Peels

Q. I’m 56 and the skin on my face is wrinkled around the brow and around the eyes, mouth area. I am also concerned with the small dark spots that have appeared on my cheeks. What kind of treatment could tackle these problems?

A. The most effective solution to combat the problems that you’ve outlined is a chemical peel.

Peels are chemical solutions which allow the skin of the face to be improved and smoothed by removing its more superficial layers damaged by pathological events (scars, acne, pre-cancerous lesions, etc.), by hyper-pigmentation or by the effects of the ageing process (wrinkles, loss of skin elasticity or tone, etc.).

There are many types of peels and your specialist will be able to advise you on the most suitable one for you, your skin type and your skin condition.

Superficial and intermediate peels do not require anesthetic, while deep peels need local anesthetic with sedation and are performed in outpatient care or with one night hospitalisation.

Q: I suffered from acne as a teenager and have been left with terrible scarring on my cheeks. What options are available to me to help lessen the scarring and are they painful? Is a chemical peel an option?

A: There are a number of cosmetic treatments available to alleviate the impact of acne scarring although it cannot be eliminated altogether.

One option is dermabrasion which improves skin irregularities by removing the outer layer of the skin, making it smoother and more uniform.

Dermabrasion is usually performed under local anesthetic and in outpatient care but, if the area to be treated is particularly large (e.g. dermabrasion on the whole face), general anesthetic and, hence, one-day hospitalization may be needed.

Acne scars can also be improved by chemical peels. Peels are chemical solutions which allow the skin of the face to be improved and smoothed by removing its outer layers damaged by pathological events (scars, acne, precancerous lesions, etc.), by hyper-pigmentation or by the effects of the ageing process (wrinkles, loss of skin elasticity or tone, etc.).

Depending on the skin layer on which they act, peelings are divided into superficial peelings (AHA), intermediate peelings (TCA) and deep peels (Phenol).

The treatment with superficial and intermediate peels do not require anesthesia, while deep peels need local anesthetic with sedation and are performed in outpatient care or with one-day hospitalisation.

Acne can also be treated by laser. CO2 laser usually provides better results, though it is more invasive than Herbium laser. In both cases, an anesthetic ointment is applied or local anesthetic is administered before the treatment.

Q. How long does a chemical peel treatment last?

A. The treatment with superficial (such as glycolid acid) and intermediate peels (such as trichloroacetic acid) lasts a few minutes and should be repeated after some days for several times, while the treatment for deep peels (phenol-derived) lasts about one hour and requires an occlusive dressing.

Q. How long does it take until I will look presentable after having a chemical peel treatment?

A. When the patient has a superficial peel, they can already resume work the day after, in that the only after-effects are a slight redness that persists for about 1-2 hours and, sometimes there will be some small scabs that will disappear after 3 or 4 days which that can be hidden by make-up.

When intermediate peels are used, you’ll have to wait about one week because, besides the initial flush the face will be quite aggravated by the peel.

In case of deep peels, the recovery time will be slightly longer and the patient won’t be presentable for about two weeks. The treated area will be puffy and red-looking but all the layers of the skin will be renewed within 7-10 days.

Q. What are the risks and complications of this kind of treatment?

A. Chemical peels are usually very safe. However, it is a real surgical procedure and though complications (hypo-pigmentation or hyper-pigmentation troubles, infection and anomalous scars) are rare they can be easily resolved only if the peel is performed by a specialist.