The Erian Centre for Cosmetic Surgery

Patients with fair complexions are better candidates than those with olive toned skin because with the latter it is more difficult to blend the demarcation line (where the peel begins and ends). Every effort is made to “feather” (blend) this line in all patients. The different color and texture from one area to the other can be a permanent effect, even if ever so slight. Patients with darker skins are more likely to have irregular pigment changes. Women are better candidates than men because their skin is thinner and there is no heavy hair growth.

TCA and less often used Phenol are chemical agents of choice. TCA has renewed interest and advantages. It is not absorbed by the skin like Phenol and therefore is free of the systemic side effects of phenol which can not be taken lightly. TCA does not burn as deeply so one is more likely to avoid total loss of pigmentation and hypertrophic (thickened) scars. Weaker chemical agents are more available but also with less strength comes less effectiveness. TCA can be applied repeatedly in one to three month intervals and its effectiveness is compared to Phenol with a much improved safety record. TCA is wonderful for the neck area and the tops of hands. A distinct advantage is that the strength can be altered to the needs of the patient.

The inflammatory reaction is red and crusty, peaking in 48 hours lasting at least 10-14 days. Frequently a slight pink discolouration may last up to 3-4 weeks. The epidermal skin regeneration actually begins the second day after application and that is completed usually by two weeks.
Although this is not a surgical procedure, it can be quite uncomfortable for several days, especially when the entire face is treated at once.

Depending on your particular skin condition, the doctor may want to “prime” your skin with retinoic acid cream for a few weeks prior to the chemical peel. This would serve to make your skin more receptive to the forthcoming treatment.At the time of the procedure, premedication is a matter of surgeon’s preference.

Application is section by section. It is necessary to come to the lip border; lips may blister but it is better than to leave a band of untreated skin and in the end you will have a nicer result.

Post operatively there will be a burning sensation for a few hours after application although vaseline will likely have been applied to reduce some of the burning and irritation. Medication may be prescribed to control intense itching the first few days if needed. After healing of the skin is complete, facial lubrication with moisturisers and retinoic cream is continued for 2-3 months and may be considered for continuous daily use.