What Lies Beneath.(cosmetic peels)

What Lies Beneath

At the Dermatologist's Office

Dermatologists are free to drop more acid than a hippie at Woodstock. "Office peels can boast up to a 70 percent concentration of glycolic acid," says Lawrence Bass, codirector of the Center for Minimally Invasive Plastic Surgery at the New York University School of Medicine. That said, superficial peels are usually the most requested, and a new laser promises to put deep chemical peels out to pasture.

Peel Type: Superficial Candidate Profile: Women in their 20s and 30s with minor sun damage, rough skin, and/or clogged pores. The Process: Superficial peels lift surface cells with a glycolic-acid solution or oil-soluble salicylic acid. A mix called the Jessner's solution (lactic and salicylic acid, combined with Resorcinol, a chemical often used to treat pimples) can be more effective on acne. The skin is degreased with an alcohol-based toner before being swabbed with acid. After two to ten minutes of mild stinging, the solution is removed with water or a gentle cleanser. Recovery Period: Superficial peels are often called "lunchtime" treatments, but chances are, you'll still be salmon-hued by dinner. "It'll look like you've been skiing for a day," says Jeffrey Dover, associate clinical professor of dermatology at Yale School of Medicine. "You're pink and a little puffy, and the skin stings a bit." Within 24 hours, those side effects subside, but slight flaking can occur for up to three days. Superficial peels should be followed by a lipid-rich moisturizer, like Rodan & Fields Compounds Moisturize or Clinique Rapid Recovery Cream, to reduce inflammation. Price: $75 to $150. One peel leaves the skin temporarily fresher and more radiant, but it will take at least four to lighten superficial dark spots or unclog pores.

Peel Type: Medium depth Candidate Profile: Women with dark spots, uneven tone, and/or fine lines from deeper sun damage. The Process: A medium peel is a bit of a misnomer. Most commonly performed with trichloroacetic acid (TCA), it breaks up embedded clumps of pigment and fine lines that fester in the base of the epidermis. Many doctors begin with a milder glycolic, salicylic, or Jessner's peel before applying a 35 to 50 percent concentration of TCA. This stronger acid can burn more intensely, and doctors often prescribe pain pills or sedatives. Recovery Period: Reversing sun damage unfortunately requires reliving some of the pain of those burns. The skin is red for a few days until a dark, stiff crust forms over the face. That leathery surface then falls off in sheets, like snakeskin. The process isn't pretty, and most women stay cloistered for about a week until it's complete. Price: $1,000 to $2,000.

Peel Type: Deep Candidate Profile: Women over 30 with deep wrinkles around the eyes and mouth, embedded acne scars, leathery texture, and/or stubborn dark spots. The Process: The phenol peel, a chemical treatment so potentially toxic it requires cardiac ...