Highly Effective Facial Rejuvenation

Dr. Guy Cappuccino is proud to offer phenol, trichloroacetic acid (TCA), and alpha hydroxy acids (AHAs) for the purpose of non-surgical facial rejuvenation to patients in Mount Airy, Frederick MD, and the surrounding areas. The precise formula used will be adjusted to meet your specific needs, making this a great way to enjoy your ideal results. Although chemical peel 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.

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Is a Chemical Peel Right for Me?

A chemical peel is most commonly performed for cosmetic reasons -- to enhance your appearance and your self-confidence. 

A chemical peel may also remove pre-cancerous skin growths, soften acne facial scars and even control acne. In certain cases, health insurance may cover the peel procedure. During your consultation, Dr. Cappuccino will get to know your cosmetic goals and walk you through the options you have available to you.

Alpha Hydroxy Acids

Alpha hydroxy acids (AHAs), such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels. These types of peels can provide smoother, brighter-looking skin for people who can't spare the time to recover from a phenol or TCA peel. 

AHA peels may be used to treat fine wrinkling, areas of dryness, uneven pigmentation, and acne. Various concentrations of an AHA may be applied weekly or at longer intervals to obtain the best result. 

Dr. Cappuccino will make this decision during your consultation and as the treatment proceeds. An alpha hydroxy acid, such as glycolic acid, can also be mixed with a facial wash or cream in lesser concentrations as part of a daily skin-care regimen to improve the skin's texture.

Alpha Hydroxy Peel (AHAs) Uses:

  • Smooths rough, dry skin
  • Improves texture of sun-damaged skin
  • Aids in control of acne
  • Can be mixed with bleaching agent to correct pigment problems
  • Can be used as TCA pre-treatment

Considerations

  • A series of peels may be needed
  • As with most peel treatments, sunblock use is recommended
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Trichloroacetic Acid

Trichloroacetic acid (TCA) can be used in many concentrations, but it is most commonly used for medium-depth peeling. Fine surface wrinkles, superficial blemishes, and pigment problems are commonly treated with TCA. The results of a TCA peel are usually less dramatic than and not as long-lasting as those of a phenol peel. In fact, more than one TCA peel may be needed to achieve the desired result. The recovery from a TCA peel is usually shorter than with a phenol peel.

Trichloroacetic acid (TCA) Uses

  • Smooths out fine surface wrinkles
  • Removes superficial blemishes
  • Corrects pigment problems

 Considerations

  • Can be used on the neck or other body areas
  • May require pre-treatment with Retin-A or AHA creams
  • Treatment takes only 10 to 15 minutes
  • Preferred for darker-skinned patients
  • Peel depth can be adjusted
  • Repeat treatment may be needed to maintain results
  • Sunblock must be used for several months
  • Healing is usually quick, much quicker than with a phenol peel

Phenol

Phenol is the strongest of the chemical solutions and produces a deep peel. It is used mainly to treat patients with coarse facial wrinkles, areas of blotchy or damaged skin caused by sun exposure, or pre-cancerous growths. Since phenol sometimes lightens the treated areas, your skin pigmentation may be a determining factor as to whether or not this is an appropriate treatment for you. Phenol is primarily used on the face; scarring may result if it's applied to the neck or other body areas.

Phenol Uses

  • Corrects blotches caused by sun exposure, birth-control pills, aging
  • Smooths out coarse wrinkles
  • Removes pre-cancerous growths

Considerations

  • Used on the face only
  • Not recommended for dark-skinned individuals
  • The procedure may pose risk for patients with heart problems
  • Full-face treatment may take one hour or more
  • Recovery may be slow - Complete healing may take several months
  • May permanently remove facial freckles
  • Sun protection, including sunblock, must always be used
  • Results are dramatic and long-lasting
  • Permanent skin lightening and lines of demarcation may occur
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Potential Side Effects

All chemical peels carry some uncertainty and risk, but the chemical peel is normally a safe procedure when it is performed by a qualified, experienced plastic surgeon like Dr. Guy Cappuccino.

However, some unpredictability and risks such as infection and scarring, while infrequent, are possible. AHA peels may cause stinging, redness, irritation, and crusting. However, as the skin adjusts to the treatment regimen, these problems will subside. With a TCA peel, your healed skin will be able to produce pigment as always; the peel will not bleach the skin. However, TCA-peel patients are advised to avoid sun exposure for several months after treatment to protect the newly formed layers of skin. 

Planning for a Chemical Peel

In some states, no medical degree is required to perform a chemical peel - even the strongest phenol peels. Many states have laws that permit non-physicians to administer certain peel solutions but regulate the strengths to which they are permitted to apply. You should be warned that phenol and TCA peels have been offered by inadequately trained practitioners claiming miracle techniques to rejuvenate the skin. During your initial consultation, it is important that you discuss your expectations and goals with Dr. Cappuccino. Don't hesitate to ask any questions or express any concerns that you may have.

Dr. Cappuccino will explain the planned procedure in detail, including its risks and benefits, the recovery period, and the costs. If you have a history of herpes, you should inform your physician prior to the procedure. Remember, chemical peel treatments are usually not covered by medical insurance unless they are performed for medically related problems.

Retin A for Pre-Treatment

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.

You will need to arrange for someone to drive you home and help you out for a day or two if you are having a phenol or deeper TCA peel. You probably won't need any extra assistance if you're having an AHA peel or superficial TCA peel. 

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AHA PeelsĀ 

Dr. Cappuccino or a member of his team will apply the AHA solution to your cleansed facial skin, a process that usually takes no more than 10 minutes. No after-peel ointment or covering is required. Depending on the strength of the peel, periodic treatments may be necessary until the desired effects are achieved.

For some patients, the application of an AHA-based face wash or cream once or twice a day at home will be sufficient to accomplish the desired goal. Dr. Cappuccino may add Retin-A or a bleaching agent to your at-home treatment schedule. After several weeks of at-home use, he will examine your skin to determine if your regimen needs adjustment.

TCA Peels

Typically, the skin is first thoroughly cleansed. Then, Dr. Cappuccino will carefully apply the phenol or TCA solution. You may feel a stinging sensation as the peel solution is applied, but this feeling will quickly pass.

A full-face TCA peel usually takes no more than 15 minutes. Two or more TCA peels may be needed to obtain the desired result, and those may be spaced out over several months. Mild TCA peels may be repeated as often as every month.

After Your Treatment

After an AHA peel, it is common to experience some temporary flaking or scaling, redness, and dryness of the skin. However, these conditions will disappear as the skin adjusts to treatment. After a phenol or TCA peel, Dr. Cappuccino may prescribe a mild pain medication to relieve any tingling or throbbing you may feel. 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. To help your face heal properly, it is essential that you follow Dr. Cappuccino’s specific post-operative instructions. A TCA peel may also cause significant swelling, depending on the strength of the peel used.

Enjoying Your Results

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. Dr. Cappuccino will work with you to ensure that you know exactly what to expect so you can rest assured and look forward to your incredible results.

For more than ten years, he’s been bringing his patient-centric approach to patients in Frederick, Mount Airy, and beyond, and he’s excited to learn more about how he can help you overcome any cosmetic hurdles you might be facing.

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Your New Look

Improvements from AHA peels may be very subtle at first. You may detect a healthier glow to your skin. With continued treatments, you will notice a general improvement in the texture of your skin. The results of a TCA peel are usually not as long-lasting as those of phenol peel. However, your skin will be noticeably smoother and fresher-looking.

If you're planning a phenol peel, you can expect dramatic improvement in the surface of your skin - fewer fine wrinkles, fewer blemishes, and more even-toned skin. Your results will be long-lasting, although not immune to the effects of aging and sun exposure.

Getting Back to Normal

With an AHA peel, the temporary redness, flaking, and dryness that you experience will not prevent you from working or engaging in your normal activities. A fresher and improved skin texture will result in continued AHA treatments. Remember, protecting your skin from the sun is also important following these mild acid peels. Dr. Cappuccino will recommend a sunblock with adequate UVA and UVB protection.

With a TCA peel, the moderate discomfort and mild swelling you may experience will subside within the first week. In about a week to ten days, your new skin will be apparent and you should be healed sufficiently to return to your normal activities. It is best to avoid sun exposure unless you are adequately protected.

With a phenol peel, new skin will begin to form in about seven to ten days. Your face will be very red at first, gradually fading to a pinkish color over the following weeks to months. During this time, it is especially important that you use a sunblock or blotchy, irregular skin coloring may result.

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