Chemical Peel

ANSWERS TO MOST COMMON QUESTIONS ABOUT CHEMICAL PEELS:

CHEMICAL PEEL PRE-OP INSTRUCTIONS

Before the Peel:

• Sunscreen: plan on using sunscreen daily; there is no point in trying to reverse/reduce sun damage if you are still trying to get tan.
• Antiviral Medication: You will start an antiviral medication the evening prior to the procedure, and continue it for one week.
• Retin-A/Renova: Most patients will benefit from using tretinoin (the active agent in Retin-A and Renova) for a few weeks before the peel, as it will speed up healing. This will be continued after the area has healed to promote more new collagen formation.
• Bleaching Agent: (Lustra or other brand) will be used in some patients to maintain an even skin tone following the peel. Patients who are naturally very fair skinned often will be able to skip this.

What to Expect During the Peel:

• 2 Hours Before the Peel: apply a thin layer of the anesthetic cream, reapply after about an hour. This will reduce the stinging associated with the procedure.
• Before the Procedure: please arrive wearing no makeup or moisturizer, or arrive 10-15 minutes early to thoroughly remove these in the restroom.
• Anxiety: can be reduced with some Valium given before the procedure, but then you will not be allowed to drive yourself home. If you feel that you will be very anxious, please have someone come with you who can drive you home.
• Pain: application of the peeling agent causes a fairly intense stinging, which does not last long. As soon as the treated area “frosts” (it looks like a light pink film over the skin), cold wet compresses are applied to the area and left in place for several minutes. The stinging decreases in intensity; most patients describe it as a sunburn-like sensation. Tylenol or Advil can be taken if necessary.

What Will I Look Like?
At first, the pink frost will fade to a mild to moderate redness very similar to a sunburn. This “sunburn” period will last for about one day, and you are usually reasonably presentable. The next stage is the damaged skin drying and separating - not very pretty. Your skin will take on a brown or bronze look and feel fairly dry and tight. As you peel off the old, sun-damaged skin, the fresh new pink skin will be revealed underneath. This is the period (usually a day or two) when your skin looks really blotchy and uneven. After the main peeling takes place, your skin will be fresh and somewhat pink, and you may resume makeup and cosmetics. Final fading or the pinkness will take a few weeks.

CHEMICAL PEEL POST OP INSTRUCTIONS

Click here to download Chemical Peel Post-Op Instructions

These are extremely important and must be followed religiously!

What to Expect
When you leave the office: you will look like you have a light pink or white "film" or frosting on your skin, and you will have a thin layer of ointment on the treated areas. The light-pink look will fade, leaving a mild redness like a sunburn, typically within an hour or two.

Daily: Keep all treated areas covered with a thin layer of Aquaphor or petroleum ointment (Vaseline). The ointment application will need to be repeated several times a day as necessary to keep the area from feeling dry. Your treatment area must not be allowed to dry out (with hard scabs and crusts); doing so will increase your risk of scarring.

At Night: Apply a thicker coat of ointment prior to going to bed. You may want to place a towel or an old T-shirt over your pillow.

You may decrease the amount and frequency of ointment each day as your skin heals, eventually just spot treating any residual peeling or raw areas. Most patients will actually peel more than once; with subsequent finer peeling over two to three weeks.

Continue the antiviral prescription for its entire course. Call the office immediately if you have signs of infection such as fever, blisters, pustules, or thick yellow or green drainage (not clear yellow - that is normal).

Itching can be treated with dyphenhydramine (Benadryl) every four to six hours as needed. If this is not adequate, call the office.

Acne may flare up the week following resurfacing. Spot application of an over-the-counter benzoyl peroxide product, such as Clearasil for sensitive skin, will typically do the trick.

One to two weeks after the procedure:

1. Begin tretinoin (Retin-A or Renova cream) every night or every other night as tolerated.
2. Use a bleaching agent (Lustra, Glyquin, Melanex, Alphaquin, Solaquin, etc.) twice daily to minimize the risk of blotchy, dark pigmentation in the treated areas. This is not used on every patient, but if it is part of your treatment, expect to use it for approximately three months.
   Note: Patients using Tri-Luma are using a combination cream with tretinoin and a bleaching agent and do not need additional products.
3. As soon as the skin has peeled (you no longer have “raw” spots), begin applying sunscreen EVERY DAY. Some people will experience stinging and sensitivity to regular sunscreen lotions for a few weeks following the peel. If this is a problem, use a chemical-free sunscreen or one designed for sensitive skin. Sunscreen will need to be used for at least six months following the procedure. We recommend that you plan to use sunscreen forever!