Hey guys, Sandra Lee, M.D. (aka Dr. Pimple Popper), here!

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Peel Preparedness: What You Need to Know Before Your First Chemical Peel

If the words “chemical” and “peel” joined together give you pause, we understand: Visualizing a layer of chemicals peeling away your skin doesn’t necessarily paint a pretty picture. But what is pretty is the healthy, glowing skin that’s revealed when that chemical peel sloughs away layers of dull, dead skin cells.

What’s a chemical peel? What do you need to know before you commit to a quality peel? What results can you expect? And does it … gulp … hurt? You’re in luck: We’ve rounded up a wealth of intel on chemical peels to set your mind at ease.

The image you may have in your head of a rich and famous star, wrapped up like a mummy with oversized sunnies resting atop her bandages has probably done a mental number on you. But, fear not: most professional chemical peels (also known as derma peeling and chemexfoliation) don’t usually require you to hide out and bundle up. In fact, they’re a common in-office treatment, sometimes performed by a physician’s assistant or esthetician, that can produce subtle or significant improvements to your skin’s texture and evenness. In a nutshell: An in-office peel involves a professional applying a chemical solution to the skin (face, neck, hands and/or chest) that causes it to exfoliate and eventually peel away, revealing fresh, regenerated skin. If you suffer from hyperpigmentation, acne scars, wrinkles, melasma, sun damage, or generally aging skin issues, a chemical peel could be the treatment to help get your skin back on track.

dermatologist or PA applying a chemical peel

Naturally, a variety of chemical peels exist, and knowing what each purports to do will help you pick what’s right for you.

Superficial peels are known in skincare circles as “lunchtime” peels due to the fact they are discreet and require virtually zero downtime. They involve a mild acid (such as alpha-hydroxy, glycolic, lactic or fruit acids) that, yes, may sting a little as it penetrates. Superficial peels only reach the outermost layer of skin to gently exfoliate and improve the appearance of mild discoloration and uneven skin texture. Recovery time is practically nil — one to seven days, depending on how sensitive your skin is. In fact, though you may experience a bit of redness, irritation, scaling and swelling, you can hypothetically return to work right after a session with none of your coworkers being the wiser. If you are a fan of squeezing in lunchtime appointments, lay off the makeup for that first day! Though superficial peels don’t go too deep, with repeated treatments (three to five, depending on your dermatologist’s recommendation) cumulative benefits — such as a reduction in pore size, a boost in collagen production and noticeable skin firming — are likely to be seen.

Slightly stronger, medium peels utilize glycolic or trichloroacetic acid to affect the outer and middle layers of skin. A medium peel, which also has a little sting to it, addresses issues like fine lines, wrinkles, freckles, age spots, rough skin, skin discoloration, and can also help to tackle some precancerous skin growths, like actinic keratosis. Post peel downtime can be anywhere from seven to 14 days, with swelling that increases over the first 48 hours. If you opt for a medium peel, you may notice your skin blistering and your eyelids swelling shut; don’t fret — this is part and parcel of a medium peel. Your dermatologist will set you up on a post-peel schedule: Soak skin daily for a specified period, then apply ointment, and take antiviral medication for 10 to 14 days. As with all levels of peels, sun exposure should be avoided. And don’t even think about makeup — at least for the first five to seven days, after which mineral makeup can be used to camouflage any skin imperfections. To keep on top of your progress, your professional will set up a follow-up appointment.

Finally, a deep peel features tricholoracetic acid or phenol and reaches the middle layer of skin to remove damaged outer layers, with the end result being a dramatic improvement of shallow scars, moderate lines, age spots and freckles that can last up to 10 years. The downtime for a deep peel can be a doozy: It can take a whopping two to three weeks to heal. The treated areas are bandaged (just like in those TV scenes you may have pictured!), and you must soak your skin four to six times daily, apply ointment for the first 14 days and take antiviral medication for 10 to 14 days. The toughest part of a deep peel is avoiding sun exposure completely for three to six months. Again, makeup needs to be shelved as well; after 14 days, you can cover any skin issues with mineral makeup — but not a day before. Due to the invasive nature of a deep peel, several follow-up appointments will be necessary to monitor progress. And, just so you know: You can only have one deep peel in your lifetime, so follow the directions of your professional to a T to ensure successful results.

Now that you know what each peel does, how should you prepare for one?

First, determine if you are a candidate. If you are nursing or pregnant; suffer from psoriasis, eczema, dermatitis or rosacea; have taken Accutane in the last six months; or have an infection, you’ll want to hold off on that peel appointment. Additionally, if you have darker skin, talk to your dermatologist about any potential issues that may arise.

If all’s a go, you may be put on a pre-peel plan for two to eight weeks that will help stave off potential side effects (more on those below) and speed up the healing process; this is a discussion to be had with your dermatologist. On the day of your peel, your skin will be cleansed thoroughly to prep it for the treatment. For a deep peel, which is performed in a surgical setting, a topical anesthetic with sedation or general anesthesia is administered. After your skin is prepped, your professional applies the peel quickly and evenly, keeping an eagle eye on your skin to adjust for the perfect time to remove it. For a deep peel, your dermatologist will treat the skin in small sections so as not to shock the body. Finally, when the peel is removed, skin is treated according to the type of peel and patient needs: Medium peels may require a cool compress followed by a soothing lotion, while a deep peel may involve an ointment and surgical dressing.

Now, about those side effects:

Yes, those who opt for peels may experience possible side effects. The most common are persistent redness that lasts for months, scarring, temporary darkening of the skin or, conversely, lightening of the skin (with medium and deep peels). However, most side effects that occur with chemical peels happen because of, ahem, the patient (that’s you!). Your dermatologist will instruct you to avoid the sun and tanning beds, care for your wounds, resist scratching and picking, and lay off makeup until an agreed-upon date. It’s more than likely that if you follow all of your dermatologist’s orders, your skin will look fresh and beautiful in the prescribed amount of time!

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