Chemical Peel

FACTS YOU SHOULD KNOW

• Fair complexioned individuals tend to get better results from this procedure than individuals with more pigment in their skin. Thick, tough, deeply wrinkled, and oily skinned individuals may require a two-staged procedure for the best results (i.e. a second peel or “touch up” of some areas at a later date.) Like painting a rough textured wall, deep creases may require more than one coat.
  

• Peeling alone is not indicated for treatment of sagging tissues.
  

• Although the new skin may be somewhat tighter, surgery may be required to remove excess skin and tighten the deeper tissues.
  

• The solution stings as it is applied, but this generally lasts for a matter of seconds. The stinging sensation will resume later in the day after the procedure but will be eased by pain medication. The sedatives and local anesthetics used during the procedure generally reduce to a minimum any anxiety and discomfort the patient feels.
  

• Considerable swelling may occur for a few days. The patient must be prepared to accept this temporary distortion of appearance to achieve the desired end result. It is best to alert family members about this prior to the procedure so as not to alarm them. Be prepared to spend a quiet week at home, especially after a full-face peel.
  

• This is an out-patient procedure performed in our accredited surgical suite. We will be seeing you frequently in the first two postoperative weeks and you may require a driver, particularly in the first week to ten days.

• With proper adherence to postoperative care and instructions, scarring is rare. The importance of following the postoperative care regimen can’t be understated. How you take care of your skin determines the final cosmetic result.

• Full-face peels are never done at the same time as a facelift, but can be done three to six months later. Segmental peels (around the eyes or mouth) can often be done at the time of a facelift.

• A peel is a surgical procedure, therefore, all risks that apply to a surgical procedure must be considered.

• Female hormones, including birth control pills, can be continued before and after a peel. However, at the first sign of increased pigment or change in skin color, they must be discontinued, possibly for up to 6 months.

• Remember the new skin will be much like a newborn baby’s. The texture and color will be somewhat different from untreated skin and may require a camouflage makeup to blend any contrast.

• Peeling (and dermabrasion) will not reduce pore size. A pore is the opening to the skin surface of a hair follicle or oil gland. In general, the size of the opening is not improved by resurfacing procedures.

• Skin peels, whether they are with chemicals, lasers, or dermabrasion, can often produce dramatic improvement in the texture of facial skin. They may be the best treatment available to your surgeon to help you obtain a fresher, more youthful facial appearance. However, they are not appropriate for every patient and your surgeon will decided whether you are a good candidate.

Laser Resurfacing and Chemical Peel  

Post-Operative Instructions

WARNINGS

• Never “pick” at crusts or pieces of skin overlying the treated areas. Keep the area moist with vaseline and allow the crusts and dead skin to peel off on its own over time. Picking at the crusts or dead skin greatly increases your risk of infection and scarring. During the first seven days after the procedure, the delicate new skin is forming under the crusts and peeling skin. It will take approximately 10 to 14 days for the crusting to disappear leaving the intensely pink new skin. The lower eyelid region is usually the last place for the crusting to disappear. Fingers and other non-sterile surfaces harbor bacteria and oils that can irritate the new skin. Avoid touching the new skin except to clean and lubricate.

• Never wear a shower cap, wig, or other hairpiece that comes in contact with treated skin. This may contribute to delayed healing and jeopardize an otherwise good result.

• Always keep the treatment areas clean and moist.

• Watch closely for early signs of a herpes simplex virus (HSV) outbreak (cold sores or fever blisters) especially if you have a prior history. They usually appear around the mouth/lips first, but can appear anywhere on the face. Classically, you will feel an intense burning or tingling sensation at the site of an outbreak before you develop tiny clear blisters surrounded by a red base. You will be given a prescription for an antiviral medication to help prevent an outbreak. However, it is not 100% successful. Herpes simplex, while alarming, rarely causes any permanent scarring. However, alert your surgeon if you suspect an outbreak.

• Do not apply makeup to peeled areas until approved by your surgeon. He will give you specific instructions on how and when makeup can be applied. A water-based, hypoallergenic makeup should be used in the beginning.

• Occasionally, small white cysts or pimples appear in the treated areas. These are blocked oil glands and will disappear in two to three weeks without treatment. Do not squeeze or “pop” them. If they persist, your surgeon will help you with them.

The intense pink color will gradually fade over the following weeks, but can persist at declining intensity for three or more months. It tends to last longer with a chemical peel or dermabrasion than for laser resurfacing. During this time period, exposure to heat, cold, wind, or emotional upset (fear, anger, crying, etc.) can cause the skin to turn intensely pink. This is due to increased blood flow to the surface of the skin or “blushing.” This phenomenon will also disappear in approximately three to four months.

MEDICATIONS

When discharged from the clinic, the patient will be provided medication or a prescription for pain. This should be taken “as needed” according to the directions on the bottle. A prescription for Zovirax (acyclovir) will also be provided. Occasionally, other medications may be prescribed. Please follow the directions as written on the bottle(s).

RESUMING ACTIVITIES

• EYEGLASSES:  If the area around the nose has been peeled, you must wait two weeks before wearing any type of eyeglasses. The pressure of the nose pieces on the treated skin must be avoided.

• SUN EXPOSURE:  The patient must avoid all sun exposure to the treated areas for at least 8 weeks. Excessive pigmentation may occur if the peeled areas are exposed to sun too early after peeling. Therefore, activities such as golf, tennis, fishing, etc., are to be avoided in the initial 8 weeks. Following that time, a wide brimmed hat and a good sunblock must be worn when in the sun for more that a few minutes.

• SKIN CARE:  Continued use of moisturizers is the best way to nurture the new skin. A greaseless, non-comedogenic product is best to maintain the new smoother, softer texture.

• RETURNING TO WORK AND SOCIAL ACTIVITIES:  The average patient returns to work and social gatherings about two to three weeks after the peel or as soon as makeup can be worn. Activities involving sun exposure must be avoided for 8 weeks. The exact time will be different for each individual according to skin type and the amount of residual redness and swelling.

• ATHLETICS:  Strenuous athletic endeavors should be avoided for one month. Activities involving exposure to extremes of heat, cold, or wind (snow skiing, water skiing, etc.) should be avoided for six months as they can damage the new skin. It will take time for the new baby skin to toughen up and endure pre peel activities.

POSTOPERATIVE CLINIC VISITS AND ACCOMMODATIONS

The patient will usually be seen in the office the day following the peel procedure and at several intervals the first week or two. Those intervals will vary according to each patient and the extent of peeling. It is of vital importance that the patient keeps the appointments because the surgeon will need to monitor your postoperative progress closely. Consider staying in a hotel the week following surgery if you live too far away to make frequent trips to the office. If only small areas are peeled or “touched up,” the patient should be able to return home immediately after the procedure.

REMEMBER, swelling, crusting, and redness are expected with every chemical face peel. You may be alarmed at the facial appearance for the first week. Time and diligent skin care will help you obtain a better result.

REMEMBER, close adherence to the postoperative care regimen is vital to avoid complications that might jeopardize the final result.

REMEMBER, it is perfectly normal to experience a period of depression following this procedure. Reasons this can happen include:

• A letdown from the excitement leading up to surgery.

• A hangover from the sedative and pain medication.

• A disappointment that you look worse instead of better in the initial postoperative period.

These feelings are common and temporary.

REMEMBER, to contact our office if you have any questions or concerns before or after the procedure. Dr. McMenamin will call you daily in the initial postoperative period. His home phone number will also be given to you. Write down your questions so he can address them for you when he calls. Our office staff will also be available to you during business hours.

REMEMBER, to contact our office if you have any questions or concerns before or after the procedure. Dr. McMenamin will call you daily in the initial postoperative period. His home phone number will also be given to you. Write down your questions so he can address them for you when he calls. Our office staff will also be available to you during business hours.