing retinoids (such as tretinoin) 1 to 2 weeks before treatment, unless your physician tells you differently. If you have been prescribed oral antibiotics or an oral antiviral medicine, you should begin taking those at least 24 hours before the procedure. Peel areas must be free of any open sores, lesions, or skin infections. Day of peel: You will need preparation time for washing and scrubbing. Additionally, you will also need time for any sedation (which is optional). Remember: Ask your doctor if you need to have someone drive you home. The procedure: During a chemical peel, the physician applies the solution to small areas on the skin. These applications produce a controlled wound, enabling new, regenerated skin to appear. During the procedure, most patients experience a warm to somewhat hot sensation that lasts about five to 10 minutes, followed by a stinging sensation. Cool compresses may be applied to help alleviate this stinging. A deeper peel may require pain medication during or after the procedure. What should be expected after the chemical peel? Depending upon the type of chemical peel, a reaction similar to sunburn occurs following a chemical peel. Peeling usually involves redness, followed by scaling that ends within three to seven days. Mild peels may be repeated at one to four-week intervals until the desired clinical effect is achieved. Medium-depth and deep peeling may result in swelling and the presence of water blisters that may break, crust, turn brown, and peel off over a period of seven to 14 days. Medium-depth peels may be repeated in six to twelve months, if necessary. You will work with your dermatologist to determine the depth of your peel. This joint decision can vary, depending upon the condition of your skin and the objectives of treatment. After treatment, some peels may require bandages to be placed on part or all of the skin that is treated. Bandages are usually removed in several days and may improve the effectiveness of the treatment. It is necessary to avoid over-exposure to the sun after a chemical peel since the new skin is fragile and more susceptible to complications. The dermatologic surgeon will prescribe the proper follow-up care to reduce the tendency to develop abnormal skin color after peeling. What are the possible complications of chemical peels? In certain skin types, there is a risk of developing a temporary or permanent color change in the skin. Taking birth control pills, subsequent pregnancy, or family history of brownish discoloration on the face may increase the possibility of developing abnormal pigmentation. Although low, there is a risk of scarring in certain areas of the face, and certain individuals may be more prone to scarring. If scarring does occur, it can usually be treated with good results. There is a small risk of reactivation of cold sores (herpes infection) in patients with a history of herpes outbreaks. This problem is treated with medication as prescribed by the dermatological surgeon. Your doctor may also choose to give you medication before, or immediately after, the peel in order to prevent a herpes outbreak. Prior to treatment, it is important for a patient to inform the physician of any past history of keloids (scar tissue overgrowth created at the site of a skin injury), or unusual scarring tendencies, listing of X-rays treatments to the face, or recurring cold sores.