Chemical peels have been applied to improve the appearance of the skin since ancient Egypt. Alpha hydroxy acids (AHAs) are a group of organic acids, some of which are derived from fruits and are sometimes referred to as fruit acids.
List of AHAs and their natural derivatives:
- Glycolic Acid- sugar cane
- Lactic Acid- sour milk
- Citric Acid- citrus fruit
- Malic Acid- apples
- Tartaric Acid-grapes
These products are commonly used in lighter concentrations in everyday skin care products, but intense concentrates can be used as peeling agents. Glycolic acid is the most frequently used AHA for chemical peels. It is usually applied to the skin in concentrations greater than 30%.
- Lighter peels can be performed with 30 to 50% glycolic concentrations, with more aggressive peels using 70% glycolic acid.
Glycolic acid peels can be used for photo-damaged skin to help correct:
- Texture
- Fine lines
- Pigment abnormalities including dyschromias.
Glycolic acid peels are safe and nontoxic. They are relatively superficial with few complications, however a higher concentration Glycolic acid peel can extend into a moderate depth peel if left on the face for longer than 5 minutes.
- The skin should be prepared for the peel for a minimum of 2 weeks with a combination of a retinoic acid and a skin-lightening agent.
- The glycolic acid peel is done in the office without any topical anesthesia.
- The entire face is coated with glycolic acid gel and then neutralized and washed off after 2 to 3 minutes depending on the amount of redness and the patient’s amount of irritation.
- A hand held fan can help alleviate any stinging.
- Deeper pigment can be treated with a deeper Glycolic peel in those areas.
The patient will have mild irritation, redness and crusting after the peel, which may last for up to three days. Expect flaking and dryness which can be alleviated with a light moisturizer, and gentle cleansing. Active skin care is started with in the first week after the peel to help with any propensity for hyperpigmentation and inflammation after the peel. The skin should be protected from sun exposure with a hat and sunscreen.
Lighter glycolic acid and other fruit peels can be repeated every month, though these would be comparable to a deep exfoliation. Stronger glycolic acid peels can be repeated though timing of this relates to the patients individual skin tolerance and healing capacity. A skin evaluation for a chemical peel can be done in the plastic surgery office of Dr. Trussler in Austin TX.
