What type of physician strength peels do you use? Does it depend on the type of skin?

Question:

What type of physician strength peels do you use? Does it depend on the type of skin?

Answer:

There are several types of physician-strength peels available.  Like any other treatment modality or technology, the technology does not necessarily give the result, but the physician and the type of experience they have with that modality or technology.  The physician-strength peels that we use are trichloracetic acid peel ranging from 10% to a 35% peel, depending on the individual patient.  This is based on my 18 years of experience with TCA peels and all types of skin.

Briefly what determines the type of peel that I would select for a patient is based on their type of skin and goals.  For example, a patient who has fair skin with lots of uneven pigmentation and wrinkles is probably better suited for a 35% TCA peel which is actually performed as an outpatient with sedation.  If the wrinkles are very deep, we still feel that the carbon dioxide laser is the best choice for those individuals although we use this much less frequently because of the recovery and downtime.

As a second example if someone is a Fitzpatrick IV-VI with regard to skin pigmentation (i.e., Asian, African-American or just dark Mediterranean skin) we are more likely to suggest multiple lighter peels when the goal is primarily improving the facial dyschromia (uneven pigmentation).  Nonetheless, peels are a very strong tool and have stood the test of time unlike so many other emerging technologies that are here today and gone tomorrow.

Posted by Dr. Williams