A chemical peel is a procedure to resurface and rejuvenate the skin of the face. The idea of applying chemicals to the skin is probably one of the oldest concepts in the beauty industry, dating back to Egyptian papyrus rolls. The chemical peel received a more solid scientific basis thanks to the German dermatologist Unna and reached some peak in popularity with the Baker formula in the sixties of the last century, which at some time was used by over 75% of surveyed plastic surgeons for facial skin resurfacing. Today, however, trichloracetic acid (TCA) is the preferred agent used during a chemical peel.
The desire for facial skin rejuvenation is at least as pervasive as the misconception what it actually is as well as what it can and cannot achieve. We like actually the following definition from Obagi’s book: “Skin rejuvenation is the art of transforming skin to its most natural and youthful state through topical agents that regulate skin function. It may or may not involve a procedure. The goal is to maintain the transformation indefinitely”. Note that it says nothing about reducing laxity, lifting or making wrinkles and folds disappear or replacing lost volume and augmenting a deficient skeleton. An accomplished dermatologist like Obagi would never make such an assertion and you will not find any of it in the marketing materials for his own skin rejuvenation product line (a global, multi million dollar company by the way, not because the products are so new or unique, but because the concept and science behind them work). It is skin rejuvenation, limited to the skin, dah.
So we want to make the skin appear youthful again. How was it when you were young then? Do smooth, even skin tone and texture, no pores, elastic and glowing more or less describe it? These are all so-called intrinsic qualities of the skin determined by the proper functioning of the skin at a cellular level in its uppermost one-quarter of its thickness. This is right where a well done TCA chemical peel comes in. A TCA chemical peel hits the reset button of the skin at that level, erases the blackboard, clears the slate or whatever other analogy you like. After healing and regrowth of skin cells from the deeper layers, which are unaffected by the chemical peel, are complete – voila, well programmed and functioning cells sit on top and produce even color tone and texture, some new collagen (thicker skin appears less aged) and a level, smooth surface, all nicely synced to a roughly six weeks cell cycle. Two more important implications – a true chemical peel requires preparation in the form of skin preconditioning prior to the peel itself and a maintenance program afterwards. Things getting out of sync again six or so months down the road ? A repeat TCA chemical peel may be part of your maintenance program. And yes, you really need to have that top layer reset / erased / cleared, anything less will not do, so ignore your hairdresser’s advice to try that gentle lunchtime peel.
We are so enthusiastic about the TCA chemical peel, because in our Caribbean clients with dark skin it is the only option to achieve significant skin rejuvenation safely without undue risks. With proper preparation a TCA chemical peel executed professionally has very few if any side effects on skin pigmentation. In fact, one of the more compelling indications for a TCA chemical peel is irregular and excessive pigmentation. Also, we have to date not observed any scarring arising after a chemical peel with TCA, while some types of acne scars (not all, mind you) actually improved after the chemical peel.
Clients with light skin do have the option of laser resurfacing for skin rejuvenation, provided they accept the side effects of the procedure: prolonged healing, visible pigment loss, long term thinning of the skin, visible spider vessels, significant potential for scarring. If you have dark skin, do not even think about laser skin resurfacing, unless you find the looks of a reverse Dalmatian desirable – light spots on a dark background with scars. Those issues are naturally known to those few laser operators in the Caribbean. Laser treatments are thus mostly conducted at lowest possible power setting to avoid the aforementioned side effects – and also any desired effects except the one on your wallet!
A TCA chemical peel is not free of required effort and commitment, however. A minimum of six weeks of skin preconditioning with hydroquinone and retin-A are mandatory. Shortly before the procedure antibiotic and antiviral prophylaxis are instituted. Tolerance of the procedure is better if either regional blocks to the face similar to blocks administered for dental procedures or some form of sedation are applied. The main technical difficulty of a TCA chemical peel is assessing the depth. Here no substitute for the experience and training of the surgeon are known to us, especially in dark skin. During the immediate healing period of five to seven days you are not presentable in public and sun exposure must be strictly avoided. Makeup can be applied once the skin surface is intact again. By that time new skin has formed and normal social and professional activities can be resumed and the rejuvenation of the skin with even color and texture as well increased glow and elasticity becomes apparent.
Contact us to start the journey !
Trinidad Institute of Plastic Surgery – the superior choice for skin rejuvenation with chemical peeling in the Caribbean, Antigua and Barbuda, The Bahamas, Barbados, Belize, Dominica, Grenada, Guyana, Haiti, Jamaica, Montserrat, Saint Lucia, St. Kitts and Nevis, St. Vincent and the Grenadines, Suriname, Trinidad and Tobago, Bermuda, British Virgin Islands, Cayman Islands, Turks and Caicos Islands, Miami, New York, Toronto, London