Taylor R. Pollei, MD
Fellowship Trained Facial Plastic Surgeon offers chemical peels in Beverly Hills and Laguna Niguel CA
How Does Skin Age?
Pollei Plastic Surgery can rejuvinate your skin using chemical peels at our Beverly Hills & Laguna Niguel locations to provide a more fresh, and youthful look. Our skin definitely changes with age and these skin changes can be accelerated with increased sun exposure, worsened by smoking, and definitely have a genetic component. Unfortunately, by the time most patients are interested in pursuing treatment to improve skin quality and appearance much of the damage has been done. Even patients who take the best care of their skin will still notice that it thins, loses its elasticity, and develops discolorations and texture changes. Additionally, fine lines or heavier wrinkles occur, pores enlarge, and small blood vessels often become more visible.
Any skin aging is exacerbated with the descent of facial soft tissues and bone loss. These changes all go hand in hand to make the face appear more aged and worn out.
What Can Chemical Peels Do For Me?
There are different ways to view resurfacing techniques including laser resurfacing, chemical peels, dermabrasion, or even MicroNeedling. The value of one versus another treatment really comes down to the desired effect, as well as what specific concerns the patient wants to address.
Chemical peels are designed to utilize a controlled concentration of a known acid to create a superficial trauma to the skin. This burn results in the exfoliation of superficial skin layers. This can include the epidermis which is treated with a superficial chemical peel or entering deeper into the dermis with a moderate or deep chemical peel. The depth of peel completely depends on the goal of treatment, expectations, and the acceptable downtime. Typically with an increase in chemical peel concentration, the more aggressive the peel, the greater the effect, greater potential discomfort, and a greater degree of recovery is required.
Most of my patients undergoing chemical peels are looking to improve specific facial concerns, including: acne, rosacea, fine lines, abnormal skin texture, pigmentation or sunspots, or simply want more youthful appearing and smoother skin.
Who Are Good Candidates For a Chemical Peel?
There are truly no bad candidates for a chemical peel. It works for all types of skin, and all skin colors. The best candidates are those who have a specific concern that they’re looking to improve. This could be younger patients with acne, rosacea, or bumpy or abnormal textured skin, or patients that are a little bit older with fine lines, large pores, or are just looking for an improvement of many of these different skin concerns.
How Is A Chemical Peel Performed?
Superficial chemical peels and medium depth chemical peels can be performed in the office. More aggressive deep chemical peels require a sedation anesthetic and are performed in the operating room. The most commonly performed chemical peels are superficial to medium depth. I perform these incredibly often in the office, and typically do not use any topical anesthetic. After photos are taken, the face is gently cleansed and toner is applied to remove all residual facial oil or cosmetics. The chemical peel substance itself is then applied. Commonly used acids are retinoic acid, trichloroacetic acid (TCA), Jessner’s solution or a modified Jessner’s solution. Personally I find that TCA is very customizable, reliable and well tolerated. In addition to the peel substance, other active serums such as growth factors, hyaluronic acid, retinoic acid, etc. are always applied. To complete the peel, moisturizer and high SPF sunscreen are applied.
What is the Chemical Peel Office Visit and Recovery Process?
Once you decide to have a chemical peel performed, an appointment for roughly one hour is scheduled. This allows time for additional questions and a detailed discussion of the post-treatment course. The peel itself is not horribly uncomfortable, but there definitely is some activity or mild burning with the application of the peel. By the time you leave the office, the face will feel close to normal, but you may feel like you have a mild sunburn, or your face skin will feel slightly tight.
That evening, I want you to wash your face with a gentle cleanser, and reapply specific treatments such as growth factors and moisturizing serums. There usually is not any exfoliation, flaking, or skin slough the first day afterward, but on day two the more active areas of the face (specifically around the mouth and around the eyes) start to exfoliate, flake, or peel. This does not occur in a large sheet of skin that falls off all at one time but occurs in small patches. The exfoliation will continue on days three and four, but even during this time the appearance of exfoliation can be minimized or completely hidden with the application of moisturizer. Most people are back to work or their regular routines immediately without needing any downtime.
The only restrictions are to avoid sun exposure for 5-7 days post peel and to avoid swimming and strenuous activity for the first 48 hours.
How Long Do The Effects Of A Peel Last?
The effects of a chemical peel can be long-lasting, typically seen for months or years. Deep layer peels done in the operating room requiring greater downtime result in permanent improvements. When a series of less aggressive peels are undertaken, the results can be more visible and even longer lasting. When treating specific concerns such as rosacea or acne, a continuation of a good skin care regimen is key. When treating sun spots, sun-related skin damage, or fine lines, the continuation of sun avoidance and religious SPF use are key.
Often the way that I view the utility of a chemical peel is to help treat sun-related skin damage from the recent past, but knowing full well that aging and additional sun damage will continue. Therefore it is seen by some patients has a great maintenance treatment to maintain youthful appearing skin overall. In these situations, I suggest repeating the peel every 4 to 5 weeks, which can be continued for several months before taking a break, or even on a regular basis for life.
What Are The Risks?
Risks of superficial chemical peels are minimal, the worst part is typically the discomfort present for a few minutes during the peel. Depending on your skin type, there is a low risk of hyperpigmentation. Also present is a risk of bleaching or hypopigmentation which is only seen with extremely deep peels.
If you are prone to develop fever blisters or cold sores, they can pop up after any depth of treatment. These are easily treated with oral antiviral medication for several days. Bacterial infections and fungal infections are incredibly rare but can be seen with extremely deep layered peels. These are similarly treated until improved.
Contact our practice to learn more about chemical peels where we serve the Beverly Hills, Laguna Niguel, Mission Viejo, and South Orange County areas.