Chemical Skin Peel, TCA peel, Obagi Blue Peel

A chemical peel is a procedure that can improve wrinkled, scarred, or sun damaged skin. It is more effective on skin with mild acne scarring, freckles, age spots, melasma, or other irregular pigmentation and skin wrinkled by age or the sun. Thick, rough, red, precancerous growths called solar keratoses can also be removed with the chemical peel.

During this procedure, chemical agents that remove the damaged skin’s outer layer are applied. Thin scabs form over the treated areas within 2-3 days and fall off a few days later revealing smother, younger-looking skin. Mild acne scarring, fine lines, some types of irregular pigmentation, and other minor skin blemishes will be minimised, and the “new” skin will be smooth and fresh looking. Three types of chemical peel are available: a light peel, which is used to lighten superficial age spots and fine wrinkles; a medium peel, for more advanced sun-damaged skin and age lines; and a deep peel, which uses the chemical phenol to help correct more severe conditions. Your doctor will determine which technique will be more effective for you.

What will happen?

The chemical peel takes about 30 to 45 minutes. Anaesthesia is not needed but very occasionally a light sedative can be given orally to relax you prior to procedure. After your skin is cleaned with an antibacterial cleanser and your eyes and hair are protected, the chemical is applied to a small area of your face with a gauze or a cotton-tipped applicator. This process is repeated on the other areas of your face.
Few side effects are associated with the lighter chemical peels. You may experience a mild to moderate burning sensation, which may last a few minutes, when your doctor applies the solution. Immediately after the procedure, your skin may feel as if it had been slightly sunburned.

After the peel, your skin becomes red and some swelling may occur the first one or two days. The skin feels tight and thin scabs begin to appear during the next 2 to 5 days. You may experience some tingling and slight itching as these scabs form and your skin heals. You can help speed the healing process by using the special cleansers and ointments your doctor will recommend. Your “new” skin will have a pink cast, which will fade within 4 to 6 weeks. For several months following the procedure you should wear a sunscreen whenever you are outdoors and avoid exposing yourself to direct sunlight.

Results

The chemical peel is very effective in minimising fine wrinkles, superficial scars, age spots, some pigmentation problems, and other minor skin irregularities. The new skin exposed by the peel is tight and smooth, which gives you a younger and fresher appearance.

Most patients who undergo this procedure are pleased with the results, and many patients experience a significant improvement in their skin’s appearance. Depending upon the extent and the depth of the skin condition to be treated, some patients may require more than one treatment to achieve maximum results. This approach (multiple lighter chemical peels, repeated every 1-2 months) is safer and sometimes more effective than performing a single deep chemical peel.

Preparing for your peel

• Follow the skin conditioning programme as prescribed by your doctor. This involves the use of retinoic acid (Retin A) and other creams for 1 to 3 months and prepares your skin for the chemical peel. This maximises the beneficial effects, shortens the healing process, and minimises the risk of side effects.
• Take all medications as prescribed before the treatment. These may include an antibiotic, an antiviral if you have a history of cold sores, and a sedative.
  · Wash your face thoroughly on the morning of the procedure and do not apply any moisturisers or other cosmetics.
• Do not wear makeup to the clinic and be sure your eyelashes are free of mascara. Wash your hair the night before, or on the morning of surgery.
• You may eat a light breakfast or lunch on the day of surgery. Do not have alcohol. Contact lenses must be removed before surgery.
• Wear loose clothes that either zip or button and do not have to be pulled over your head. Do not wear any jewellery to the clinic on the day of surgery.
• Arrange for someone to accompany you to and from the clinic. You will not be allowed to drive as your face may be swollen.
• You may apply a topical anaesthetic gel to the area to be treated 1 hour prior to your visit. This then needs to be covered with cling film to stop it drying out. This product will be prescribed by your doctor if needed, and may be purchased at your local pharmacy.
• Obtain Aqueous Cream from your local pharmacy for use at home after the peel.
• Be sure to discuss with the doctor any history of herpes infection (cold sores) or allergies to medications and review all medicines being taken or used.

After care

Go home and relax.

Do not be alarmed if swelling appears around your eyes and mouth, it subsides gradually within 1-2 days. To help reduce this natural swelling sit up as much as possible and sleep in a head-elevated position by using 2 or 3 pillows the first few nights.

For pain relief you can take paracetamol every 3 to 4 hours as needed, but not aspirin or Nurofen. The burning sensation may last for several hours but eases gradually. Continue any other medications as prescribed.

Your new skin will appear red. This is normal and should be expected. Any excessive redness, tenderness, swelling, pus or bleeding should be reported to the clinic during office hours on 020 7435 7521.

Wash you hands before touching your face. Apply Aqueous cream, or any other moisturiser recommended by your doctor, liberally to keep the skin moist throughout the day. The skin should not be allowed to dry out. At bedtime, reapply Aqueous cream liberally.

You may shower daily, but avoid wetting the treated areas for 3 days. After 3 days, the face may be rinsed lightly with water but the skin should not be rubbed. Do not use soap or any other product, including makeup, on treated areas until skin is completely healed. If stinging occurs when you resume using makeup, remove it and try again in 5 to 7 days. You may shampoo your hair after the third postoperative day but avoid water or shampoo running onto treated areas. For men, no shaving for 5 to 7 days. Do not use Retin-A and glycolic acid products until your skin has completely healed.

Avoid any unnecessary touching or rubbing of the face. Scratching and peeling at scabs may cause scars or hyperpigmentation. You may trim any loose scabs with scissors if they annoy you.

Avoid physical exertion for 1-2 weeks so as not to perspire. Also avoid exposure to strong wind and extreme cold for 2 weeks. The developing new skin is delicate.
After the skin is healed up, a sunscreen with an SPF of 15 or higher must be applied daily when outdoors. Direct sun exposure must be avoided completely for at least 3 months because of the increased photosensitivity and risk of pigmentation of the chemically peeled areas. This is very important.

Your first postoperative visit should be between 7 and 14 days following the procedure. You should be seen again in the clinic 6 weeks after your peel for a further check.

Chemical Peel Treatment Costs:

• Light £350
• Medium £450
• Deep £600

Consultant Dermatologist opinion only: £90