Chemical Peels (Soft to deep – TCA to Phenol)
What is a chemical peel ?
A peel is the application of a chemical solution to accelerate cell renewal of the surface layers (epidermis) and deep (dermis) of the skin. The choice of the solution to be applied will depend on the indication of a patient’s skin, ranging from superficial TCA, through the diluted phenol, until phenol Exopeel.
There is a wide range of peels, from the softer bringing a glow deep to the deeper (phenol) regenerating the deep dermis.
1) The softer peel : Glycolic acid (derived from fruit)
This is the lightest existing peeling. It offers only a light tap of radiance to the skin.
Unfortunately, its use may cause a risk of pigmentary rebound on the patient’s skin after sun exposure. Therefore, due to the location of the medical office of Dr. Foumentèze in Nice, he does not practice this type of peel. In addition, the soft peel based on trichloracetic acid (TCA) gives better results for a lesser need for precaution.
2) The superficial peel: Trichloroacetic acid (TCA)
Indeed, the TCA peel has the advantages of the peel with glycolic acid, being even more effective, but without its cons-indications of sun exposure.
- Possible any time in the year
- Effective against dull skin, irregular skin tone, smoking effects, and enlarged pores
- Accelerating the renewal of skin cells
- Restores radiance, uniformity to the complexion, and reduce small wrinkles
- Assumes no period of social withdrawal or nuisance (pain or marks)
3) Average peel: Diluted phenol
This peel, more powerful because also acting on the superficial dermis, can treat diffuse wrinkles and pigmentation spots especially due to the sun.
4) Deep phenol peel (Exopeel)
This is a true rejuvenation treatment for very wrinkled skin, marked by acne or victim of pigmented spots. The deep phenol peel is a heavy medical procedure reserved for very few experienced practitioners in France. Despite the advent of lasers, it remains the gold standard in the treatment of wrinkles, acne scars, or aging spots.
Medical indications : very marked skins
1) Very wrinkled skins
2) Skins marked by acne
3) Skins victim of pigmented spots
Principle and results : a 15 years rejuvenation
This act is the most important and powerful among the family of peels. It consists in applying a chemical solution comprising several components on the skin, carbolic acid, salicylic acid, Croton oil and a mixture of different oils and “buffer“. The hindsight on these components and on the overall solution far exceeds several decades since that peel is practiced in France for 20 years and in the US for over 30 years.
The application of the solution will cause a disappearance of the epidermis and regenerate the elastin and collagen fibers at the base of the dermis. This regeneration will thus have two positive effects :
1) Allow the appearance of a new epidermis, making disappear the major part of wrinkles, spots, and scars.
2) Retighten the skin with precisely this regenrated fibroplastic and collagen frame, creating a significant lifting effect although less important than with a thread lift or a surgical facelift.
The most appropriate skin for this treatment is thin and white, between 35 and 80 years old. However, the thick skins can also be quite treatable but can produce less quickly observable results. As for the thicker and darker skin, each case must be analyzed individually by the doctor to confirm or not the indication of peeling.
The medical procedure :
Despite the high quality of this treatment, one must bear in mind that this is heavy for the patient and so that he has to be prepared and well informed.
Before the peel
- The patient will have to pass a blood and heart check-up in order to avoid any potential cons-indication.
- His or her skin will have to be prepared following the doctor’s advice during the 15 days before the intervention.
During the peel
- The entire face peel will last between 1h30 and 2h, under local anesthesia, within a dedicated operating theater.
- The peel will not induce any pain after the 6 first hours, during which the doctor will take care to make it disappear.
After the peel
- A dressing with zinc oxide will be worn by the patient during the 24 hours following the peel.
- The next day, the doctor applies a powder on the patient’s face for a period of about a week. This powder is there to prevent crust formation.
- The 8th day, the powder will be disintegrated by the application of Vaseline.
- During the first month, no prolonged sun exposure is tolerated and sunblock should be applied during 1 year.
Complete rest at home, without go out (dressing then face powder).
A few oedema. The skin is red but can receive make-up.
Full resumption of activity, personal and professional, after 15 days.
3 to 6 months:
The skin is red and cleared to pink, but is quite maquillable.
Some side effects can occur in very rare cases :
- A small area of depigmentation may appear exceptionally. Maquillable, it will fade with time.
- The lighter skin can take longer to dissipate postoperative redness. This is the sign quite positive of the the dermis reconstruction. This will fade smoothly.
- The occurrence of hypertrophic scars is itself purely exceptional. Measures will be taken by the doctor to correct this.
Cons-indications to know :
This peel must not be practiced on a person suffering from :
- a severe or untreated diabetes;
- a severe heart disease;
- a sever liver or renal disease;
- or active rash (herpes, etc.)
This peel is usually applicable on all skin although darker can sometimes appear as cons-indications. These cases are left to the discretion of the physician and should always be considered with the greatest attention.