FAQ peelings

Q. I’m 56 and the skin on my face presents wrinkles on the brow and around the eyes and the mouth, and small dark spots have appeared on my cheeks. What kind of treatment do you advise me to eliminate both blemishes?
A. The most indicated treatment to eliminate these defects is represented by chemical peelings.
Peelings are chemical solutions which allow the skin of the face to be improved and smoothed by removing its more superficial layers damaged by pathological events (scars, acne, precancerous lesions, etc.), by hyperpigmentation or by the effects of the ageing process (wrinkles, loss of skin elasticity or tone, etc.).
Depending on the skin layer on which they act, peelings are divided into superficial peelings (AHA), intermediate peelings (TCA) and deep peelings (Phenol).
Superficial peelings (AHA) such as glycolic acid, lactic acid, etc. allow the most superficial wrinkles of the face and the hands to be removed, the skin to recover elasticity, the small skin marks to be removed, the acneic skin and the post-acneic scars to be improved.
Intermediate peelings (TCA), used in various concentrations, allow the less superficial wrinkles of the face to be eliminated and the skin marks and the small keratoses to be removed.
Deep peelings, phenol-derived and used in various concentrations, allow the deepest wrinkles of the face to be eliminated, the skin to be completely renewed, the skin marks (even the largest ones) and the precancerous lesions to be removed and the post-acneic scars and marks to be improved.
The treatment with superficial and intermediate peelings does not require anaesthesia, while deep peelings need local anaesthetic with sedation and are performed in outpatient care or with one night hospitalization.

Q. Due to teenage acne, I have awful marks on my cheeks. I would like to know if there are any cosmetic treatments capable of eliminating them and whether they are painful or not.
A. Cosmetic medicine and cosmetic surgery allow post-acneic scars to be improved, although no treatment can eliminate them completely.
In my opinion, the most indicated treatments of cosmetic medicine to correct these defects are dermabrasion, chemical peelings and laser.
Dermabrasion is a treatment that allows skin irregularities to be improved by removing the outer layer of the skin, thus making it smoother and more regular.
Dermabrasion is usually performed under local anaesthetic and in outpatient care but, if the area to be treated is particularly large (e.g. dermabrasion on the whole face), general anaesthetic and, hence, one day hospitalization may be needed.
Post-acneic scars and marks can also be improved by chemical peelings.
Peelings are chemical solutions which allow the skin of the face to be improved and smoothed by removing its more superficial layers damaged by pathological events (scars, acne, precancerous lesions, etc.), by hyperpigmentation or by the effects of the ageing process (wrinkles, loss of skin elasticity or tone, etc.).
The treatment with superficial and intermediate peelings does not require anaesthesia, while deep peelings need local anaesthetic with sedation and are performed in outpatient care or with one day hospitalization.
Acne can also be treated by laser. CO2 laser usually provides better results, though it is more invasive than Herbium laser. In both cases, an anaesthetic ointment is applied or local anaesthetic is administered before the treatment.
Finally, fillers like hyaluronic acid may be used to correct the small depressions on the skin but not to fill post-acneic scars. Moreover, since they are absorbable materials, I remind you that the improvement provided is temporary and it is necessary to repeat the treatment after a few months.

Q. How long is the treatment with peelings and hoe much does it cost?
A. The treatment with superficial (such as glycolid acid) and intermediate peelings (such as trichloroacetic acid) lasts few minutes and should be repeated after some days for several times, while the treatment with deep peelings (phenol-derived) lasts about one hour and requires an occlusive dressing.
The cost of the whole treatment with superficial and intermediate peelings ranges from 300 to 600 euros, while the treatment with deep peelings costs 3000-4000 euros.

Q. How long must one wait to appear in public after a treatment with chemical peelings?
A. When superficial peelings are used, the patient can already resume work the day after, in that the only after-effects are a slight redness that persists about 1-2 hours and, sometimes, some small scabs that will disappear after 3 or 4 days and that can be hidden by the make-up. When intermediate peelings are used, you’ll have to wait about one week because, besides the initial flush, there will be exfoliation after 3 or 4 days which will last for 6 or 7 days. In case of deep peelings, instead, the recovery time will be slightly longer and the patient won’t be presentable for about two weeks, in that the treated area will be puffy and oedematous, will show desquamation and all the layers of the skin will be renewed within 7-10 days.

Q. What are the risks and complications of this kind of treatment?
A. The cosmetic treatment with chemical peelings is usually very safe. However, it is a real surgical procedure whose complications (hypopigmentation or hyperpigmentation troubles, infection and anomalous scars) are rare but may occur and can be easily resolved only if the intervention is performed by a specialist in plastic surgery.