PLASTIC SURGEONS OFFER GUIDELINES FOR SAFE LASER TREATMENTS
For Immediate Release March 25, 2002
To find ABPS-certified plastic surgeons in your area or to learn more about cosmetic and reconstructive surgery, call the Plastic Surgery Information Service at 1-888-4-PLASTIC (1-888-475-2784) or visit www.plasticsurgery.org.
The chemical peel is a non-invasive technique that is designed to restore wrinkled, blemished, unevenly pigmented or sun-damaged facial skin. Using a chemical solution usually of phenol, trichloroacetic acid or alpha-hydroxy (fruit acid), the skin's top layers are peeled away, allowing for new cells to grow that produce a smoother, tighter, younger-looking skin surface.
Phenol -- Phenol is the strongest of the chemical peel solutions. It is mainly used to treat patients who have blotches on the skin caused by pregnancy, sun exposure, birth-control pills or illness, or on people with coarse facial wrinkles, severe sun damage or pre-cancerous growths. Because it lightens the treated areas of the skin, phenol is most often used for full-face peels. However, in patients with fair, unfreckled skin, phenol can be used on specific facial regions, where the contrast with the untreated areas won't be obvious. Phenol is used primarily on the face, scarring may result if it is applied elsewhere.
Trichloracetic Acid (TCA) – TCA peels employ a milder chemical formula than phenol peels. A TCA peel is used primarily to treat fine surface wrinkles, superficial blemishes or pigment problems. Because TCA peels do not produce the same bleaching effect as phenol peels, they may be preferred by darker-skinned patients for partial peels on specific regions of the face. The results of a TCA peel are usually less dramatic and much shorter-lasting than those gained from a phenol peel. In fact, sometimes more than one TCA treatment may be needed to achieve the desired result. However, a TCA peel treatment requires less time than a phenol peel, and the recovery from a TCA peel is usually shorter than with a phenol peel.
Glycolic Acid -- Is the mildest of the peel formulas. This type of peel, sometimes called an alpha-hydroxy acid peel or "fruity" acid peel, can provide smoother brighter-looking skin in people who can't spare the time needed to recover from a phenol or TCA peel. Patients who have glycolic acid peels are usually seeking only a fresher look and have only minor skin problems, such as fine wrinkling, areas of dryness or uneven pigmentation. When glycolic acid is applied to the face at a concentration of about 70 percent, it is considered a "peel," even though the acid solution doesn't penetrate the skin as deeply as it does for a phenol or TCA peel. Treatments are usually performed in a series – perhaps one peel a week for about six weeks. Glycolic acid can also be mixed with facial wash or cream at a concentration of about 10-14 percent and used as part of a daily skin-care routine to improve the skin's texture.
Because chemical peels involve some risks and long-term considerations regarding exposure to the sun, prospective patients should take care to find a properly-trained plastic surgeon. After the patient's preparation for surgery, which may involve several weeks' use of Retin-A or fruit acid on the area to be treated, the doctor will apply the chemical solution to the skin area to be treated. The chemicals will usually cause a stinging sensation, depending on which solution is used. After the treatment, which can last up to two hours for a full-face treatment, the doctor applies petroleum jelly or another occlusive compound to help with the healing process.
After the peel, patients should expect considerable swelling. After seven to ten days the swelling subsides and new skin begins to form. Complete maturation of the new skin and lightening of the pinkness may take up to six months when using phenol, and patients must take care to avoid exposure to direct sunlight as it can cause blotching on the treated area. During recovery, patients maintain a regime of medication to speed healing and can apply makeup to camouflage the treated area.
Laser Skin Resurfacing
Men and women of all ages can benefit from laser resurfacing. The ideal patient for this procedure has fair, healthy, non-oily skin. Patients with olive skin, brown skin or black skin may be at increased risk for pigmentation changes no matter what type of resurfacing method is recommended. The plastic surgeon will evaluate the patient's skin characteristics and make recommendations accordingly.
Also, individuals who have taken accutane in the past 12-18 months or are prone to abnormal (keloid-like) scarring, or those with active skin infections on the treatment area, may not be appropriate candidates for this procedure.
Having laser resurfacing can help enhance the patient's appearance and self-confidence, but it won't completely remove all facial flaws or prevent aging.
Laser surgery is a relatively quick procedure. It usually takes anywhere from a few minutes to one and a half hours, depending on how large of an area is involved. When the imperfections are especially deep, the surgeon may recommend that the resurfacing be performed in two or more stages.
During the procedure, the activated laser is carefully passed back and forth over the skin until the surgeon reaches the level that will make the wrinkle or scar less visible.
When the procedure is over, the surgeon may choose to treat the resurfaced skin with applications of protective creams or ointments until healing is complete. Some surgeons choose to apply a bandage over the treated areas, which will cover and protect the healing skin for the first five to ten days.