Many patients believe that a peel needs to literally make them PEEL their skin off. I need you to understand that this is really NOT the case at all. I think too many companies market chemical peeling in a way that they make patients believe that we are “pulling off their old skin,” which is not entirely correct. You also need to understand that there are peels, and peels, and peels. Some peels are designed to be mild and they work in a way that the skin exfoliates in fine microscopic flakes, that in most cases are not particularly visible (these would be like our mild glycolic peels).
Then there are other peels that work slightly differently in their action and they will release the skin in clumps or flakes that are visible, but still not terribly painful or uncomfortable and within about two days the skin feels normal again (like our salicylic acid peels).
Then there are other peels that are more aggressive, like our combination acids and our TCA’s. They make the skin peel in sheets and there is considerable downtime (some as long as a week or more).
Yes, there are peels that we can apply to the skin that will penetrate so deep that it quite literally resurfaces the whole skin and you will peel like a snake for a few days after that treatment, but these tend to be quite aggressive, they can be risky (pain, redness, swelling and infection if not taken care of properly), and they tend to be more expensive. It is not a good idea to have this type of peel as your first experience simply because of all the risks involved in doing such a treatment. Generally the safest and most effective way to approach peeling (if you even need an aggressive peel at all), is to start off having a course of superficial peels first in order to prepare the skin and increase the natural skin cell turnover, so that by the time you have your aggressive peel, your skin is ready and able to heal quickly and efficiently, reducing the risk factor and giving you an even better result.
The other big question you have to ask yourself is “What is the goal of the treatment?” You need to remember that when we peel skin, we are causing a controlled injury to that skin, and we would rather slowly, over time build your skin up treatment by treatment. So we “train the skin,” to start regenerating and turn over on its own by responding to the injury we give it.
So very often we find we get the results we need LONG before ever having to get to the point of doing such an aggressive peel, and in the long term, this is the better course of action. Of course, if your concern is deep in the skin (for example acne scarring), then we need to get deeper into the skin, but even so, we would never inflict maximum injury on day one. That is just asking for trouble.
So yes, if you are just having peels for rejuvenation, evening out the texture of your skin and evening out your skin tone, having a really deep aggressive peel is not necessarily the way to go and you need to remember that the skin is alive and it turns over on a monthly basis, so a once-off peel is not going to give you everything you want. These have to be done in courses of at least six treatments before you’re going to see a dramatic change. I suggest you take good close up photo’s of your skin now. Have your six peels (once a month or so), and then take the same close up pics of your skin at the end of your six treatments and compare the two sets of photos. You will find you are pleasantly surprised at the improvement.
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