Skin Resurfacing Can Revitalize Dull,
Tired Skin
Skin resurfacing, using chemical peel, laser peel or dermabrasion, is one of the most popular methods of achieving healthier, younger-appearing skin. These techniques improve the skin's appearance by removing the superficial surface of the skin (epidermis and, in some cases, effect dermis) and allow newer, undamaged skin (called the epithelium) to replace the sun-damaged skin.
Skin resurfacing may improve the skin's color, texture and pigment (brown spots, age spots and dark areas due to a variety of environmental factors). Resurfacing may also treat scars caused by acne or other problems.
Many resurfacing agents are available, but the three main types are chemical peels, laser peels and dermabrasion. Microdermabrasion is also a commonly used, superficial technique for rejuvenating skin.
The depth of peeling depends on the depth or severity of the problem to be treated (wrinkle, fine line, pigment or scar). Deeper wrinkles or deeper injuries require deeper peeling techniques, which increase recovery time, post-treatment redness and risks.
For superficial peeling, acids such as glycolic acid, salicylic acid or Jessner solution are often used.
Intermediate depth peels include various types of TCA (trichloroacetic acid). The Obagi Blue Peel, for example, is a TCA-type peel. Various types of laser peels are also considered intermediate depth agents. Deeper peels are required when wrinkles, lines related to aging or acne scars are deep. Such deep chemical peels utilize phenol-croton oil techniques. Laser techniques can also be used for deep injury.
Superficial peels require minimal downtime. Intermediate-depth peels generally require a recovery time of one week to 10 days, and deeper peels require two weeks before makeup can be worn and before patients can socialize without being self-conscious. The duration of redness is also related to the depth of injury or depth of the peel.
Your surgeon is best equipped to choose the proper peeling technique to address the depth of injury required to give you the best results.
How is Skin Resurfacing (Peel) Performed?
In most cases, pretreatment with skin care products such as tretinoin or similar exfoliating agents and/or bleaches will be prescribed by your doctor prior to your peel. Superficial peels are performed on an outpatient basis without sedation; deeper peeling techniques require sedation.
Superficial peels require minimal aftercare. Intermediate peels with trichloroacetic acid require special care after the peel. Laser peel aftercare often requires using tape to cover the peeled area.
Superficial peels may be performed over the entire face, including the neck. Intermediate techniques may be performed over the entire face or over a portion of the face, such as the eye or mouth areas. Similarly, deep peels can be performed in specific areas only, such as the lips and mouth, or over the entire face.
What are the Risks?
The risks with superficial peeling techniques are minimal. Occasionally peeling will occur for a short period of time (24 hours).
With intermediate and deep-peeling techniques, skin darkening (hyperpigmentation) or skin lightening (hypopigmentation) may occur. Hyperpigmentation is minimized by pretreatment as discussed earlier. If hyperpigmentation occurs, it is treated with bleaches and will resolve over time. Hypopigmentation occurs because of injury to the pigment-producing cells and is related to the depth of the chemical peel and to the patient's skin color. For example, darker-skinned patients are more likely to experience hypopigmentation than are lighter-skinned patients.
Scarring after an intermediate or deep peel is a highly unusual complication, although possible. Infections may also occur. Herpetic infection (fever sores) may occur in patients prone to herpes. These patients should be treated with an antiviral medication (Valtrex, Famfir or Acyclovir). All patients undergoing deep-peeling techniques are generally treated with these medications to prevent herpetic infections, even if no previous history of herpes simplex exists.
Long-term Care
Once the skin has healed, patients should resume their skin care regimen to maintain their results. It is important to avoid sun exposure, especially for several months following peeling, because sun exposure will make hyperpigmentation more likely to occur.
Appointments
Cleveland Clinic Main Campus:
216.444.6900 or 800.223.2273, ext. 4-6900
Cleveland Clinic Family Health Centers:
Beachwood 216.839.3000
Independence 216.986-4000
Solon 440.519.6800
Strongsville 440.878.2500
Westlake 440.899.5555
