Deep Peels

A deep peel is an aggressive chemical peel performed using either trichloroacetic acid (TCA) in concentrations of greater than 50% or preparations containing phenol which is also called carbolic acid. A solution is applied on the skin which then penetrates into the deeper layer of the dermis. The solution initiates the peeling process where old skin is removed and new healthy skin is regenerated in its place. This leaves the skin smoother and brighter with the signs of aging being dramatically reduced. Deep peels can be used to treat patients with severe photodamage, acne scars as well as in those who have precancerous lesions called actinic keratosis. Actinic keratoses pertains to the scaly patch on the skin that develops as a result of frequent sun exposure. It appears most commonly on the scalp, face, neck, forearms, and hands.

TYPES OF DEEP PEELS

There are different types of deep chemical peels for facial rejuvenation and each one is based on the variety of ingredients in the peeling solutions used to achieve the deep peel. Chemical peels, in general, are highly customizable to fit the cosmetic need of a particular patient. They can be made to fit the patient’s cosmetic concerns and needs including how deep they want the peel to go and what issues they are actually addressing.

CANDIDACY 

Ideal candidates for a deep peel facial resurfacing are lighter skinned patients with more advanced imperfections. Deep peels work to repair deeper wrinkles, uneven skin tone, skin irregularities, blotchiness, and pigment abnormalities. It will also treat various kinds of scarring as well as cancerous growths on the skin.

Deep peel treatment is not recommended for patients with darker skin tone because of the risk of discoloration.  A deep chemical peel can leave the skin a lighter color so in patients with dark skin, this can manifests as a very thin line of demarcation separating the treated and untreated areas.  Therefore, lighter skin patients are ideal for this particular treatment.

TREATMENT COMPARISON 

Deep peels only take a single treatment session while microdermabrasion and non-ablative laser skin resurfacing often require multiple appointments for optimal results. These appointments are spread out over many months. The cosmetic results of a deep chemical peel are often more dramatic than that of microdermabrasion and non-ablative laser rejuvenation. On the other hand ablative lasers can be customized to reach depths comparable to deep chemical peels.

LIMITATIONS 

The main limitation for chemical peels is the recovery time needed for healing which is often an obstacle in today’s fast-paced world. Also, the treatment is not for everyone. There are specific patient characteristics required to make someone an optimal candidate for a deep peel. Finally, while deep chemical peel can dramatically repair wrinkled and sun-damaged skin, it is not the best treatment option for loose and sagging skin. There are other skin tightening options one would consider. It does not work the way a facelift does so it will not give a facelift effect.

RISKS

Deep peels are generally safe when performed by an experienced, board-certified physician. As with any cosmetic procedure, it is important to note there are still some risks involved. Short-term risks include allergic reaction, infection, pigment changes, and reactivation of HSV (herpes simplex virus) in patients with a history of cold sores. Long-term complications include scarring and permanent pigment alteration.

RECOVERY 

Recovery from a deep peel can take two to three weeks. The face will be red and swollen for the first few days. There may also be some crusting. Mild to moderate discomfort may be experienced but this can easily be managed with oral pain medication. Complete peeling of the skin will occur around day seven or ten leaving behind bright red skin. Within a month or so, the patient can go out and the redness will not be as noticeable. However, there will still be some pinkness of the skin which looks like a sunburn. As long as the patient is protecting his skin from the sun, this pinkness will slowly resolve but may take two to three months.

RESULTS 

Deep peels can produce immediate results. After two to three weeks, once the skin has started to heal, the patient will notice a brighter and more luminous complexion. There will also be an impressive improvement in the texture of the skin as well as a reduction in the appearance of wrinkles. Further improvements can be seen in the next few months. The results are said to be long lasting and can last for years or even decades especially if the patient adopts a comprehensive skin care regimen.  Something as simple as using a sunscreen with an SPF of 30 or higher can make a big difference.

FINAL THOUGHTS

A deep peel is an excellent option for addressing certain cosmetic concerns. Dermatologists have been doing chemical peels for over 50 years with a high degree of patient satisfaction. If considering this procedure, it is extremely important that a deep chemical peel be performed by a board-certified physician experienced in this arena. 

Written By Cosmetic Town Editorial Team - AA

Based on an exclusive interview with Holly Singletary, MD in Austin, TX