Dermatologists separate peels into three main categories – Light, Medium and Deep, based on what layer of the epidermis they affect. In general, the deeper the peel, the more dramatic the results, but also the greater chance of side effects, down time, and the greater the skill required to perform them.
What to Expect
After your peel some pinkness may occur but the skin is not open or raw. Some dry peeling may occur afterwards but varies from person to person. You may wear makeup immediately afterwards. Microdermabrasion, which involves vacuuming a fine crystal spray over the face is one variety of a light peel, and is performed by Dr. Berger. She also does a Beta Lift peel, which is a light salicylic acid peel useful for treating acne. These are considered no-down time procedures and do not require a consult ahead of time.
Light Peels
These have become very popular as a way to rejuvenate the face, neck and even chest and back or hands. Light peels remove dead skin layers. This gives the skin a smoother, fresher, appearance; makeup goes on more smoothly, and pores appear smaller especially if you have a problem with plugged pores (comedones and acne). Repeat treatments are possible every month to every week, and are needed to maintain the desired effect.
What to Expect
After your peel some pinkness may occur but the skin is not open or raw. Some dry peeling may occur afterwards but varies from person to person. You may wear makeup immediately afterwards. These are considered no-down time procedures and do not require a consult ahead of time.
Mid-depth or Medium Peels
Medium depth peels take off living cells to papillary dermis allowing the skin cells to regrow and smooth over minor defects, including fine lines. Medium peels are useful for sun-damaged skin where there is a lot of spotting and undesirable freckling often seen in patients who have had a lot of sun or are older.
What to Expect
Numbing of the face with a topical cream and other local anesthesia is required before the procedure for maximum comfort. Because afterwards the skin is open, expect some care of weeping and oozing skin for a week afterwards before makeup can be worn. Afterwards, the brown spots and warts are greatly improved, but there may be some residual pinkness of the skin that needs to be adjusted with makeup or lightweight green tint for up to 6 months. Expect about a 40% improvement in wrinkles and acne pits. Mid depth peels, because of a slightly higher chance of scarring, are performed only by Dr. Berger. A consult is required ahead of time.
Deep Peels, Dermabrasion, and CO2 Fraxel
These deep peels go to the lower papillary dermis and are the best for heavily wrinkled, leathery, or acne- scarred skin. Because living tissue is removed, local anesthesia is required. In addition, deep cooling spray may be used to firm the tissue during the procedure. It is usually best to do the whole face to ensure that the treated skin matches the surrounding areas, but local treatment around eyes for crow’s feet and around lips for lip wrinkles “barcode lips” may be done in older patients where makeup will be worn and color matching is not critical.
What to Expect
Oozing and crusting of the skin may last up to 3 weeks while the skin is healing and smoothing itself out. Residual pinkness of the skin can last approximately 6 months, and the treated area sometimes is more lightly pigmented than surrounding areas. Like the mid depth peel, these are performed only by Dr. Berger and require a consult ahead of time.