Why do people have chemical peels?
If a top layer of skin is removed it reveals a fresh layer with few imperfections or lines. Chemical peels use a range of different acid solutions to remove this damaged outer skin in order to expose a younger look.

Depending on the type of procedure and the strength of the solution type, chemical peels can be used to remove skin growths, help limit the facial impact of acne scars, smooth wrinkles, reduce unevenly pigmented skin and soften scars.

Most chemical peel clients are looking to improve a level of self-confidence that has been undermined by the appearance of their skin. In localised situations this procedure is most commonly used on the forehead and around the eyes, however, full facial peeling is common.

Realistic expectations
Chemical peel solutions vary greatly in strength and it is vital that you discuss which procedure is best for you.

It is critical that you spend time thinking about what you want from the procedure and talk about your hopes with your surgeon. Everyone’s skin type is different and the surgeon will discuss what you can realistically achieve.

What happens during consultation?
The surgeon will want to know why you want a specific procedure to gain a complete understanding of what you want to achieve from the treatment. It is important that you are honest and thoroughly discuss any medical problems or medication that you may be taking.

Getting the most out of your consultancy
Often in cases where clients are unhappy with the results of a treatment it is because they did not discuss their expectations thoroughly or were afraid to talk about the outcome or risks.

You have to make an informed decision before signing the consent form so ask plenty of questions. You want to feel relaxed and confident and completely understand what will happen.

You may want to know:

•		About the surgeon’s qualifications.
•		How many chemical peels are carried out each year by this person.
•		How you prepare for the treatment and how long it will take.
•		What realistic results can be expected and when.
•		Which peel procedure is the most appropriate for you.
•		How long the results will last.
•		About the side-effects and possible complications.
•		How long it will take to recover.
•		How the skin will change in time.
•		What happens if anything goes wrong.
•		Where you will have the peel applied.

Preparing for your chemical peel
Your surgeon will advise you of any special requirements before your procedure. What may be required will depend on the type of treatment you have discussed and the results you want to achieve.

As a general rule you should be free of skin infections such as acne or cold sores and limit your sun exposure to the minimum a month before treatment. You may also have to stop taking certain medication.

What happens during chemical peeling?
This depends on the type of procedure you require. There are different percentages of acid solution that can be applied to your face according to skin type or the results desired.

Procedures

•		Alphahydroxy acids For light use to achieve a fresher complexion, surgeons apply alphahydroxyl acid (AHA) that features lactic or fruit acids. The solution is used to help control acne, correct minor complaints and help sun-damaged skin. AHA takes only minutes to apply, however a series of visits may be required.
•		Tricholoroacetic acids For more intense penetration, tricholoroacetic acid (TCA) removes skin to a deeper level for minor blemishes or wrinkles. In line with the strength and peel depth you may require a couple of treatments to maintain the results. Depending on the extent of the area to be treated the procedure may take between 30 minutes and an hour.

Application
Normally anaesthesia is not required for chemical peeling however the surgeon will advise you if he or she feels you should be sedated for your own comfort during the procedure. Normally chemical peels are carried out in an outpatient environment. In all cases your face is thoroughly cleansed before the procedure is carried out.

•		With AHA treatments the solution is applied to your face and normally carried out in about 10 to 15 minutes. There is rarely any need for ointment or covering. In some cases the solution can also be applied at home with regular monitoring by the surgeon.
•		TCA peels usually take between 15 and 30 minutes and you are likely to feel a tingling sensation as the solution is applied. Depending on the results you may wish to achieve you may require two or more treatments spread over a few months. Mild peels can be carried out on a regular basis.

After the procedure
After an AHA treatment it is unlikely that you will need time off from your job or take a break from normal activities.

In most cases you will probably experience slight swelling that gradually subsides after a few days. Skin dryness is normal with AHA and in the case of deep skin treatments your surgeon will advise you to take a break.

With an AHA or TCA peel your skin will continue to be able to produce colour pigment and tan, however with phenol the skin often loses its ability to tan and you will have to protect it from the sun.

Following a TCA or phenol peel it is likely that the surgeon will prescribe mild medication to alleviate any sensations of tingling.

Road to recovery

•		You will be advised on the ointments that you can use to keep your skin supple.
•		The effects of chemical peeling can last for years, however this varies between skin types and patient age. Your surgeon can advise you on how long you can expect the peeling to last.
•		It is important to avoid direct exposure to the sun after a procedure. Following a phenol treatment, sun protection must always be used.
•		With a TCA peel the minor swelling you experience will subside in up to 10 days and the effect of the procedure will become apparent.
•		You can return to work after about two weeks after a phenol peel.
•		Seek the advice of your surgeon on when you can start using makeup again. This will vary between procedures.
•		The results of an AHA peel will be subtler than those of TCA. However you will notice a fresher younger looking complexion.
•		TCA peels dramatically improve your skin’s surface and you will see fewer wrinkles and blemishes.
•		Despite the process, your skin will not be immune to the effects of the sun or aging as the result of a peel.
•		If you are in doubt about any of the post operative effects of peeling speak to your surgeon.

Complications are rare and depend greatly on individual circumstances such as a person’s health and skin type or the extent of the procedure. Your surgeon will be able to explain how the risks apply in your circumstances.