Phenol Peels

Phenol peel is a type of chemical peel used for facial skin resurfacing. It helps rejuvenate and tighten the skin as well as reduce wrinkles. The chemical used for the peel consists of a mixture of different chemicals with phenolic acid as the main ingredient. Other ingredients include water, Septisol, and croton oil. Septisol is an antiseptic skin cleanser that helps eliminate bacteria while croton oil is a known skin exfoliant. The strength of the peel can be varied by alternating the concentration of ingredients in the mixture. Although most patients refer to it as a “deep peel”, phenol peel can actually be made into a light peel or a very deep peel depending on the ratio of the ingredients used.   

CANDIDACY 

Patients who will benefit most from a phenol peel include those with an advanced degree of facial aging and skin laxity. It also works well on patients with very deep and coarse wrinkles.   

TREATMENT COMPARISON 

Phenol peel is said to produce the best results among all kinds of chemical peels. It is the most effective in skin rejuvenation and smoothing out wrinkles. Laser resurfacing is the closest as far as the results are concerned. Phenol peel is also much better than microdermabrasion which only works on the outer layer of the skin. Microdermabrasion will not have as great effect on wrinkles. The same goes with microneedling which is done for skin re-texturing and getting rid of acne scars. Phenol peel is the way to go if the patient’s main problem is wrinkles. This is particularly true if he or she wants to get rid of them without having to undergo an invasive procedure like a facelift. 

LIMITATIONS

Probably the biggest limitation of the phenol peel is the downtime. The peel is not something that can be done over lunch or during breaks. At least two weeks healing time is needed. The same thing goes for laser treatments and other deep facial resurfacing procedures. The depth of injury from the treatment correlates with the downtime and expected results. The deeper the treatment goes, the better the results will be, but a longer downtime is required.

RISKS

All kinds of skin resurfacing treatments can cause complications and phenol peel is no exception. The most common complication is hypopigmentation or discoloration which is similar to what is seen in a CO2 laser treatment. This happens when the peel went so deep that it affected the cells which give the skin its color. But as long as the peel does not go excessively deep, there will be either very minimal or no discoloration at all.

The biggest long-term risk is facial scarring which happens if the peel goes too deep. This scarring would normally be seen right away.  Scarring means that the peel has gone to the deeper dermis below the top layer of the skin’s epidermis. During resurfacing, “controlled” damage is introduced to the epidermis and upper dermis. This damage is repaired through the repopulation of cells coming from the deep portion of the dermis. If the peel goes too deep, there will be too much damage on both the epidermis and dermis. As a result, the dermis will not be able to send cells that help heal the epidermis which results in scarring.

RECOVERY

Recovery from a phenol peel takes about two weeks at minimum. The peel can be quite painful especially during the first 24 to 48 hours. The patient will be advised to take painkillers to relieve pain and discomfort. Then a week after the treatment, there will be an eschar over the face. An eschar is basically a huge scab. Over the first 7 to 10 days, this scab will start to lift off. After 10 to 14 days, new skin can be seen as the scab pulls off completely. At that point, the new skin will be pinkish or reddish depending on the amount of extra blood flow to the area the body is putting in to help heal the skin. The pinkness or redness will go away completely after 2 to 3 months. Wearing any kind of makeup is not recommended in the first 2 weeks following the peel. At week 3, the patient may start putting on light makeup, but only enough to mask the pinkness of the skin.

RESULTS

Results become apparent in as early as 2 weeks once the pinkness and redness of the skin has started to subside. The improvements are quite amazing as the peel can make the skin look younger by about 5 to 10 years. The results last for a good 4 to 5 years if the patient takes care of his or her skin.

FOLLOW-UPS

Most patients who have had a phenol peel do not require follow-up treatments. But for those who want a re-peel, it is recommended to wait for at least a year after the first treatment. Phenol peel is not something a patient should do often because of the potential for permanent skin damage.

FINAL THOUGHTS

Phenol peel is one of the best skin resurfacing treatments out there. It is flexible enough to accommodate patients of all ages. While it is true that this peel requires a much longer recovery time than other peels, the results are nonetheless worth it.

Written by Cosmetic Town Editorial Team- AA

Based on an exclusive interview with Sam Sukkar, MD in Houston, TX