Jessner, TCA, and Phenol peel today
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free skin care · Fri Jul 24, 2009 3:38 pm

I'm about 4 hours post peel right now and it's really painful. This is my first post but I wanted to see if anyone else has had these peels. I've had Jessners before and liked the results...but today I had first a Jessner, then TCA peel including all around my eyes, then Phenol on the upper lip and he did a few extra areas.

I prepped my skin for a couple of weeks using Tazorac. Today they first put numbing creme on my face and gave me a steroid injection to reduce swelling, then Valium and Lortab, and then a nerve block of six injections in my face. The doctor I went to is a national expert on peels and he was really the "inspiring confidence" kind of doctor. There were a couple other people in the room assisting him. I have to say it was pretty intense but they all kept saying how great I'm going to look.

So now it's day one and I think it's going to be another 7-10 days before I can even leave my house. Day 3 is supposed to be the worst, I can't wait...haha...JK!

Do any of you have experience with this peel combo? I've read a lot of forums talking about DIY peels, I wouldn't attempt this in a million years on myself. Shock

They gave me a plastic bottle with a long pointy end so that I can drink by pouring it down my throat and now opening my mouth too wide. When I had the Jessner peels it was very Freddy Kruger like during the first 6 days but I can't imagine what this is going to be like???

free skin care · Fri Jul 24, 2009 5:03 pm

Hi Secretly,
I haven't had the peels you mentioned, but I'm very interested in your experience!

What skin issues are you addressing and hoping to correct?

I'm considering a Jessner's at some point for some overall refinement of my skin after I finish the Obagi Nuderm system.

Hope you're doing well -- and not in too much pain. Please post back as I'd like to know how you're doing!! Seems like a pretty intense treatment!

free skin care · Fri Jul 24, 2009 5:12 pm

No secretly, no experience with this combo. You really went for the heavy duty stuff here and should see a major difference when you heal. I expect that it will be very uncomfortable, I hope your doctor gave you good after care instructions. Please keep us posted as to your healing process and results.

free skin care · Fri Jul 24, 2009 5:29 pm

Thanks to both of you! I'm 58 and I look pretty good for my age because I've never gained and lost a lot of weight, so minimal to very little sagging. I do have a loooooooong history of acne and I had some scars, some pre-cancers, and blotches. My skin was looking very un-fresh and dull with lots of fine lines.

This doctor worked along side Obagi back in the day, he said they were competitors so he's really top notch. They showed me pics of women who looked very old, wrinkly and saggy and the results were phenomenal.

I'm hoping to look like I do when I take a pic and airbrush it, now I just look tired, scarred, and blotchy with upper lip wrinkles (the phenol is going to get rid of them!!). He said it does tighten the skin up some and will do a lot for around the eyes too. The pain is much better now I just feel tight and burny. I'll keep ya'll posted.

They gave me some bismuth powder I think for the upper lip area when it starts to ooze, and lots of other stuff, a "post laser kit" that has a water aerosol spray that feels really good. And pain medication etc. Yeah I did go for the heavy stuff because I thought I would see how much improvement it would do before any slicing and dicing! Very Happy

They also said NO EXERCISE for 71-10 days!!!!

free skin care · Fri Jul 24, 2009 7:48 pm

Secretly, I just wanted to give you some words of encouragment. I am 2 wks out from my own 25% TCA peel and the first week was horrible. When I read your post I kept on saying, "What a woman!!!" Shock

Right now, I have a few little scraggles right here and there, but not as bad as it was.

It wasn't until I was forced to get a new * spam * that I noticed how great my skin looked. Dreading the photo I had to get, I was so nervous, hell this can't be changed for 6 years! When it printed up and I saw my skin......AMAZING! Smile

I barely wear makeup anymore, I just know that it is bad for my face and acne. I couldn't even wear it so close to my initial week of peeling but I was jumping up and down at the DMV! I only had mascara on!

You are going to look great! Just stick in there! YOu have a long road of healing ahead of you! Keep us posted. These are going to be very emotional weeks for you and we are all here. Hell, we have...somewhat...gone through what you are going through right now!

free skin care · Fri Jul 24, 2009 7:49 pm

Sounds great, Secretly! I didn't know that different peels could be performed one on top of the other. The phenol peel is the "Big Gun" of all the various peels -- is that correct?

How do you think the peels compare to laser resurfacing?

free skin care · Fri Jul 24, 2009 7:49 pm

Sounds rough! All I can say is I sure hope the results are killer! Because it sounds like the recovery is... Laughing

free skin care · Fri Jul 24, 2009 8:00 pm

Well, I know that I do not need that intense of a peel at my age. I would just ruin it, but yes, Phenol is the 'Mac Daddy' of them all. The hard thing is that you really have to stay out of the sun AND use sunscreen religiously.

That is the hard part for me. I am an absolute sun worshiper. I have a convertible! But, I know that if I truely want to turn my skin around and not abuse it like I have, I need to do this and stick with the after care regimin.

free skin care · Sat Jul 25, 2009 6:53 am

Thanks for all the super replies, I woke up in the middle of the night with intense burning on my upper lip but went back to sleep. It's very burny looking and tight/swollen today.

This doctor told me the phenol is a one time, never have to do it again type peel. And if you have the full face phenol you have to have cardiac check up and monitoring etc. Miss Tina you ARE way too young to need this, I love your story, I'm def going to get a new DMV shot after this.

And kims I've had 3 Jessners, 2 were GREAT because they first did dermabrasion so the peel "took" really well, without the dermabrasion I hardly peeled at all. Also prep your skin with retin-A or tazorac first, so you can get the best results. They are SO worth it.

free skin care · Sat Jul 25, 2009 7:14 am

Just wanted to let you know I'm following your progress. I have had TCA at my derm, but that is really mild compare to yours. I went back to work the next day, started peeing three days later, and peeled for a week. Not a huge change, just a little fresher looking. I have been using Retin A for forever. I am rather poor right now, so can't go to the derm (I may order an over the counter peel, but would not do a very strong one at home.)

I saw the befores and afters of your type peel in my derm's office, and they were AMAZING. It took off 20 years and looked like a new skin. I will be reading your posts for your updates. Feel better soon!

free skin care · Sat Jul 25, 2009 1:44 pm

Hi Secretly,
Hope you're progressing well today. I think you're going to have fantastic results!

My esthetician offers a Jessner's peel which I think I might try within a few months. Since I'm using Obagi, I've been using Retin A for about four months now.

Did you have the microdermabrasion on the same day as the Jessner's? How was the peeling?

I'm still looking at peels vs. laser. Do you have an opinion? Thanks!

free skin care · Sat Jul 25, 2009 3:17 pm

Hi Secretly,

Just wanted to say how brave I think you are.
Good luck with the healing, I'll look forward to reading your progress reports. Very Happy

free skin care · Sat Jul 25, 2009 5:52 pm

I had a CO2 peel a while back and it took a week to feel comfortable going out. I also wore pink to go with my skin so I wouldn't stand out so bad. Smile

Hang in there, you are going to love the results so all that you are dealing with right now will be worth it.

free skin care · Sun Jul 26, 2009 8:19 am

I couldn't post an answer yesterday cause I'd reached my 5 post new person limit. Today I'm more swollen, itchy, burny, uncomfortable. Gosh I didn't realize I wouldn't be able to floss my teeth!

I'm doing a picture diary which if I'm brave enough will upload online in a PDF file. My friend said I look 100 years old and beat up by aliens.

It was ok sleeping but I had to sleep on my back most of the night or with my head hanging over the pillow on the side.

I can't wait to start peeling but right now it's really a wound, not even close and my upper lip is really big....

kims yes I had the micro-dermabrasion in the same procedure, then followed by the Jessner. And the esthetician was really into making it as deep as possible, she was in a dermatology office, also she just threw it in I didn't have to pay extra.

My advice would be to ask a lot of questions and to find someone that is used to doing it that way, because the results of with MD and without were like totally different peels. Or ask if there is any way you can get it as deep as possible. With MD I swelled a little, got really tight and burny, and peeled very heavily. Without I barely peeled and felt like it was a waste of money.

I saw PS talking about laser vs. peels but I can't post the link because I'm new here but you can find it by Googling:
Chemical Peels vs. Laser Peels - Watch WebMD Video

From my experience and asking tons of questions I think any procedure depends on your skin and your skin condition along with the experience of the person working on you.

My doctor also said I have "thick" skin which surprised me to hear cause I feel very thin in the face area. I asked him, "Dr. X (derm across the street where I got my Jessners) said they don't do TCAs because of the risk what do you think?" He said, "Dr. X is very young and it's all about experience." and then he told me about his long history and experience with peels. I asked him, "I had my eyes done when I was 35 and the receptionist in the PS office had him do a phenol peel and her skin was disfigured." He said, "We use a much lower diluton of phenol now and things have changed a lot over the years." So ask questions and find out what you can get that will be the best peel for what you can afford.

So another day of trying to figure out how to make it go by, have to confess I ended up painting my dining room yesterday. I just cranked down the A/C really low and stopped any time I felt like I might be sweating. I can't just sit around and do nothing! Today I'm going to do some "mild" ab exercises and some arms, as long as I don't strain or sweat I think it's OK?

Oh yeah also I have a lighted magnifying makeup mirror (love it!) and it's so fascinating to look at my face up close!

free skin care · Sun Jul 26, 2009 11:48 am

Secretly,
THanks for the post and the update! I bet you do look kind of scary ha ha!

I will do as you suggested and do some research on line in regards to chemical vs. laser peels. My face is better with using Obagi and I still have several weeks to go, but I am considering some type of procedure to really get it where I want it. I think the trick after that is to have a good skin care regimen ready to go in order to maintain the results.

Take care!!

free skin care · Mon Jul 27, 2009 10:49 am

Day 4 and I'm starting to look more human. Last night the itching & tightness was so intensely uncomfortable I had to peel off my cheeks on both sides to relieve the tension. Today I woke up swollen still, it's just all over now. I've been putting Vitamin E from a capsule on it. Gosh I've been keeping a picture diary and day one I looked exactly like you look with a nylon stocking over your head it's SO FUNNY!

Also last night I thought Oh already peeling this isn't going to be any better than Jessners, NOT! The area he did around my mouth with phenol is going to take at least 10 days to do anything, and also the other spots he got with the phenol. I still look very burned and injured looking.

The new skin is really gorgeous too, I'm psyched!!! I'm not going to peel it anymore myself I just had to a little last night because it was so tight and itchy it was intensely painful.

Miss Tina I saw you talking about going to school on another thread and would love to throw in my 2 cents if you don't mind (didn't want to hijack that thread). Have you thought about going to nursing school? I'm an RN and the doors that license opens are endless. If you got your degree on top of easthetician license you could do botox, restalyne, and laser treatments etc. in a doctors office. I know RNs who did the same thing I did (Pediatric trauma) who are now working with PS and doing interesting stuff making great $. Also you're very gorgeous which is something to your benefit when you apply to work for PS, and with a nursing degree you can do many things in derm or PS offices.

Mon Jul 27, 2009 3:52 pm

Those of you who have researched this, please help me with "peel confusion". I wish I could understand the theory behind the deep peels, but I can't. I thought the new thinking was to leave the skin's outer barrier intact. Doesn't a deep peel demolish the epidermis, or does it improve it and somehow make it thicker?

Also, would a moderate TCA peel repeated frequently accomplish the same thing as a single deep peel?

free skin care · Mon Jul 27, 2009 4:31 pm

The chemicals vary in strength and depth of peeling, but basically they boost collagen formation and cause the top skin layer of skin to peel off leaving fresher, tighter skin cells that are not as damaged. The depth of the peeling action also varies by factors such as how long the chemical remains on the skin and whether they are applied lightly or rubbed more vigorously onto the skin.

Superficial peels don't affect the deep skin cells so depending on your skin's condition it really depends on what affect you're going to have.

I thought my skin quality was really nice, I do have "great" skin, but it had a lot of damage, scars, fine likes, blotches etc. That's why I wanted a deeper peel.

Face4ward I copied this rundown, maybe this makes it clearer for you. (necrosis is "death" or destruction).

Levels of Peels

Very superficial (exfoliation): These peels thin or remove the stratum corneum and do not create a wound below the stratum granulosum.

Superficial (epidermal): These peels create necrosis of part of all of the epidermis, anywhere from the stratum granulosum to the basal cell layer.

Medium (papillary dermal): These peels create necrosis of the epidermis and part or all of the papillary dermis.

Deep (reticular dermal): These peels create necrosis of the epidermis and papillary dermis, which extends into the reticular dermis.

Classification of Peeling Agents

Very Superficial: Glycolic acid 30% to 50% applied briefly (1 to 2 minutes)
Jessner's solution applied in 1 to 3 coats
Low-concentration resorcinol 20% to 30% applied briefly (5 to 10 minutes)

Superficial: Glycolic acid 50% to 70% applied for a variable time (2 to 20 minutes)
Jessner's solution applied in 4 to 10 coats
Resorcinol 40% to 50% applied for 30 to 60 minutes.
TCA 10% to 30%

Medium Depth: Glycolic acid 70% applied for a variable time (3 to 30 minutes)
TCA 35% to 50%
Augmented TCA (Jessner's solution plus TCA 35%, glycolic acid 70% plus TCA 35%)

Deep: Phenol 88%
Baker Gordon Phenol Formula

I've read that doing phenol peels is a real art and that many doctors don't do them because they don't feel qualified.

free skin care · Mon Jul 27, 2009 4:41 pm

secretly wrote:

I'm about 4 hours post peel right now and it's really painful. This is my first post but I wanted to see if anyone else has had these peels. I've had Jessners before and liked the results...but today I had first a Jessner, then TCA peel including all around my eyes, then Phenol on the upper lip and he did a few extra areas.

I prepped my skin for a couple of weeks using Tazorac. Today they first put numbing creme on my face and gave me a steroid injection to reduce swelling, then Valium and Lortab, and then a nerve block of six injections in my face. The doctor I went to is a national expert on peels and he was really the "inspiring confidence" kind of doctor. There were a couple other people in the room assisting him. I have to say it was pretty intense but they all kept saying how great I'm going to look.

So now it's day one and I think it's going to be another 7-10 days before I can even leave my house. Day 3 is supposed to be the worst, I can't wait...haha...JK!

Do any of you have experience with this peel combo? I've read a lot of forums talking about DIY peels, I wouldn't attempt this in a million years on myself. Shock

They gave me a plastic bottle with a long pointy end so that I can drink by pouring it down my throat and now opening my mouth too wide. When I had the Jessner peels it was very Freddy Kruger like during the first 6 days but I can't imagine what this is going to be like???

Did your Dr. prescribe a salve of some sort? Mine did and it saved the day. Wish I could remember the name of it, I do remember she gave me a tube and I bought one OTC.

Mon Jul 27, 2009 5:24 pm

Thanks very much, Secrets. I'm beginning to understand a little. Also, I just read on Dr. Todorov's forum that wrinkles reside in the dermis. That's a new one on me, and surely explains why a very deep peel can help with wrinkling (and why a few mild peels would not, since they do not reach the dermis). However, I don't understand the "necrosis" factor. Isn't necrosis a bad thing? And since a deep peel is burning right through the epidermis, how does one get back to having a fully functioning epidermis?

free skin care · Mon Jul 27, 2009 10:45 pm

secretly wrote:

Miss Tina I saw you talking about going to school on another thread and would love to throw in my 2 cents if you don't mind (didn't want to hijack that thread). Have you thought about going to nursing school? I'm an RN and the doors that license opens are endless. If you got your degree on top of easthetician license you could do botox, restalyne, and laser treatments etc. in a doctors office. I know RNs who did the same thing I did (Pediatric trauma) who are now working with PS and doing interesting stuff making great $. Also you're very gorgeous which is something to your benefit when you apply to work for PS, and with a nursing degree you can do many things in derm or PS offices.

That is what I would love to eventually get to. I already have my BS, however, this is in psychology so when i try to get into nursing school, I will hopefully have a step ahad. Thanks for the info though. I definatley would love to go that route! It is my dream and passion!

free skin care · Tue Jul 28, 2009 9:40 am

Face4word, the necrosis that they are talking about is "controlled" damage of the skin layer, the skin layer regenerates. The peels are designed to only go a certain depth so that the layers that control pigment aren't destroyed. I was reading about why they use different peels together and basically they found that if they use something like jessner or glycolic acid to partially remove the top layer then it's a better result with less risk of damage to follow that with a lower concentration of TCA. The higher concentrations TCA by itself were what was causing skin damage in earlier days of peels.

Frodo, they gave me aquaphor by Eucerin and I'm also using Vitamin E out of a capsule. I don't know anything about Co2 peel? Can you tell me?

Day 5 my face is bright red, forehead and upper eyes haven't peeled, it looks like my upper lip wrinkles are gone, WOW! My eyelids were so heavy by the end of the day yesterday from the lizard skin on them. My face is still a little swollen and I have a lot of scabbys on my forehead from where he zeroed in on the pre-cancers there.

So it looks like I may be able to leave the house with makeup on by Friday. The nurse is going to email me their "before" pics so I can have those for my photo diary. I'm going to see the Dr. a week from Friday and talk to him also about a little filler in some of the acne pits I have left on chin area.

Miss Tina, I wish I would have had the options that you have now when I first started my RN career. I loved ICU trauma but it's very burnout inducing and if you work in a PS or derm it's 9-5 and your work is full of joy making women look more beautiful. With your degree you'll have to take Human anatomy, physiology, Microbiology and Chemistry (inorganic, organic and biochemistry) in order to start the nursing program. But if I were you I'd take as much as possible in an accelerated program, then when you graduate work for 6 months in acute care and a year in ICU and you will be SO MARKETABLE. The time flies too, I have 2 friends in nursing school right now and I love to give pep talks and be encouraging. Let me know if you ever have any questions.

free skin care · Tue Jul 28, 2009 9:48 pm

That is awesome and so generous of you! Yes, I will definitely keep that in mind to make sure that I keep myself on top of the game!

Thanks for the tip!

free skin care · Wed Jul 29, 2009 8:43 am

Miss Tina you're welcome!

Here I am day six and first I have to rant about yesterday which was really pretty horrible. I looked so hideous because my face had pretty much peeled but was bright purple red especially in the middle, I had crusty rashy skin all around my mouth, my face was really swollen, so tight, I felt like I had snorted a blow torch my sinuses burned so bad, my eyes also hurt and burned from having the weight of the lizard skin on them, and to top it off I looked like I had small pox or cigarette burns on my forehead. Sad

I was also feeling a little wrung out and very stir crazy. I put mineral oil ointment in my eyes before bed because that always helps my chronic eye pain problem.

Today I'm more calmed down but I see that my whole face is going to peel again, around my mouth is still very red but I don't look like an alien lizard, the swelling has gone down, I don't feel as burny hot, and the burns on my forehead are more red scaly instead of out and out wounds.

Wow, I hope that's not TMI...it's going to be worth it but seeing yourself look so scary and hideous day after day takes a little toll. A week from Friday I'm also going to get a little filler and I've had my upper lip done before and it swelled up like I got hit with a baseball bat so I know I'm in for another 4-5 days of hibernating after that too. The pain, agony, and hideousness we go through to be more beautiful...haha.....!!!!!

The nurse emailed me my before pics too yesterday and that was another rather unpleasant experience. But today I feel a lot more up and relieved, The skin around my eyes looks markedly better, almost like I got my eyes done. So we'll see, it's only going to be a few weeks to be done with this. In the mean time I'm really glad I have this forum because ya'll are great in your support and listening..! Thank you. Embarassed

free skin care · Wed Jul 29, 2009 9:54 am

Hey Secretly,
Sounds like you're hanging in there! Maybe the worst is over...?? You know, I think you've hit on an important point when anyone gets a procedure that requires some down time -- especially one that impacts your looks. I think doctors can be very good about preparing us for what physically lies ahead in terms of healing, but they often neglect the emotional side. I think many people can feel a little depressed during the healing process, and I don't think those issues are addressed much. I guess that's why it's so important to really do your research in regards to a procedure.

Since you're going to look absolutely fabulous when all of this is over, what kind of skin care regimen will you need in order to maintain your fresh new look?

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