The term resurfacing is used to describe a wide range of skin treatments from superficial chemical peels and microdermabrasion, to ablative laser resurfacing. These procedures can resurface damaged outer layers of the skin to reduce wrinkles, fine lines, sun spots, age spots, freckles, blotchiness, mild scarring, some forms of acne lesions, precancerous lesions, and red veins.
Peels vary according to their active ingredients, strength, length of time on the skin, and the pH. They are all similar in that they involve applying a chemical solution to remove damaged outer layers of skin so that newer layers can replace them. A peel treatment consists of the application of a chemical exfoliating solution to the skin.
Depending on the severity of the skin damage, the solutions are applied in varying concentrations to alter the superficial, medium, or deep layers of the skin. Superficial peels, often referred to as lunchtime peels, are the most commonly used because they require minimal downtime. The deeper a peel penetrates, the more visible results you can achieve, but the longer the recovery may be. Most peels can be performed on the face, neck, chest, hands, arms, and legs. Your doctor may use a combination of chemicals for your procedure to tailor the treatment specifically to your skin type and condition.
Common chemical peels
• Glycolic Acid
• Beta Hydroxy Acid
• Jessner’s Peel
• Trichloracetic Acid (TCA)
Chemical peel techniques
You must be free of active skin infections, including acne and any type of cold sore, including herpes simplex. You must also not have taken Accutane® for a period of 12 months before a treatment, depending on your doctor’s specifications. You will be asked to limit your sun exposure before the peel. A peel treatment begins with cleansing the skin and removing all traces of grease with rubbing alcohol or acetone. The face is then rinsed with water and dried with a small fan. The doctor or nurse applies the peeling agent so that all areas of the skin to be treated are covered evenly. The peeling solution is left in place for a few minutes and then thoroughly neutralized or removed with water.
- Superficial Peels
These peels use mild chemical solutions like glycolic acid, lactic acid, and salicylic acid to lightly peel the skin with almost no recovery involved. They are typically done in a series to maintain results over time. Your face may seem slightly pink followed by temporary flaking, dryness, and scaling until your skin adjusts to the treatments. Superficial peels are usually combined with an at-home skin care regimen for best results. The solution will typically be adjusted for each treatment session based on your skin’s response.
- Medium Peels
Jessner’s Solution, Trichloroacetic Acid (TCA), or other solutions are used to correct pigment problems, superficial blemishes, moderate sun damage, fine lines, and acne scars. TCA peels are performed in a doctor’s office or medspa. You may feel a warm or burning sensation, which is followed by some mild stinging. Flaking, redness, and healing will take a few days to a week to resolve.
- Deep Peels
Phenol and croton oil peels are usually one-time procedures. They can produce more dramatic, long-term results on wrinkles, brown age spots, mild scarring, and pre-cancerous growths. Because phenol peels can cause permanently lighten skin, they are not recommended for darker skin tones and require that sunscreen be used at all times afterward. Phenol peels are performed in a doctor’s office or surgical center. A full-face, deep chemical peel requires twilight anesthesia.
Microdermabrasion is considered a peel alternative. It entails blasting the face with sterile micro-particles to rub off the very top skin layer, then vacuuming out the particles and the dead skin. Through a wand-like hand piece, tiny aluminum oxide or salt crystals are delivered at high velocity onto the skin’s surface and immediately vacuumed away with the same instrument, taking the top-most layer of dead skin cells with it. The technique exfoliates and gently resurfaces the skin, promoting the formation of new, smoother skin. It is usually performed on the face and neck but can be performed on any part of the body, including the hands, chest, arms, and legs.
Microdermabrasion can improve rough skin texture, some types of mild scarring, uneven pigmentation, and superficial brown spots. It is also good for acne lesions, blackheads, some stretch marks, and fine wrinkles. Microdermabrasion can be safely used for all skin types. The results are similar to a light chemical peel with no need for anesthesia and no downtime. Tiny crystals are sprayed on the skin and suctioned back up into the machine. The pressure can be varied to control the amount of penetration or pass over an area several times to remove the most damaged skin. Each treatment can take about 30-45 minutes. A typical regimen consists of a series of four to eight treatments done at intervals of two to four weeks. Your skin will have a pink glow and feel as smooth as glass after the treatment. Microdermabrasion can be combined with other resurfacing procedures, such as peeling solutions and infusion of cosmeceuticals.
Costs: Treatments vary in cost according to the area treated, the individual physician, and the geographic location. Generally, superficial peels or midcrodermabrasion can range from $150 to $350, whereas TCA peels can cost from $500 to $2,000. Typically peels performed in a medical setting are more potent than treatments done in a salon or spa, where only superficial peels are usually offered.
Recovery: Light peels and microdermabrasion treatments require little or no downtime. After the procedure, the skin may be coated with a mild ointment or cooling gel. With all peels it is important to avoid sun exposure for several months to protect the newly formed layers of skin.
Risks and side effects: Possible complications from deeper peel treatments may include infection, scarring, temporary or permanent color change in the skin, and uneven pigment changes. Darker skin types are at a higher risk for hyperpigmentation and skin discoloration.
When you’re ready to discuss skin resurfacing treatments with your dermatologist, bring this list of questions with you.
Questions to ask your dermatologist about skin resurfacing treatment
• Is this the most effective treatment for my skin type and condition?
• Is my skin type appropriate for this type of treatment?
• What are the possible side effects?
• How long lasting are the results?
• How many treatments will I need?
• How often should I have a treatment?
• What will happen if I stop having treatments?
• What is the recovery process?
• When can I wear makeup?
• When can I start using my normal skin care regimen again?
• Is there anything I should be using on my skin before the treatment?
• Are intravenous sedation or local anesthesia necessary?
• Is this treatment best done during the winter or when I will not be outdoors?
• Who will be administering my treatment and what are his/her qualifications?
Have you had chemical peels or microdermabrasion? What was your experience? Please share your tips in the comments section below!
Wendy Lewis is the author of the new Vibrant Nation beauty guide, Cosmetic Procedures and Plastic Surgery After 50: Expert Advice for Choosing the Best Option for You.