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Dermatology & Cosmetic Surgery

Dr. Eugene Nowak- 336 Oxford St., Suite 101 

(619) 420-1840   

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Chemical Peels 

Some of the most effective and popular cosmetic surgery procedures today don't involve surgery at all.

Very often, improvement in facial lines can be achieved through the use of topical treatments. If you are not ready for surgery, or if all you need is a slight improvement, this can be an excellent interim step. Sometimes, it's an option to delay the need for surgery.

This procedure has a rather unattractive name - but it can produce beautiful results.

It's a way to minimize the effects of aging, such as fine lines and wrinkling over the forehead, about the eyelids and cheeks, and around the mouth.

A chemical peel can also be helpful for superficial acne and skin problems associated with chicken pox and pigmentation problems. Many times, it's performed along with other procedures, such as a facelift or an eyelid lift.

True to its name, the procedure involves a chemical solution that actually burns away the uppermost layer of skin. The solution is applied only to problem areas, except for a full face peel, where it's applied everywhere on the face but the eyes and lips. For many patients (especially smokers), only the area around the mouth is treated.

Although chemical peels may be performed in conjunction with a facelift, it is not a substitute for such surgery, nor will it prevent or slow the aging process. But most patients are usually very happy with their results. A chemical peel can give you tighter, smoother skin that is relatively free of blemishes and wrinkles. It can leave your face looking younger, healthier and prettier.

Types of Chemical Peels


The primary ways in which chemical peels vary is the type of specific ingredients and their strength. How much peeling action they give, will also be determined by how long they stay on the skin and how they are applied to the skin (are they applied lightly or rubbed on).

A chemical peel can be applied to your whole face or just to certain areas of the face; some peels can be used on other parts of the body.


AHA's are a category of peeling agents that includes Glycolic acid, lactic acid and fruite acids. They are the mildest of the peel formulas because they deliver a lighter peel. Even though this is the mildest, most superficial, peel, sometimes just a single treatment will give the skin a fresher, healthier look. However, most people usually need a series of six treatments done over the course of several months.

An alphahydroxy acid peel will do the following:

  • Smooth rough, dry skin.
  • Improve the texture of skin damaged by exposure to the sun.
  • Help to control acne.
  • Minimize the appearance of fine wrinkles.
  • Reduce the look of brown spots.

AHA's can also be mixed with a facial wash or cream in lesser concentrations. This becomes part of a daily skin-care regimen to improve the skin's texture. In some cases, they can be mixed with a bleaching agent to correct uneven skin tones. Or even used as pre-treatment for a TCA peel.


Glycolic acid ("fruit acid") treatments can help produce smoother skin for people of all ages. This treatment works best on people who have rough, sun-damaged skin. It can smooth rough, sun-damaged skin and fade age spots. When the acids are formulated with bleaching chemicals, it can correct areas of uneven pigmentation.

Your first application of glycolic acid cream will include a lesson on how to continue your proper skin-care routine at home. The manner in which glycolic acid is applied depends upon what form it's in: cream or facial wash. Both forms contain about 12% glycolic acid, which is the ingredient that helps slough away dry, sun-damaged skin on the face's surface. Each also contains a special moisturizer and, if needed, a bleaching agent. In most cases, the acid is applied to the face twice daily, either by smoothing on the cream or using the facial wash. Dr. Nowak can adjust the strength of the formulation and/or frequency of its use after evaluating your skin condition in follow-up visits.

Since the glycolic acid thins the skin's outer layer, you'll need to use a sun block consistently to protect yourself from ultraviolet light, and you may even have to stop using certain cosmetics on your face.

Though the degree of improvement varies from person to person, glycolic acid can help produce subtle improvements in both the texture and tone of your skin. In most cases, patients notice an overall freshness and smoothness. Soon, pigmented blotches will fade or disappear as the bleaching component begins to work. Some patients see results in as little as six weeks. Most people find that maintaining their new look is easy - it will become a normal part of your daily routine - and the improvements you'll see will be worth the extra effort.


A TCA peel depth can be adjusted. It's preferred for darker-skinned patients. Often this type of peel is used on the neck or other body areas. TCA can be used in many concentrations, but it is most commonly used for medium-depth peeling. Most people need this treatment repeated every year or two.

A Trichloracetic acid peel will do the following:

  • Smooth out fine surface wrinkles.
  • Eliminate superficial blemishes.
  • Correct uneven pigmentation.
  • Work on smaller areas such as around the mouth or eyes.
  • Work on areas exposed to the sun.
  • Work on the neck and other areas.
  • Be effective on darker-skinned people.

This is the strongest of the chemical solutions. It produces a deep peel. A Phenol chemical peel will do the following:

  • Correct blotches caused by the sun.
  • Correct blotches caused by aging.
  • Correct blotches caused by birth-control pills.
  • Smooth out coarse wrinkles.
  • Remove pre-cancerous growths.

Are You A Good Candidate?


No single part of our body is as affected by everything we do as our skin. If we don't eat right, it shows on our skin. If we don't get enough sleep…if we get too much sun…if we smoke or drink too much… it's reflected in how our skin looks, the texture, etc. So how do we make up for the daily effects that living brings? How do we improve the look of our skin and give it back some of that healthy glow life has taken away and dulled? A chemical peel will go a long way towards addressing these factors and help improve the overall vitality of your skin.

You're a good candidate for a chemical peel if you have:

  • Wrinkled, sun damaged skin on your face
  • Lipstick "bleed" - those vertical wrinkles around your mouth
  • Crow's feet around your eyes
  • Fine wrinkling on you upper lids
  • Blotchy skin coloring or brown spots
  • Pre-cancerous growths
  • Acne scars
  • Chicken pox scars
  • Superficial facial scars form an old injury

Chemical peels are flexible in that there are several different types, depending on the severity or condition of your skin. And you can have a chemical peel at almost any age.

Your Consultation


At your initial consultation Dr. Nowak, will point out the areas on your face or body where you'd like the skin improved.

An examination to thoroughly assess your skin type (and to what extent a peel needs to perform) will determine which peel would be best for you. And even though it's hard to predict completely what the results will be, it is possible to give you a good idea of a peel's outcome.

Your general health may also be discussed. If you think there is something in your medical history that could adversely affect the procedure or proper healing, please tell your doctor. Patients with liver, kidney or heart aliments need to make that known to their doctor. If you have herpes, tell Dr. Nowak prior to the procedure.




Anesthesia is not needed for an Alphahydroxy (AHA) acid peel; they cause only a mild stinging sensation upon application.

The chemical solution in TCA and Phenol peels act as an anesthetic for a few minutes. However, depending on the doctor and the individual situation, a local or a general anesthesia may be given for full face peels.

Even when there is no anesthesia administered, often sedation may be used before and during the procedure to relax you and keep you comfortable.

Preparing Before The Procedure


Sometimes Retin A - a prescription medication derived from Vitamin A - is used to pre-treat the skin. This thins out the skin's surface layer, allowing the TCA solution to penetrate more deeply and evenly. If your skin won't tolerate Retin-A pre-treatment, an AHA cream may be used instead. Hydroquinone, a bleaching agent, is sometimes used in conjunction with Retin-A or AHA pre-treatment, especially if you have blotchy skin areas or pigmentation problems. You may have to spend a month or more in the pre-treatment phase before the doctor will schedule your actual peel.

If you're having an AHA peel or a superficial TCA peel, you won't need any help getting home afterwards. If you are having a Phenol or a deeper TCA peel, it would be best to arrange for someone to assist you.

After The Procedure


After all chemical peels, it's important to avoid any exposure to the sun - direct and indirect - until all the pinkness or redness of the skin has gone away. Once it has, you must use a sun block to protect the skin. Wearing a wide brimmed hat would also be advisable. If you've had a peel around the eyes, wear good quality sunglasses when you're outside. And, depending on the treatment, some people have to be especially careful about exposing their skin to chlorinated water.

Following an AHA peel, it is not uncommon to experience temporary flaking, scaling, redness and dryness of the skin. This will disappear as your skin adjusts to the treatment. You should be able to go back to work and resume normal activity right away.

Following a TCA or Phenol peel you may experience tingling or throbbing. If this is the case, a mild pain medication will be prescribed. If tape was used to cover your face, it will be removed after a day or two. A crust or scab will form on the treated area. A TCA peel may also cause significant swelling, depending on the strength of the peel used. Within the first week, discomfort and mild swelling will subside. In about a week to ten days, your new skin will be visible. In about a week to ten days you should be healed sufficiently to return to your normal activities.

Following a phenol peel, your face may become very swollen. Your eyes may even be swollen shut temporarily. If this happens, you will need someone to help care for you for a day or two.

You may also be limited to a liquid diet. Try not to talk too much during the first few days of recovery, as it may result in facial pain or discomfort. Your face will initially be very red. Make sure you wear sun block (and a wide brimmed hat if possible) when outdoors. All chemicals heighten the skin's sensitivity to the sun, but phenol is even more dramatic in that it eliminates the skin's ability to tan.

In about seven to ten days, new skin will begin to form. In the weeks and months after treatment, skin will gradually fade to a pinkish color. About two weeks after treatment, you may return to work and resume some of your normal activities. Your skin will be healed enough for you to wear makeup. (For makeup tips, ask your plastic surgeon for the ASPS brochure on camouflage cosmetics.)

The Results


You knew you were looking tired and rundown, but you didn't realize the extent of the deterioration until you saw the results of your peel. Not only is the color back in your cheeks, you can now look at yourself in the mirror without wondering what you would look like if you had extra sleep, a healthy diet, etc. You'll still see a familiar face, but one that is rejuvenated.

You can maintain this fresher, improved skin texture with continued AHA treatments. Or if you used the TCA peel, it can be repeated every one or two years. With a Phenol peel, you can expect dramatic improvement in the surface of your skin - fewer fine wrinkles, fewer blemishes and more even-toned skin. And your results will be long lasting. No need for further treatments.

Regardless of the type of peel, your skin will be noticeably smoother and fresher looking. Keep in mind that you are not immune to the effects of aging and sun exposure, so be sure to adopt a good skincare regime.

How do you sign up?  You will receive a complimentary consultation with Dr. Nowak if you call for a appointment at (619) 420-1840.  Your peels can then be scheduled after that appointment.