SALISBURY, MARYLAND CHEMICAL PEELS
WHO COULD BENEFIT:
Individuals with pigment irregularity over the entire face.
Individuals with sun spots or "liver spots."
Individuals with fine wrinkling.
THE GOALS:
More uniform skin tone and improvement of fine and moderately deep wrinkles.
Skin that is clear of sun spots and "liver spots."
Improved self image.
CHOICE OF PEEL
The table below contains information obtained throughout our sixteen-year experience with chemical peels. When planning the timing of your peel, pay particular attention to the last column, which indicates the length of peeling for each peel type.
PEEL TYPE |
PROBLEMS ADDRESSED |
DEPTH |
ANESTHESIA REQUIREMENT |
DAYS OF PEELING |
|
A |
glycolic acid |
pigment irregularity |
epidermis |
none |
0 |
B |
V-i |
same as B |
superficial papillary dermis |
none |
2-5 |
C |
Obagi 15% |
same as A plus sun spots and fine wrinkles |
superficial papillary dermis |
none |
4-7 |
D |
Obagi 20% |
same as C plus more spots and deeper winkles |
deep papillary dermis |
IV sedation or regional blocks |
7-10 |
E |
TCA 30% |
same as D plus even more spots and even deeper winkles |
superficial reticular dermis |
IV sedation or regional blocks |
8-12 |
PREPARATION:
For optimal results, patients should be on Retin-A and Hydroquinone for at least three weeks prior to a chemical peel. The Retin-A thins the keratin layer of skin and thereby ensures a deep and more uniform penetration of the peel. Retin-A should be discontinued three days prior to the peel and restarted three weeks after the peel. The Hydroquinone lowers the risk of pigment irregularities following the peel, which is critically important for individuals with darker skin. Hydroquinone should be discontinued the day before the peel and restarted two weeks after the peel.
Patients with a history of fever blisters should start a prophylactic anti-viral medication prior to the day of the procedure.
On the morning of the procedure, the patient should thoroughly wash her/his face and refrain from applying any kind of cream or make-up.
THE PROCEDURE:
First, we apply IV sedation, if needed.
We cleanse the face of all make-up and natural oils.
Next, we apply regional blocks, if needed.
We then use a marking pen to divide the face into aesthetic units.
Next we apply one or more passes (coats) of the peel. The entire process takes twenty to thirty minutes.
Cold packs and fanning are used as needed.
POST-OP RECOVERY:
Patients must follow the specific written instructions that apply to each particular peel.Thereafter the skin is pink for several weeks. The pink hue could be covered with make-up.
Two weeks following the peel, all patients should start re-applying hydroquinone cream.
Three weeks following the peel, all patient, except those with Rosacea, should resume re-applying Retin-A. Rosacea patients should select a different form of exfoliant.
To maintain the beautiful results of a chemical peel, we advised patients to start or continue a skin care program approved by their plastic surgeon.
OTHER POSSIBILITIES:
Laser resurfacing and Fraxel
INSURANCE?
We usually perform chemical peels for cosmetic reasons. Therefore, we do not expect health insurance to cover the cost of the procedure.
NOTE
The suitability of chemical peel for an individual is determined during the office consultation. All procedures have risks. Minor complications occur occasionally. Major complications are quite rare.