Acid peels, also known as chemical peels, are applied to destroy the superficial layer of the skin and then remove (exfoliate) the dead skin cells (corneocytes). This allows a new skin layer to develop resulting in smoother facial skin. Acid peels that penetrate deeper into the outer layers of skin (epidermis) are often used to treat more subtle wrinkles (rhytid) than what a facelift (rhytidectomy) addresses, particularly around the eyes, mouth, and lips. It may also help remove the black/white heads of pimples, superficial scars, and superficial benign skin growths. An acid peel is usually an elective procedure.
Substances typically used for this procedure are found in nature, such as alpha-hydroxy acids or glycolic acids (AHAs), and are associated with fruits, spoiled milk, or sugarcane. AHAs are generally used for mild skin scars and plugs of material within dilated hair follicles that frequently contain bacteria (comedones). Trichloroacetic acid and Jessner's peel (resorcinol, lactic acid, and salicylic acid in ethanol) are more toxic than AHA peels and cause destruction to the deeper layer of the skin. They are used to treat deep scars and skin growths but also permit the underlying new skin to resurface. The penetrating ability of the acid peel generally depends on the type or concentration of acid used. |
Source: Medical Disability Advisor
| An acid peel stimulates the skin's natural rejuvenation processes. During the aging process, the skin thins and wrinkles, losing its elasticity. The acid peel removes (exfoliates) outer layers of dead skin while creating a healing response that both repairs and rejuvenates. When the new layer grows, a layer of collagen is formed that reduces the appearance of wrinkles. Some individuals seek treatment primarily to augment the results of a facelift and eliminate wrinkles that other cosmetic procedures fail to resolve. The treatment addresses sun-damaged (photo aged) skin, precancerous skin lesions (actinic keratoses), skin growths (seborrheic keratoses), acne scars, patches of pigmented skin (lentigo), scaly skin (xerosis), dry skin disorder (ichthyosis), brown spots (melasma), and freckles. |
Source: Medical Disability Advisor
About 2 weeks prior to the procedure, individuals may be given lotion containing 3% to 10% AHA for applying once or twice daily to increase tolerance for the upcoming acid peel. Individuals undergoing an acid peel to remove actinic keratoses may be asked to apply fluorouracil cream for 5 to 7 days before the peel to make the lesions easier to identify. Individuals may also be instructed to temporarily stop using certain products, such as hair dyes that might irritate the skin. On the day of the procedure (done on an outpatient basis), the individual may be asked to refrain from wearing cosmetics or lotions. Residual debris or oils will also be cleansed from the face.
The individual's face is then coated with the acid peel agent. The more common, superficial peels (50% to 70% of cases) are done using an AHA when multiple treatments may be required. Trichloroacetic acid (TCA) is used in 15% to 50% of cases for deeper peels to remove scars. The deepest peels produce the smoothest skin and are done using substances such as phenol (carbolic acid, 88% in solution with water, oil or other substances). These are now used far less frequently however, because of potential complications.
Aestheticians can use solutions of up to 30% glycolic or lactic acid. Physicians are allowed to use higher-concentration glycolic acid peels and lotions.
After applying an AHA, a burning sensation and reddening (erythema) of the skin usually begin to appear in a few minutes. This pinkish discoloration quickly returns to normal. If a TCA or Jessner's peel is used, the skin will turn white and then pink. After the skin changes color, the acid solution is diluted and rinsed from the face. Deeper peels can take as long as an hour. The treatment may be followed by cool compresses applied to the face and a final cleansing. AHA peels occasionally result in slight flaking in a few localized areas for 1 to 2 days but the skin will not actually peel. After a TCA or Jessner's peel, the skin may turn brown, feel dry, flake, and peel for a few days.
After treatment, the face may be washed, but only with gentle cleansers. A special emollient-type lotion is generally given for follow-up use at home. The individual may be told not to wear makeup until the skin returns to normal, usually in a few days to a week. Sunscreens should be worn, and direct sunlight must be avoided. The individual may experience sensations of stinging, itching, or burning during the healing period, but must refrain from peeling, pricking, scraping, or scratching the skin. Depending on the type of acid peel used, follow-up treatments may be required at various intervals. The individual may also need to apply low concentrations of AHA (3% to 10%) at home to maintain the skin's smoothness. |
Source: Medical Disability Advisor
| The results of an acid peel often depend on the type of agent used, the individual's skin type, physician or aesthetician expertise, and the individual's compliance with necessary follow-up measures such as home treatments. Since the peel tends to stimulate natural body processes, results are usually successful in terms of removing unwanted dry skin and improving appearance. In order to maintain results from the procedure, the individual may need to continue to regularly apply a low concentration of AHAs to the face. In most cases, disability is not expected. |
Source: Medical Disability Advisor
| Burning, stinging, and itching will result from treatment, although these effects tend to resolve as healing progresses. Redness caused by dilation of the vessels (vasodilation) may linger in some cases. Some types of acid peel solutions may cause crusting or necrosis. Scarring, changes in skin pigmentation and whiteheads may occur. Infection, eversion of the eyelid, or activation of the herpes simplex virus or toxic shock syndrome may occur in rare cases. Less potent acid peels rarely produce adverse effects. |
Source: Medical Disability Advisor
| The individual will need to apply sunscreen and avoid direct exposure to the sun for at least a week after the procedure. If additional procedures are needed, time off from work may be necessary. The individual may need time during work to apply lotions to aid in the skin's recovery immediately after the procedure. |
Source: Medical Disability Advisor
| General "2003 ASAPS Statistics." American Society for Aesthestic Plastic Surgery. 1 Oct. 2004. 1 Oct. 2004 <http://www.surgery.org/press/news-release.php?iid=325>. |
Source: Medical Disability Advisor
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