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Chemical Peels St. Louis

Chemical peels are a great way to refresh and rejuvenate your appearance. They use various topical liquids to remove the outer layers of the skin. This is like power washing your deck. It unclogs pores, exfoliates the top layer of dead skin cells, tightens the dermis, and brings out the underlying fresh, baby skin. Peels can even help clear away minor sun spots, blemishes, and fine lines and wrinkles.

Chemical peels typically have an easier recovery than most laser peels. They usually have more “dry” healing with flaking that recovers in 7 days whereas lasers produce a wet surface and may take a little longer to heal. Peels can be performed in the office or combined with other procedures in the operating room. Your surgeon will assess your goals, skin quality and color, and review the best options to help you attain a refreshed appearance. They will discuss any necessary pre-treatments which will help optimize your skin for medication penetration and for recovery. After care will be discussed, and any medications needed can be prescribed ahead of time.

CHEMICAL PEELS CAN:

  • Smooth fine lines and wrinkles
  • Exfoliate the top layer of dead skin cells
  • Remove small blemishes and sun spots
  • Bring out a glowing, freshened appearance

QUICK FACTS:

  • Length: 15 min
  • Anesthesia: none, oral sedation, local blocks, or IV sedation
  • Stay: Outpatient, same day surgery, office procedure
  • Recovery: 5-7 days
  • Side Effects: redness, flaking, peeling, pigment changes

CHEMICAL PEEL TECHNIQUE:

Our lighter, lunch-time Obagi Blue Radiance peels are often performed by our wonderful medical assistants. The deeper, trichloroacetic acid (TCA 15-30%) peels are always performed by one of our surgeons. To start, a special medication will be used to clear away any remaining skin oils. The peel of choice will be meticulously applied in 1-4 coats as needed. Patients will feel some warmth on the area treated during the procedure, proportional to the strength of the medications being used. A hand-held fan will help cool the area and help with comfort. If you have someone to drive you to and from appointment, your surgeon can prescribe a pain pill and/or light sedative (valium) that you can take 1 hour ahead of time. This helps for deeper peels, but not necessary for lighter peels. After the peel is complete, our staff will apply cool towels and an ointment to help protect your skin. Aftercare instructions will be reviewed.

PREPARING FOR CHEMICAL PEEL:

PRETREATMENT: Pre-treating the skin is an essential part of a successful chemical peel. If you are having a deeper or TCA peel, our surgeons require you to pretreat the skin for several weeks beforehand as below:

Retin-A cream: Start using this at least 1 month ahead of time. This will get the skin ready for cellular turnover and primed for healing. Most patients will start with Tretinoin Cream 0.025%. Apply light coat to entire face every 3rd night for 1-2 weeks, then increase frequency to every other night for 1-2 weeks, and finally apply daily. Redness and flaking will happen (this means the medication is working!). This is the intended effect of helping to speed up your skin’s turnover, shedding the old, dead skin cells and bringing newer cells to the surface. Stop using a few days prior to peeling and resume use 2-3 weeks after the peel.

4% Hydroxyquinone: Helps turn off the pigment cells in our skin to prevent abnormal skin darkening after the peel. Very important to use prior to peeling, with timing dependant on skin color. Caucasian/light skin types need to use 3-4 weeks prior to peeling. Asian/light brown skin start using 6-8 weeks ahead of time. Dark skin needs 8-12 weeks of use prior to peeling. Place small amount on fingertip and dab in several spots around the face prior to rubbing in for even application over the entire face. Stop using a few days prior to peeling and resume use 2-3 weeks after the peel. Very important and essential to use sunscreen regularly and reapply frequently when using hydroxyquinone as this medication inhibits our body’s natural sun protection.

Let your surgeon know if you have any history of cold sores or fever blisters. They will pre-treat with Acyclovir or Valtrex for 7 days (starting 2 days before the peel, continue for 5 days afterwards) as the body’s reaction to the peel may induce one of these sores to begin.

DAY OF PEEL:

Wash your face prior to coming to your appointment. Do NOT apply any makeup, creams, ointments, medications, etc. These will block the peel from penetrating the skin.

RECOVERY FROM CHEMICAL PEEL:

Apply a light coat of ointment on your peeled skin several times per day. Our surgeons recommend using either Vaniply, Vaseline, or Aquaphor. All of these are over the counter and available at your local pharmacy.

Wash your face twice daily with gentle cleanser (Obagi or Cetaphil), pat dry, then reapply ointment.

Do NOT peel your skin. This will be tempting but do not peel away the flaking skin. This will cause little knicks deeper in the skin levels where the skin is still adherent, causing wounding, which leads to scarring. Let the skin naturally fall off with twice daily facial washes.

When peeling is finished in ~7 days, stop with the ointment and resume your regular hypoallergenic moisturizer (such as Obagi Hydrate) and sunscreen.

Resume Retin-A/Tretinoin and hydroquinone creams 2-3 weeks after the peel. You should remain on these at least 3 months after your peel, but they can be used life long as part of a good skin care regimen.

FAQS:

A: Each peel has a little different recovery depending on the strength and the depth of penetration. Lighter, lunchtime peels (Obagi Blue Radiance) have minimal downtime and flaking for only a day or two. This lets your continue with your regular activities and is perfect for those on the go. Depending on the individual skin concerns, a course of 4-6 peels at intervals of 2-4 weeks is usually recommended. For the deeper, stronger (TCA) peels it will usually take 5-7 days to recover. The skin will be a little red for the first day or two before turning brown and thicker. The skin usually starts to peel around mouth, eyes, and areas of movement. Most peeling occurs on days 4-7. After that, patients can return to their regular moisturizer and resume retin-A, hydroxyquinone, sunscreens, and makeup.