Facial Peels

Chemical face peeling is a time tested technique that when performed properly provides significant rejuvenation with minimal healing time.

There are many types and levels of chemical peels that vary from extremely superficial peels to deep peels. The very superficial chemical peels may be performed by beauty salons or non-medical facilities. Although these “lunch time” peels provide some benefit, they are in no way as effective for rejuvenation as the deeper peels. The deeper face peels require IV sedation for pain control. All of the discomfort happens while the patient is sedated. After this, the healing is virtually pain free. The face feels tight and small areas of irritation my be noticed, but the pain is much less than a sunburn.

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Chemical face peeling can improve fine lines and small acne scars. The main benefit of chemical face peeling is a rapid turnover of the skin cells which causes the formation of new collagen. This causes a generalized tightening of the skin and eliminates much of the superficial pigmentation such as sun spots, age spots, liver spots, freckles and blotchiness.

Click here to see Dr. Niamtu‘s Blog on sunscreens and protecting the skin from sundamage.

Trichloroacetic acid (TCA) is a common peeling agent that can improve fine wrinkling and pigmentation problems. This type of peel is done with IV sedation in our fully accredited surgery center. The TCA solution is applied to the face and reacts with the skin. The procedure takes about 30 minutes. The patient feels like they have sunburn for the first day. At 4-5 days, the skin begins to peel and the “new” skin becomes visible. The improvement is obvious immediately and is much smoother than before the peel. Most of the abnormal pigmented areas are cleared as well. Most patients heal by day 7 and are back in makeup. Patients usually miss one week of work when recovering from a face peel. This is one procedure that has virtually no post operative pain and the patient could acutally not miss any work if they were not interacting with the public. The peeling skin would be quite visible, but again, it does not hurt or prevent the patient from working.

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The above image shows Dr. Niamtu just after TCA peel and progressing to day six. He did not miss any work during the peel
recovery. (click to enlarge picture)

The new skin is sensitive and sun protection is imperative to preserve the effects of the peel and to prevent the skin from premature aging. We also encourage all of our chemical peel patients to begin our medically based skin care program after the peel to maintain their rejuvenated skin.

For patients with more severe sun damage and wrinkling multiple peels may be performed. Most patients can be safely peeled again three months later.

Obagi Blue Peel, Richmond VAThe Blue Peel (Obagi Peel) is a type of peel that is gentler than some other types of face peels. This type of peel may be used on all skin types including African-American, Asian and Hispanic. Aggressive chemical peeling can cause permanent pigmentation problems with darker skin types. The Blue Peel is a safe alternative to aggressive peeling and is safe with all skin types. The Blue Peel is also performed in the outpatient facility with IV sedation and requires a one week recovery period. Our office deals with all skin types and colors to safely improve skin imperfections and pigmentation problems.

The  patient to the right is shown immediately after an Obagi Blue Peel. The blue coloring is washed off after the procedure.

What is the recovery for a face peel?

Face peel recovery depends upon the depth of the procedure and the amount of skin damage.  Most patients can return to work at one week.  If residual pinkness is present at that time, makeup can be worn.  Patients that work from home or don’t work with the public usually don’t miss any work as the peel is not painful or limiting.  The reason most patients take time off is because of their appearance not their recovery.

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The above patient is shown during the recovery process of a chemical peel.  A typical recovery is about a week.


The video below demonstrates how the sundamaged skin peels off, leaving the rejuvenated skin beneath.


This patient is shown immediately before her TCA chemical face peel and 7 days later.

The above patient is shown 7 days after medium TCA chemical peel


Post Chemical Peel Hyperpigmentation

Many laser or chemical peel patients can experience temporary hyperpigmentation (blotchy tan coloration of the lasered skin) as part of the normal healing process.  Patients with pigmented skin and/or dark eyes or hair color are more prone to hyperpigmentation.  It is a temporary condition and resolves in several weeks with bleaching creams.  Post laser hyperpigmentation will generally appear about a month after the procedure and resolve in the recovery process.

Chemical peels can be used in many age groups. They can be utilized in younger patients as part of an acne control program or to improve pigment problems. In adults the most common reasons for face peeling are wrinkles, dark spots and weathered skin. The face peel can remove decades of skin damage like stripping layers of paint from an old wall.


The above patient was treated for excess freckles. Although the chemical peel can dramatically improve freckling, prudent skin care and sun protection is important to keep them away.
The above patient was treated with the Obagi Blue Peel to improve pigmentation spots.  The left handed pictures shows the large areas of brown spots on the left cheek and the right handed picture shows the improvement after peel.



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The above patient was treated for lower eyelid wrinkles with a 5 minute TCA chemical peel

Dr. Niamtu has published a 1,000 page comprehensive textbook on cosmetic facial surgery which includes a large chapter on facial aging.  Few surgeons receive the honor to publish such a text with a major medical publisher like Elsevier.