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KayaKalp
75 Herrick Street
Parkhurst Building, Suite 105
Beverly, Massachusetts, 01915

Ph. 978.927.6556
Fx. 978.927.9467

 

Chemical Peel

 

Chemical peel is especially useful for the fine wrinkles on cheeks, forehead, and around the eyes, and the vertical wrinkles around the mouth
Chemical peel is especially useful for the fine wrinkles on cheeks, forehead, and around the eyes, and the vertical wrinkles around the mouth.

 

The chemical solution can be applied to the entire face, or to a specific area -for example, around the mouth - sometimes in conjunction with a facelift
The chemical solution can be applied to the entire face, or to a specific area -for example, around the mouth - sometimes in conjunction with a facelift.

 

At the end of a phenol peel, a thick layer of petroleum jelly may be applied to the treated area
At the end of a phenol peel, a thick layer of petroleum jelly may be applied to the treated area.

 

A protective crust may be allowed to form over the new skin. When it's removed, the skin underneath will be a bright pink.
A protective crust may be allowed to form over the new skin. When it's removed, the skin underneath will be a bright pink.

 

After healing, the skin is lighter in color, tighter, smoother, and younger looking
After healing, the skin is lighter in color, tighter, smoother, and younger looking.

Superficial Peels (non ablative)

ALPHA & BETA HYDROXIES (AHA & BHA)

AHA/BHA’s have been used for years by Aesthetic surgeons as "chemical peels".  The peels include,  trichloroacetic acid, phenol, resorcinol, and salicylic acid and  are a means to remove undesirable signs of skin aging, such as discoloration, roughness and wrinkling. The chemicals cause the skin to lose its outer layer, or peel off, revealing a fresher-looking layer of skin. Known as chemical exfoliation, the procedure is done in doctors' offices so that doctors can control the process and prevent deep skin burns from the highly acidic solutions. Around 1989 Cosmetic manufacturers began to market similar but milder versions of these chemical peels containing AHAs for salon and at-home use. They quickly caught on, and by 1992, mass marketing of these peels began. The AHAs used most often in cosmetics are glycolic acid and lactic acid, although there are others, many are used in combination. Increasingly, poly-AHAs, with larger molecules, and ingredients such as salicylic acid are used because these products produce less skin irritation. However skin reaction varies in different individuals
Disorders Treated

Their efficacy depends on

Concentrations

Increased

OTHER HYDROXY ACIDS
1. Malic acid (apples, vinegar, applesauce, cider);
2. Lactic acid (buttermilk, yogurt, powdered skim milk, sour cream, blackberries, tomatoes);
3. Tartaric acid (grapes, grape juice, wine, cream of tartar);
4. Citric acid (citrus fruits such as lemons, limes, grapefruit, and orange); or glycolic acid (sugar cane).

Exfoliation

The exfoliation of the top layer of skin sheds old skin cells and triggers new cell production. After the treatment, the skin is softer, smoother and plumped. Any active ingredients that is applied afterwards, is much more readily absorbed into the skin. This helps stimulate blood circulation which induces the regeneration of the skin producing new cells and collagen fibers. Enzyme exfoliations are a gentle way to lift off dead skin cells and reveal the natural luminosity of the skin.

Herbal Peels

Herbal peels are effective exfoliant alternative to chemically derived acid peels. They refresh and rejuvenate the skin by triggering the body own exfoliating reaction to them. The result is the exposure of new radiant healthy skin. The use of specific herbals and minerals have been in use by the ancient Ayurvedic system to enhance the penetration capabilities of various other ingredients in skin rejuvenating formulations. In the hands of a qualified skin therapist, Herbals are effective and safe for all skin types. After your skin has been analyzed, and depending on the skin condition and requirement, you will benefit from either a light or medium peel. It is a less invasive and not as traumatic as chemical peels. In the hands of a qualified skin therapist they are easily controlled and have effective results.

A Deep Chemical Peel (Ablative)

Procedure: Improve the appearance of facial blemishes, wrinkles and uneven skin pigmentation by using chemical agents.
Length: 30 minutes -60 minutes
Anesthesia: Local Lidocaine
In/Outpatient: In Office Procedure, outpatient.
Side Effects: Temporary pain. Swelling, soreness, bruising, redness  and crusting of the skin.
Risks: Hyperpigmentation, Scarring, Skin sensitivity changes, damage to Deeper structures, Allergic reactions to the chemical solution.
Recovery: Back to work: 1-2 weeks depending on the depth of the peel and chemical used. . More strenuous activity: 2 or more. Fading of redness and hyperpigmentation  3 months to 2 years.

Chemical peel uses a chemical solution to improve and smooth the texture of the facial skin by removing its damaged outer layers. It is helpful for those individuals with facial blemishes, wrinkles and uneven skin pigmentation. Phenol, trichloroacetic acid (TCA) and alphahydroxy acids (AHAs) are used for this purpose. The precise formula used may be adjusted to meet each patient's needs. Although chemical peel may be performed in conjunction with a facelift, it is not a substitute for such surgery, nor will it prevent or slow the aging process. This brochure provides basic information about certain types of chemical peel treatments and the results you might expect. It won't answer all your questions, since a lot depends on your individual circumstances. Once you and Dr. M. Patel or Dr. J. Patel have decided on a specific peel program, be sure to ask about any details that you do not understand.

Deciding if chemical peel is right for you Chemical peel is most commonly performed for cosmetic reasons -- to enhance your appearance and your self confidence. Chemical peel may also remove pre-cancerous skin growths, soften acne facial scars and even control acne. In certain cases, health insurance may cover the peel procedure. Be sure to check your policy and contact your insurance company before the procedure is performed.

Alphahydroxy acids (AHAs), such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels. These types of peels can provide smoother, brighter-looking skin for people who can't spare the time to recover from a phenol or TCA peel. AHA peels may be used to treat fine wrinkling, areas of dryness, uneven pigmentation and acne. Various concentrations of an AHA may be applied weekly or at longer intervals to obtain the best result. Your doctor will make this decision during your consultation and as the treatment proceeds. An alphahydroxy acid, such as glycolic acid, can also be mixed with a facial wash or cream in lesser concentrations as part of a daily skin-care regimen to improve the skin's texture.

Trichloroacetic acid (TCA) can be used in many concentrations, but it is most commonly used for medium-depth peeling.  Peels using TCA should always be performed by an experienced physician.  Fine surface wrinkles, superficial blemishes and pigment problems are commonly treated with TCA. The results of TCA peel are usually less dramatic than and not as long-lasting as those of a phenol peel. In fact, more than one TCA peel may be needed to achieve the desired result. The recovery from a TCA peel is usually shorter than with a phenol peel.

Phenol is the strongest of the chemical solutions and produces a deep peel. It is used mainly to treat patients with coarse facial wrinkles, areas of blotchy or damaged skin caused by sun exposure, or pre-cancerous growths. Since phenol sometimes lightens the treated areas, your skin pigmentation may be a determining factor as to whether or not this is an appropriate treatment for you. Phenol is primarily used on the face; scarring may result if it's applied to the neck or other body areas.

All chemical peels carry some uncertainty and risk. Chemical peel is normally a safe procedure when it is performed by a qualified, experienced plastic surgeon. However, some unpredictability and risks such as infection and scarring, while infrequent, are possible.

AHA peels may cause stinging, redness, irritation and crusting. However, as the skin adjusts to the treatment regimen, these problems will subside.

With a TCA peel, your healed skin will be able to produce pigment as always; the peel will not bleach the skin. However, TCA-peel patients are advised to avoid sun exposure for several months after treatment to protect the newly formed layers of skin. Even though TCA is milder than phenol, it may also produce some unintended color changes in the skin.

With a phenol peel, the new skin frequently loses its ability to make pigment (that is, tan). This means that not only will the skin be lighter in color, but you'll always have to protect it from the sun. Phenol may pose a special risk for patients with a history of heart disease. It's important that you make your surgeon aware of any heart problems when your medical history is taken.

It is also possible that phenol will cause some undesired cosmetic results, such as uneven pigment changes. Certain modified phenol peels are gentler and may be preferred in some circumstances.

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Peel Formulas at a Glance

Alphahydroxy acids (AHAs)Uses:

Considerations:

Trichloroacetic acid (TCA)Uses:

Considerations:

Phenol Uses:

Considerations:

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Before your Chemical Peel

In some states, no medical degree is required to perform a chemical peel - even the strongest phenol peels. Many states have laws that permit non-physicians to administer certain peel solutions, but regulate the strengths which they are permitted to apply. You should be warned that phenol and TCA peels have been offered by inadequately trained practitioners claiming "miracle techniques" to rejuvenate the skin.

It is very important that you find a physician who has adequate training and experience in skin resurfacing. Dr. M. Patel or Dr. J. Patel may offer you a choice of peel techniques or suggest a combination of peels to obtain the best result for you.

During your initial consultation, it is important that you discuss your expectations with Dr. M. Patel or Dr. J. Patel. Don't hesitate to ask any questions or express any concerns that you may have. Expect Dr. M. Patel or Dr. J. Patel to explain the planned procedure in detail, including its risks and benefits, the recovery period and the costs. If you have a history of herpes, you should inform your physician prior to the procedure. Remember, chemical peel treatments are usually not covered by medical insurance unless they are performed for medically related problems.

Preparing For Your Chemical Peel

Dr. M. Patel or Dr. J. Patel will instruct you on how to prepare for your peel treatment in conjunction with KayaKalp Skin care specialist.

Sometimes Retin-A - a prescription medication derived from Vitamin A - is used to pre-treat the skin. This thins out the skin's surface layer, allowing the TCA solution to penetrate more deeply and evenly. If your skin won't tolerate Retin-A pre-treatment, an AHA cream may be used instead. Hydroquinone, a bleaching agent, is sometimes used in conjunction with Retin-A or AHA pre-treatment, especially if you have blotchy skin areas or pigmentation problems. You may have to spend a month or more in the pre-treatment phase before the doctor will schedule your actual peel.

You will need to arrange for someone to drive you home and help you out for a day or two if you are having a phenol or deeper TCA peel. You probably won't need any extra assistance if you're having an AHA peel or superficial TCA peel.

Where Your Peel Will Be Performed

Most chemical peels may be safely performed in a plastic surgeon's office, office-based surgical facility or outpatient surgical center. Dr. M. Patel or Dr. J. Patel may want you to stay overnight in a facility or hospital if other cosmetic procedures are performed simultaneously.

Types of Anesthesia

Anesthesia isn't required for phenol or TCA peels because the chemical solution acts as an anesthetic. However, pre-procedure medication may be given to you orally (e.g. valium, etc.) before and during the procedure to relax you and keep you comfortable. No anesthesia is needed for AHA peels since they cause only a slight stinging sensation during application.

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The Peel

AHA peels/treatments: Your doctor will apply the AHA solution to your cleansed facial skin, a process that usually takes no more than 10 minutes. No "after-peel" ointment or covering is required. Depending on the strength of the peel, periodic treatments may be necessary until the desired effects are achieved.

For some patients, the application of an AHA-based face wash or cream once or twice a day at home will be sufficient to accomplish the desired goal. Dr. M. Patel or Dr. J. Patel may add Retin-A or a bleaching agent to your at-home treatment schedule. After several weeks of at-home use, your doctor will examine your skin to determine if your regimine needs adjustment.

Phenol and TCA peels: Typically, the skin is first thoroughly cleansed. Then, the surgeon will carefully apply the phenol or TCA solution. You may feel a stinging sensation as the peel solution is applied, but this feeling will quickly pass.

A full-face TCA peel usually takes no more than 15 minutes. Two or more TCA peels may be needed to obtain the desired result, and those may be spaced out over several months. Mild TCA peels may be repeated as often as every month.

If phenol solution has been used, Dr. M. Patel or Dr. J. Patel may coat the treated area with petroleum jelly or a waterproof adhesive tape. With lighter peels, no covering is necessary.

A full-face phenol peel generally takes one or two hours to perform, while a phenol peel to a smaller facial region (perhaps the skin above the upper lip) may take only 10 or 15 minutes. A single treatment usually suffices.

After Your Chemical Peel

After an AHA peel, it is common to experience some temporary flaking or scaling, redness and dryness of the skin. However, these conditions will disappear as the skin adjusts to treatment.
After a phenol or TCA peel, your doctor may prescribe a mild pain medication to relieve any tingling or throbbing you may feel. If tape was used to cover your face, it will be removed after a day or two. A crust or scab will form on the treated area. To help your face heal properly, it is essential that you follow your doctor's specific post-operative instructions.
A TCA peel may also cause significant swelling, depending on the strength of the peel used.
If you've had a phenol peel, your face may become quite swollen. Your eyes may even be swollen shut temporarily. You will need someone to help care for you for a day or two. You may also be limited to a liquid diet and advised not to talk very much during the first few days of recovery.

Getting Back to Normal

With an AHA peel, the temporary redness, flaking and dryness that you experience will not prevent you from working or engaging in your normal activities. A fresher and improved skin texture will result with continued AHA treatments. Remember, protecting your skin from the sun is also important following these mild acid peels. Ask your doctor to recommend a sun block with adequate UVA and UVB protection and use it every day.

With a TCA peel, the moderate discomfort and mild swelling you may experience will subside within the first week. In about a week to ten days, your new skin will be apparent and you should be healed sufficiently to return to your normal activities. It is best to avoid sun exposure unless you are adequately protected.

With a phenol peel, new skin will begin to form in about seven to ten days. Your face will be very red at first, gradually fading to a pinkish color over the following weeks to months. During this time, it is especially important that you use a sun block or blotchy, irregular skin coloring may result.

About two weeks after treatment, you may return to work and resume some of your normal activities. Your skin will be healed enough for you to wear makeup. (For makeup tips, ask Dr. M. Patel or Dr. J. Patel for the ASPS brochure on camouflage cosmetics.)

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Your New Look

Improvements from AHA peels may be very subtle at first. You may detect a healthier glow to your skin. With continued treatments, you will notice a general improvement in the texture of your skin.

The results of a TCA peel are usually not as long-lasting as those of phenol peel. However, your skin will be noticeably smoother and fresher-looking.

If you're planning a phenol peel, you can expect dramatic improvement in the surface of your skin - fewer fine wrinkles, fewer blemishes and more even-toned skin. Your results will be long-lasting, although not immune to the effects of aging and sun exposure.

 

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