In addition to Dr. Macdonald’s double-board certification in facial plastics & reconstructive surgery as well as head & neck surgery, he has taken a keen interest in and pursued advanced knowledge in cosmetic dermatology. His in-depth understanding of the skin’s natural aging process and his familiarity with various maintenance regimens and products that promote good skin health, with improved natural elasticity and youthful appearance, is highly valued by his patients. Both surgical and non-surgical patients benefit from Dr. Macdonald’s focus in this area as it often helps to maximize the outcome of their treatments, and elongate the results.
Dr. Macdonald routinely performs physician-strength peels (or series of peels, depending on the patient’s “recovery time” requirements) to help his patients achieve healthy, rejuvenated, vibrant, youthful skin with minimized texture, tone and pigmentation irregularities. A general description of the types of peels he performs is provided below.
Light Chemical Peels
Chemical peels range from very superficial to deep, depending on the chemical used. Dr. Macdonald tends to use the Co2 or Erbium laser for deeper peels, TCA for medium peels and glycolic acid, AFAs (Amino Fruit Acids) or PCA (containing a combination of light peeling and depigmentation ingredients) for lighter peels. The advantage of the lighter peel, when performed for the correct indication, is that there is virtually no recovery time required. Glycolic acid is a natural substance derived from sugar cane, which stimulates the production of collagen and thickens the dermis. AFAs are potent antioxidants and exfoliants. The PCA peel is an enhanced jessner’s solution with hydroquinone and resorcinol.
Because the penetration and effectiveness of these peels is considered “light”, a single peel alone does not usually produce significant results. Instead it is recommended that these peels be performed in a series. Ten days to 3 weeks is allowed between each peel in the series, so that a series of 5 peels will normally take 6 to 15 weeks to complete. Once the initial series is completed, patients will often consider going on to have a “maintenance series” of treatments, with a longer interval between peels, to maintain the health of their skin.
These peels can dramatically lessen the appearance of fine lines, reduce visible photo-pigmentation (age spots), and reduce irregularities in skin texture and tone. They are an excellent basic platform upon which to maintain the skin’s optimal health and appearance.
Recovery Information
As noted above, there is virtually no recovery time required. There may be some light flaking of the skin, similar to that which occurs after a sunburn. If this does occur, it usually begins 2 to 3 days after the peel and continues for 2 to 3 more days. It is easily controlled with a light moisturizer. Please use a good sunscreen during your series of peels (and as a part of your regular skin care routine!).
Medium Strength Chemical Peel
The Obagi Blue Peel is a significant improvement in skin rejuvenation over light chemical peels. This type of peel is particularly well suited for the management of uneven skin pigmentation or areas of hyperpigmentation, including melasma. It is considered a “medium” strength peel; however, it may take 2-3 peels to obtain the maximum desired improvement in wrinkles, scars or large pores. Deep pigmentation or spots may need a greater number of Blue Peel procedures to achieve desired results. The best time to judge the results of the TCA Peel is 3-4 weeks after complete healing.
Procedure Information
A topical anesthetic gel is used prior to treatment to minimize any discomfort. Varying concentrations of the peeling agent TCA is mixed with a special base prior to its application. Depending on the condition of your skin, 1-3 coats of the TCA peel will be applied. At each treatment level, you may experience a mild burning sensation. Because TCA is self-neutralizing within 2-3 minutes, any burning sensation resolves within this short time.
Recovery Information
Your skin will begin to peel within 2-3 days and should be healed in an average of 7-10 days. Healing is usually painless but may be accompanied by the following common reactions: minor swelling, skin temporarily darkening and feeling tight, occasional itching, and perhaps a mild degree of oozing.
To aid in optimal healing after a TCA peel, follow these home care instructions:
- 2x/day for 7-10 days (or until skin is completely healed)
- gently cleanse with cleanser and tepid water
- apply light moisturizer (do not over-moisturize); keep skin dry
- for itching, use Tolereen or 0.5% Hydrocortisone sparingly
- Avoid sun exposure or use of sunscreens until skin is healed
- Do not pick, rub or force off any skin
- Avoid extreme facial expressions for the 1st week
- Sleep on your back
- Avoid strenuous exercise and sweating until skin is healed
|
