Full boarded in Plastic and Reconstructive Surgery
Peeling is a method that uses chemical substances to improve facial tissue tone removing the surface layers of the epidermis. It can be very helpful for patients with skin pigmentations and minor facial wrinkles. Phenol, trichloroacetic acid (TCA) and alpha-hydroxy acids (AHA) are used for this purpose.
Peeling is a method that can be used by itself or with face-lifting. It cannot in neither case be a substitute for a surgical operation and does not slow down skin ageing.
The alpha-hydroxy acids, such as glycollic acid, of all the acids are the most delicate and allow for carrying out very light actions. They come in different concentrations and are used in the treatment of very fine wrinkles, pigmentations and can be used by patients at home in the form of a cream to improve skin appearance.
Trichloroacetic acid can be used in different concentrations, but the most used is that which results in a medium to deep peeling. It acts more strongly than the AHA and therefore has stronger effects. It requires a more careful post-treatment check.
Phenol is the strongest chemical substance, consequently producing a more aggressive peeling. It acts deeply on the wrinkles, skin blemishes and precancerous lesions.
All the procedures carry a minimum of unpredictability and risk.
If the peeling is carried out by an experienced Plastic Surgeon it can be considered a safe procedure without risk. However, complications may emerge in rare cases such as infections or scarring.
Glycollic acid and trichloroacetic acid peeling can be done in a Plastic Surgeon's surgery while phenol peeling requires close monitoring and hospitalization of the patient and is therefore carried out in an operating theatre, even though it is not a terribly gruesome procedure.
No anesthetic is administered.
AHA - The face is first prepared with a thorough cleaning and removal of grease, then the chemical substance is applied. The method requires about 10 minutes for the application. A soothing mask is applied in the immediate post-treatment. The peeling is repeated once a week for about 5 or 6 weeks.
TCA - The face is prepared with a thorough cleansing, then the acid is applied. The method takes about 15 minutes and generally 2 applications are sufficient with some months between each (the interval depends on the product concentration).
Phenol - The preparation is the same as for TCA, but the method takes about one hour. It requires a light medication.
AHA - No problems from the first post-treatment hours. If in some points small crusts occur, they are not removed but treated with specific creams. It is important there is no exposure to the sun.
TCA - Can cause facial swelling which is more marked the higher the concentration of the substance. Recovery time takes about 10 days. Exposure to the sun must be avoided at all costs if no adequate protection is used.
Phenol - The face beomes very swollen and it is highly advisable to have the procedure carried out in a hospital to have the patient under observation for the first 48 hours. Sometimes it may be necessary to administer a drug to control the post-treatment pain. The skin, very red in the first days after the peeling, gradually becomes pink after some weeks. Exposure to the sun is absolutely prohibited in the first month in order to avoid skin disclouration during the healing phase. After the first 2 weeks it's possible to return to normal activities.