Metamorphosis Clinic

When you're ready for something special

Chemical Peels

Your skin is a living organ, made tip of millions of cells. Everyday, thousands of cells die, fall off and arc replaced by new cells from below. This is a slow and haphazard process that does not allow your skin to shed dark spots, sun damage, or a dull, lifeless complexion. The purpose of a facial peel is to cause the even, controlled shedding of several layers of damaged cells, so you are left with a new fresh layer of skin, with a more even texture and color. This process is similar to a snake shedding its skin.

Many types of facial peels have been performed in this country during the past 20 to 30 years. The main ingredient is trichloroacetic acid (TCA). This creates a peel that offers less risk of starring and pigmentation changes than the phenol chemical peel.

Because the peel that we perform at the clinic is not as deep as a phenol peel, it is not as effective in improving deep wrinkles, but it can make marked improvements in blotchy pigmentation, freckling, sun damage, fine wrinkles, and some types of acne scars. When you have healed after a TCA peel, you should have skin that is your own natural color and texture. The peel is an outpatient procedure performed in our clinic. It consists of the application of one or several layers of medication to your skin to create a controlled chemical burn There is normally a few minutes of stinging and burning after the medication is applied. This usually stops within 2 or 3 minutes, and there is no more discomfort during the rest of the time you arc peeling, although most people experience itching during the healing process. During the next several days, your skin turns darker, feels tight, then cracks and peels off, leaving you with a new fresh layer of skin. There arc no scabs, bleeding or bandages.

During healing, you should have no pain - Most people look strange during peeling, but if you don’t mind your appearance, you are able to go out and even go to work. However, you will not be able be in the sun or do anything that would cause you to perspire heavily. The average peel takes 5 or 6 days to complete. Deeper peels for heavily sun-damaged and wrinkled skin, may take 8 or 10 days. There are specific medicated creams you will need to use during peeling. Most patients require more than one peel to achieve their best improvement. For most skin types, two peels are needed to give the best results, but some skin problems, such as excessive pigmentation from pregnancy or birth control pills, may require multiple peels for maximum improvement.

Should you wish to have a gentler peeling agent, perhaps the Alpha Hydroxy Acid peels may be an option for you. Here the agent is applied in a similar fashion to the TCA peels but there is no visible peeling just redness of the skin which lasts for 24-48 hours. The benefit of this type of peel is that your recovery is a lot faster and the peel is a lot gentler than the TCA peel.

Everyone’s skin is different, so each person’s peel program is tailored to his or her individual needs.

When we examine your skin we will tell you what we believe needs to be done for your skin to accomplish what you desire. Please feel free to make an appointment for an assessment.

The Non-Surgical Solution to a better complexion
Unfortunately the ageing process, modern living, alcohol, smoking, processed foods and stress all take their toll on our bodies. The first place for this to show is in our skins. We develop a dingy, tired look and before we realise it skin ageing has crept up on us. We do not, however, have to just live with it.

In this age of new technology and medical advancement we have choices. One of the choices we are discussing is the SKIN PEEL. This can be a quick, rejuvenating treatment, which may be combined with a surgical procedure, or it may be performed alone. Although chemical peel may be performed in conjunction with a facelift, it is not a substitute for such surgery, nor will it prevent the ageing process. Certain peels may, however, be used as a long-term skin maintenance to help keep the skin in the best possible condition.

Chemical Peels and Natural Peels
Peels come in different forms and concentrations. The 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. The most popular chemical solutions are Phenol and Trichloroacetic Acid (TCA). Alphahydroxy acids (AHAs) offer the Natural, gentler alternative. The precise formula used may be adjusted to meet each patient's needs.

This page provides basic information about certain types of skin peeling treatments and the results one might expect. It will not answer all your questions, since a lot depends on your individual circumstances. Once you and your plastic surgeon have decided on a specific peel programme, be sure to ask about any details that you do not understand.

Deciding if skin peeling is right for you
Skin peeling is most commonly performed for cosmetic reasons - to enhance your appearance and your self-confidence. Peels may also help remove pre-cancerous skin growths, help smooth wrinkled or sun-damaged skins, soften acne scars and even control acne. Skins with hyper pigmentation may be helped by conservative AHA treatment. A series of peels would be carried out in the doctor's rooms and a home regime would be commenced. Chemical and Natural peels provide the patient with another alternative treatment if for example they are not a candidate for or they do not wish to undergo laser skin resurfacing.

If one is considering a skin peel to remove pigmentation one must firstly eliminate the cause if known. In other words if pigmentation has been caused by pregnancy the peels should work well. However, if the cause is the Pill and the hormonal problem remains then one will not achieve the desired result.

INFORMATION ON SPECIFIC PEELS OFFERED

Alphahydroxy Acids (AHAs) - LIGHT TO MEDIUM NATURAL PEEL
Alphahydroxy acids (AHAs), such as glycolic, lactic, and other fruit acids are the mildest of the peel formulas and produce light peels. They do, however, come in higher concentrations for the use only of Plastic Surgeons. These types of peels can provide smoother, brighter-looking skin for people who cannot spare the time to recover from a deeper phenol or TCA peel. AHA peels may be used to treat fine wrinkling, sun damage, and 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 in lesser concentrations would be commenced as part of a daily skin-care regimen to improve the overall skin colour and texture.

RégimA New Age 'Peel and Heal' is an AHA preparation, which is now available to doctors. This not only achieves a rapid exfoliation of the skin but contains numerous skin and wound healing ingredients and plants: Centella Asiatica, Bulbinella Frutescens, St John's Wort, Elastin, Silica etc. The preparation is available in different concentrations and the doctor will decide which is your better alternative. This peel is suitable for sun damaged, pigmented or scarred skins, for the face and hands and in the case of acne, for the chest and back. This type of peel may also be used conservatively on dark, pigmented skins.

During and After the Procedure:
AHA peels MAY cause stinging and redness and itchiness during the peeling procedure, dependent on the concentration used. This is not excessive and usually well tolerated and dependent on the concentration used. 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.

Your doctor will apply the AHA solution to your cleansed facial skin, a process that usually takes between 10 to 30 minutes depending on skin problem and concentration used. A Hydration Concentrate will be applied following removal of the peel.. Depending on the strength of the peel, periodic treatments may be necessary until the desired effects are achieved.

A simple home regime will be suggested requiring only RégimA cleanser, daily preparation with high SPF and AHA night maintenance. If one has a pigmentation problem then one may require the addition of a Colour Corrector cream.

How often can you have the peel?
Your doctor will discuss your personal needs. With the New Age AHA 'Peel & Heal' one can have peels on a weekly basis if necessary until the particular problem is controlled and then one could have them on a monthly basis.

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. Your doctor will recommend a sun block with adequate UVA and UVB protection and use it every day - RégimA Daily Survival for Normal to Dry Skins or Basal Treatment Gel for Oily or Problem Skins.

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 and a gradually firming and smoothness.

Trichloracetic Acid (TCA) - MEDIUM STRENGTH CHEMICAL PEEL
TCA can be used in many concentrations, but it is most commonly used for medium-depth peeling. Fine surface wrinkles, superficial blemishes and pigment problems are commonly treated with TCA. The results of TCA peeling 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.

During and After the Procedure:
A full-face TCA peel usually takes no more than 15 minutes. One usually experiences a stinging sensation and redness of the skin during the peeling procedure. Pinkness of the skin, flaking and peeling may last for approximately a week.

After a TCA peel, your doctor may prescribe a mild pain medication to relieve any tingling or throbbing you may feel. A TCA peel may also cause significant swelling, depending on the strength of the peel used. To help your face heal properly, it is essential that you follow your doctor's specific post-operative instructions. He may prescribe a Post Laser/Post Peel Gel to help speed the healing process.

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 colour changes in the skin.

Getting back to normal
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.

How often can you have the peel
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.

Your New Look
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.

PHENOL - STRONG, DEEP CHEMICAL 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. A popular area for using the phenol peel is around the mouth to help eradicate deeper wrinkles.

Important information regarding possible effects of phenol
It is possible that phenol will cause some undesired cosmetic results, such as uneven pigment changes.
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 colour, but also you will always have to protect it from the sun. 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 is applied to the neck or other body areas. 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.

Certain modified phenol peels are gentler and may be preferred in some circumstances.

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

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.

If phenol solution has been used, your plastic surgeon may apply a waterproof adhesive tape or he may coat the treated area with Post-Laser/Post Peel Gel to help speed up the healing process.

After a phenol peel, your doctor may prescribe a mild pain medication to relieve any tingling or throbbing you may feel.

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 few days. You may also be limited to a liquid diet and advised not to talk very much during the first few days of recovery.

With a phenol peel one develops crusting of the peeled area and 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 colour over the following weeks to months. During this time, it is especially important that you use a high sun block or blotchy, irregular skin colouring may result.

Getting back to normal
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 your plastic surgeon for advice on RégimA Under Cover Green Foundation, which is formulated to help counteract redness. One applies a normal colour foundation over the top.)

How often can you have the peel
One phenol peel will usually provide the desired smoothness of the skin.

Your New Look
If you are planning a phenol peel, you can expect a 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 ageing and sun exposure.

Peel formulas at a glance - USES & CONSIDERATIONS

Alphahydroxy acids (AHAs)

Uses:

Smoothes rough, dry skin

Refines enlarged pores

Improves texture of sun-damaged skin

Helps correct pigment problems (with a series of peels & home care)

Aids control of acne

Considerations:

A series of peels may be needed

Can be used on face and other body parts

Peel depth can be adjusted by use of different concentrations and treatment time

Average treatment time, dependent on concentration: 20 to 30 minutes

With a lighter 40% peel pinkness of the skin subsides within 24 hours

With a 70% peel light pinkness (resembling sunburn) and superficial peeling may last for a few days

A home care kit, containing AHAs for night and a high SPF for day is suggested to maintain the best results

As with most peel treatments, sun block use is recommended

Trichloroacetic acid (TCA)

Uses:

Smoothes out fine surface wrinkles

Removes superficial blemishes

Helps correct pigment problems

Considerations:

Can be used on neck or other body areas

Treatment takes only 10-15 minutes

Preferred over phenol for darker-skinned patients who require a medium peel

Peel depth can be adjusted

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 deeper TCA peel

Skin may be pink and peel for up to a week

Repeat treatment may be needed to maintain results

Sun block must be used for several months

Healing is usually quick, much quicker than with a phenol peel

Phenol

Uses:

Corrects blotches caused by: sun exposure and ageing

Smoothes out coarse, deeper wrinkles

Helps remove pre-cancerous growths

Considerations:

Used on the face only

Not recommended for dark-skinned individuals

Procedure may pose risk for patients with heart problems

Full-face treatment may take one hour or more

Recovery may be slow - Complete healing may take several months

May permanently remove facial freckles

Sun block must always be used

Results are dramatic and long-lasting

Permanent skin lightening and lines of demarcation may occur

Planning for a chemical peel
It is essential for patients prone to herpes (fever blisters) to inform the physician so as to commence an anti-viral treatment 2 days prior to a deep chemical peel and continue the course. You will need to arrange for someone to drive you home and help you out for a day or two and also consider that you will be unable to go out during the first week of recovery if having a large area of phenol peeling

Where would a skin peel be performed safely?
It is very important that you find a physician or nurse who has adequate training and experience in skin resurfacing. Your plastic surgeon may offer you a choice of peel techniques or suggest a combination of peels to obtain the best result for you. Most chemical peels may be safely performed in a plastic surgeon's Rooms. Your plastic surgeon may want you to stay overnight in a facility or hospital only if other cosmetic surgical procedures are performed simultaneously.

Expectations
During your initial consultation, it is important that you discuss your expectations with your plastic surgeon. Do not hesitate to ask any questions or express any concerns that you may have. Expect your plastic surgeon to explain the planned procedure in detail, including its risks and benefits, the recovery period and the costs.

What are the risks involved with Chemical Peeling?
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 as outlined above, while infrequent, are possible.

Preparing for your chemical peel
Your plastic surgeon will instruct you on how to prepare for your peel treatment.

Sometimes the doctor MAY suggest a pre-treatment phase if one is considering the phenol peel. One may have to spend up to a month in the pre-treatment phase before the doctor will schedule your actual peel. Skin is prepared on a home care basis. The patient would use an AHA night preparation.

Do you need anaesthesia?
No anaesthesia is required for AHA peels since they cause only a slight stinging sensation during application. Anaesthesia is not required for phenol or TCA peels because the chemical solution acts as an anaesthetic. However, sedation may be used before and during the procedure if necessary to relax you and keep you comfortable.

Costs
Please enquire at reception about costs involved for the different peels. If a series of peels are required a discounted fee is offered. Remember, chemical peel treatments are usually not covered by medical insurance unless they are performed for medically related problems.

Maintenance
It is advisable to have an AHA based long- term maintenance programme together with a sun block. Please enquire about RégimA medical skin care products that are available at reception.