We use the Phenol peel to decrease the fine wrinkles that cannot be removed by a facelift or eyelid surgery. These wrinkles typically occur in the forehead, around the eyes (including "crow's feet") and the upper lip. Depending on the needs of each patient, part or all of the face may be peeled. After the chemical solution is applied to the skin, the top layer peels like a sunburn. However, it also affects the deeper layers by inducing the deposition of new collagen, the normal protein of the skin. The texture of the skin is improved, rejuvenating the skin and giving it a more youthful appearance. The improvement achieved is long lasting because of the structural change in the skin.
We feel that some type of skin lend themselves better than others to this procedure. Patients with fair complexions, for example blondes and redheads, get much better results than those with dark pigmentation. In fact, people with darker, olive skin may not be suitable candidates for this technique because there is frequently a slight decrease in the pigmentation of the skin depending upon the type of solution used. With any patient, the inherent color of the skin is an important consideration. In patients with fair complexions, this slight decrease in pigmentation usually is not visible and creates no post-operative problems. We often use a weaker solution in patients with darker skin, thereby decreasing the risk of pigmentation changes. However, the results are not as dramatic. Laser resurfacing is an alternative procedure for some patients.
The solution is applied in the operating room under light sedation used to control the slight burning sensation that may occur during surgery. After surgery, the skin will continue to weep a straw-colored tissue fluid for seven to ten days with some peeling solutions. During the "weeping" period, we instruct the patient to keep the skin moist with ointment in order to avoid scab formation. After the weeping has stopped, the patient uses cosmetics to camouflage redness of the skin which may persist for four to six weeks. Redness may or may not occur, depending on the type and strength of solution used. Sun exposure is prohibited for about six months after the procedure and then a sunscreen must be used. If a patient does not follow these instructions carefully, permanent, undesirable pigment changes may occur.
The patient must be extremely careful about sun exposure. If not, there may be irregular, blotchy, increased pigmentation of the treated skin. Some slight decrease in pigmentation may occur after the procedure depending upon the solution which is used and the patient's natural pigmentation. Scarring is possible, depending on the amount and type of solution which is used, but this is very rare.