Premier TCA Peels Treatment Center in NYC - Dr. Gary Jayne Rothfeld

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TCA Peels Treatment Center of New York, NY

 
Introduction to Chemical Peels

Chemical peels represent a sophisticated and effective approach to facial rejuvenation, involving the application of chemical solutions to exfoliate and resurface the skin. This treatment is subdivided into three primary categories: superficial, medium-depth, and deep peels, each targeting different skin concerns and depths.

Superficial Facial Chemical Peels

Superficial peels primarily address the outermost layer of the skin, promoting exfoliation and the removal of dead skin cells. The most commonly used agents for these peels are alpha hydroxy acids (AHAs), naturally occurring fruit acids including glycolic, lactic, citric, tartaric, and malic acids. Glycolic acid, derived from sugar cane, is particularly popular. Over-the-counter products typically contain 3-10% AHAs, while physician-administered treatments may utilize concentrations of 50% or higher. The depth of penetration is controlled by the duration of application, with the solution being neutralized by a bicarbonate solution or water rinse.

Alternatively, superficial peels can be performed using Jessner’s solution, which consists of resorcinol, salicylic acid, lactic acid, and ethanol. Application of Jessner’s solution results in a light frost on the skin, indicating the appropriate depth of penetration. Following treatment, patients typically experience redness and minor swelling, with re-epithelialization completing in about a week.

Superficial peels are often used as preparatory treatments before deeper peels, enhancing the efficacy of subsequent procedures. Physicians may recommend a low-concentration AHA regimen prior to or following deeper treatments to maintain results.

Medium Depth Facial Peels

Medium depth peels commonly utilize 20-35% trichloroacetic acid (TCA). The depth of penetration is directly related to the concentration of the TCA solution, with higher concentrations achieving deeper effects. TCA application induces a white frost on the skin, marking the end point of the procedure. The initial burning sensation can be mitigated with topical lidocaine or fanning, subsiding within approximately 30 minutes. Exfoliation occurs over several days, with full re-epithelialization taking about two weeks. During this period, patients may experience redness and flaking.

Deep Facial Chemical Peels

Phenol is the preferred agent for deep chemical peels, often combined with other additives in formulations such as Baker-Gordon, Venner-Kellson, Maschek-Truppman, and Grade. Due to the potency of phenol, these treatments require anesthesia and, in some cases, IV sedation. Phenol peels necessitate cardiac monitoring due to the risk of arrhythmias, as phenol is absorbed through the skin, metabolized by the liver, and excreted by the kidneys.

The face is divided into 6-8 regions, with a 20-minute interval between areas to ensure safe application. Post-treatment, patients experience significant redness that may persist for several months. Discomfort is minimal after the initial 24 hours, with complete re-epithelialization occurring in about two weeks.

Post-Treatment Care

Chemical peels compromise the skin's natural defense mechanisms, necessitating meticulous aftercare. Keeping the treated area moist with petroleum-based creams or other formulations is crucial to prevent scarring. For medium to deep peels, physicians may prescribe antibiotics and antiviral medications to prevent infections and cold sore flare-ups.

Patients must refrain from picking at sloughing skin and adhere to post-peel soaks with antimicrobial solutions like vinegar or hydrogen peroxide. Sun protection is vital for several months post-treatment to prevent hyperpigmentation and scarring. Patients should avoid applying unapproved products, including makeup and sunscreens, until the skin has fully re-epithelialized to avoid adverse reactions.

Close follow-up is essential for medium to deep peels to promptly address any complications.

Expertise of Dr. Gary Jayne Rothfeld

Dr. Gary Jayne Rothfeld, a Harvard-educated, board-certified dermatologist, is internationally renowned for his contributions to cosmetic dermatology. Recognized by the entertainment industry as one of America's leading dermatologists, Dr. Rothfeld has treated some of Hollywood's most prominent faces. At the Park Avenue practice, he offers a comprehensive skin care center, providing personalized, state-of-the-art services in medical, pediatric, and cosmetic dermatology.

Dr. Rothfeld's philosophy emphasizes personalized care, eschewing the use of physician assistants or nurse practitioners. He personally sees every patient, ensuring that treatments are tailored to the unique needs of each individual. His approach is rooted in thorough medical history-taking and physical examination, critical for diagnosing dermatological and cosmetic conditions. This meticulous attention to detail distinguishes his practice, aligning with the highest standards of care.

Why Choose Our Practice?

Our commitment to excellence ensures that each patient receives the highest level of care, grounded in respect, dignity, and courtesy. Dr. Rothfeld's practice is dedicated to providing the same caliber of dermatological care that he would seek for his own family, embodying the ethos of the "Doctor's Doctor."

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