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Peel Sessions

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Unveil fresher, younger-looking skin by choosing the chemical peel right for you

Chemical peels are an effective way to improve the appearance of your skin. The simple application of a chemical solution will cause the top layers to separate and peel off, leaving the new skin less wrinkled, smoother and more even. “Chemical peels are used to resurface the skin for wrinkles, discoloration and acne, and all ages can get them,” says Dr. Deirdre Hooper, a dermatologist at Audubon Dermatology.

Contrary to popular belief, not all chemical peels are the same. “There is a range, including some that we do year-round and some when you will not be in the sun a lot,” says Dr. Kamran Khoobehi, a plastic surgeon in Metairie. The sensitivity of the skin is also something that is taken into account. “It depends on what patients want, an examination to see how much is sun damage and how much is loss of elasticity, and then we come up with the peel that fits the patient,” says Khoobehi. The Fitzgerald classification is used to see what skin type the patient has. Based on that, you decide which peel to use. Other considerations include skin thickness and how much downtime a patient can afford.

A chemical peel is certainly not for everyone. “Dark skin types cannot use a deep chemical peel because of the risk of altering their pigment or leaving dark or light discoloration after the peel,” says Hooper. These individuals must use peels with caution or not at all. “The other people who have a problem using chemical peels are people who have an infection on their face, because the peel could allow the infection to spread more easily,” says Hooper. Pregnant women are advised not to use a peel either.

Some plastic surgeons offer up to eight kinds of chemical peels, all of which basically consist of acid. It is important to know the kind of acid, concentration and how much will be left on the skin. “If you have a glycolic acid that goes from 20 to 25 percent, usually it is very mild and you have some redness and may have mild peeling for two to three days,” says Khoobehi. The same applies to silicic acid, but that’s not the case for all. “Milder than 30 percent is vitamin C acid, where you have redness and a little bit of light peel for one day,” says Khoobehi.

The Blue Peel from Obagi has gained in popularity and has four to five days of peeling. Another desired peel is the phenol peel, which is much stronger and done under sedation or in surgery under anesthesia because it is more painful and is a deeper, more aggressive peel. Every doctor has his favorites. “My favorite peel for acne is salicylic acid peels, because they penetrate into the oil glands very effectively,” says Hooper. Each peel has its own purpose. “My favorite peel for rejuvenation is a light peel called a vitalized peel, which is a type of modified Jessner’s Peel that combines anti-acne, anti-pigment improving and a general refreshing of your face,” says Hooper. “My favorite peel for deep wrinkles is a TCA peel, or a trichloroacetic acid peel,” says Hooper.

The newest offering is the Vi Peel. “The Vi Peel is a special combination from a skin care company that combines different acids and applies them so you can leave it on for about seven to eight hours and then take it off,” says Khoobehi. It helps with pigmentation and toxins of the skin but can take more time to do. “It is stronger and potentially deeper, so you have about five days after the peel, the top layer of the skin peels off and new skin underneath will come out,” says Khoobehi.

Some areas tolerate peels better than others. “The face tolerates chemical peels much better than the neck or hands, because the face has a lot of glands and the skin is thicker compared to the neck, where you have to be careful,” says Khoobehi. Peels are most commonly applied on the forehead, face and sometimes eyelids, but you should try to avoid [the eyelid] unless someone is very qualified. “We can apply it to the cheek, chin, jawline and the whole face,” says Khoobehi.

Usually a cotton swab is used to apply it. “You clean the face, remove the excess oil and apply it based on the instructions,” says Khoobehi. For each chemical peel, there is a certain amount of time it should be left on and then you wipe it off or neutralize it and apply other creams.

Each peel has its own advantages and disadvantages. “The lighter the peel, the more you have to do to get the same result,” says Khoobehi. Skin that is oilier and thicker will require a stronger peel. Some patients seek a more refreshed look if they have sun damage, pigmentation issues or large pores. Acne scars can also be helped but not removed completely.

Be sure to do your research, and remember that the type of acid determines how deeply the peel penetrates. “Stronger acids penetrate more deeply, and you will have more downtime, which means more redness, more peeling and more risk of side effects, but a deeper peel will also give you more benefits as far as wrinkling, acne and anti-aging,” says Hooper.

Sometimes a chemical peel is used in combination. “The other spectrum is the laser, which is more effective and sees more response but usually has more downtime and is more expensive,” says Khoobehi. The decision is often about compromise. “You talk with the patient and understand what the goals are, how much result he is expecting and then offer the peel or the laser to provide the best result,” says Khoobehi. There is not a one-size-fits-all approach.

When getting a chemical peel, it is important to see a board-certified plastic surgeon or dermatologist so you know they will take the appropriate precautions. “If the chemical peel is not properly applied, you can cause damage or burn, so it should be done by somebody who is qualified,” says Khoobehi. This means making sure that the person who applies the chemical peel will not cause any permanent damage to the skin, like applying it too deep or in too high of a concentration that the skin type cannot handle.

There is no perfect result because the rejuvenated look is usually temporary unless maintained. “You turn the clock back but stopping the clock depends on smoking, the patient’s lifestyle and sun exposure,” says Khoobehi.