Chemical Peels

Chemical Peels

Cosmetic Treatments

Visage offers a variety of chemical peel options to fit your needs that will improve the appearance and texture of your skin.

Pre-Procedure Precautions
  1. Avoidance of Accutane for the past 6 months.
  2. Discontinue retinoids 24 hours prior to procedure.
  3. Avoid sun exposure/burns /tanning beds 24-48 hours prior to procedure.
  4. Avoidance of IPL/Laser procedures for the past 7 days prior.
  5. No waxing, depilatory creams or electrolysis 5-7 days prior to treatment.
  6. Discontinue use of topical agents that may increase skin sensitivity. Meaning no acids or exfoliants that may be drying or irritating to the skin (such as alpha hydroxyl acid (AHA) beta hydroxyl acids (BHA), exfoliating masks, hydroquinone, or benzoyl peroxide acne products- 24 hours prior to chemical peel.
  7. No shaving the day of the procedure.
  8. Skin is clean without lotion, oil, makeup, deodorant, powder, perfume or sunscreen.
  9. Antiviral agent for 2 days prior to and day of treatment if history of cold sores. Fitzpatrick IV–VI, pigment may darken prior to lightening.

NOTE – Patient is denied day of treatment if the following is present: active cold sores, herpes simplex, or warts in the area to be treated, open sores, sunburned, or excessively sensitive skin within the application area, pregnancy, dermatitis or inflammatory rosacea.

Day of Treatment Instructions
  • Do not shave.
  • Omit lotions, creams, make up or deodorant in area to be treated.
  • Arrive with clean washed skin.
  • Inform provider of any changes in medical history and of all medications you are taking
Post-Treatment Instructions

Immediately after your Medical Chemical Peel procedure, your health care provider will provide postcare and a recommended skincare program to maximize your results.
Do not take any anti-inflammatory medications such as ibuprofen, Motrin or Advil. These agents will interfere with the natural inflammatory process that is critical and responsible for your skin rejuvenation.
Avoid sun tanning and prolonged exposure to direct sunlight. When exposed to sun, always use sun screen SPF30 or above. After your chemical treatment it is advised to adopt the less is more rule. Meaning if possible do not put anything on your skin for the first few hours. You may clean your face with a gentle cleanser before bed. (Avoid Cleansers with AHAs and BHAs)

  • Redness or sensitivity (tight feeling) might be present (and last up to a few days) after peel.
  • Peeling may or may not occur; start 3-5 days after peel. Do not pick or scratch at treated skin but instead keep moisturized.
  • Avoid strenuous exercise or sweating for 24 -48 Hours immediately following treatment.
  • Treat skin gently washing with a gentle cleanser, cool water, using hands only and pat dry,
  • Avoid sun exposure for 3 days and if possible 10 days. Apply a minimum of SPF 30 daily.
  • May use mineral makeup after 24 hours.
  • Restart regular skin care regimen in 48 hours and Retinoids in 72 hours.
  • Recommend follow up and repeat treatments – For AFA 20-60, 6 treatments are recommended. (can be performed weekly or bi-weekly)

Chemical Peels

offered by Visage
At Visage Cosmetic Clinic we offer superficial peels with 30% salicylic acid.

Superficial peels are a great way to achieve overall skin rejuvenation with minimal downtime.
They can gently improve fine lines, skin texture and tone, pigmentary concerns, pore size, and overall skin vibrancy.

Superficial peels gently exfoliate the skin, removing dead and sun damaged epidermal cells while stimulating collagen production. This gentle resurfacing treatment will leave you feeling softer, brighter, and refreshed.

Sun damaged and aging skin can be depleted in healthy amino acids and the natural hydration found within a healthy epidermis. AFA peels aim to improve overall tone, texture and skin hydration.

AFA stands for Amino Acid Filaggrin based Antioxidant. Filaggrin is a protein found in the epidermis which plays a key role in the epidermal structure and the amino acids that create the Natural Moisturizing Factor. The Natural Moisturizing Factor is the skin’s natural hydration that allows the skin to maintain an overall healthy tone and texture. AFA peels are derived from fruit acids and have a chemical resemblance to commonly known alpha hydroxy acids (AHA) such as lactic and glycolic acid. These AFA’s are carboxylated precursors to the AHA’s which are derived from immature sugarcane and other fruit plants.

These topically applied gels work to duplicate the natural-moisture-retaining amino acid system of the stratum corneum, and are known for their super antioxidant capabilities and their ability to counteract photopigmentation. They are remarkably non-irritating even at their highest concentrations.

These AFA peels can be used any time of the year, on any skin tone, with minimal downtime. They are minimally irritating, non-allergenic, and non-comedogneic.
These peels aim to improve overall skin tone, texture, dyspigmentation, and even acne.

AFA peels aim to provide overall skin improvement while avoiding irritation. They are a beautiful way to carry through benefits seen from more aggressive treatments pursued in winter months. In addition to supporting an already existing skin care regimen, AFA peels are a great way to start your journey toward more vibrant skin rejuvenation with little to no downtime or irritation.

The pH and molecular size of these AFA peels allows for a keratolytic effect that is subtle, with minimal visible peeling or irritation. Yet the improvements in tone and texture can be seen within a matter of days.

The AFA Progam is ideal for the following concerns:
  1.  Photodamage and dyspigmentation
  2. Sensitive Skin
  3. Dry Skin
  4. Darker Skin types more prone to hyperpigmentation with other keratolytic treatments
  5. Patients pursing non-ablative rejuventation treatments such as IPL or radiofrequency.
In Office Applied Peels are offered as follows:

1. AFA Peel system for dry sensitive skin – AFA 20,30,40,50,60

  • This effective peel system targets improvement in overall tone, texture, and skin hydration and rejuvenation.
  • We recommend weekly or biweekly application for a total of 6 treatments with increasing strength of the peel as you proceed in your treatment series.
  • Monthly use thereafter can maintain the benefits achieved in the initial series.

2. AFA Clay Peel System for Normal to oily and acne prone skin.

  • The clay peel is a 2-step system, first with a clay mask applied and left on the skin for 4-6 minutes before being cleansed away with the AFA Toner Mist
  •  Then the active AFA peel is applied and removed within 1-2 minutes based on skin tolerance and response.
  •  These two steps work synergistically to optimize peeling and limit irritation.
  • The Clay Peel System pushes the envelope of a superficial peel and should be avoided in those with sensitive skin types, rosacea, and excessive dryness.
  • A series of 6 treatments spaced apart by 2 or more weeks is recommended with once per month treatment to maintain the response if desired.
What to Expect on the Day of the Peel:

Your skin will be cleansed before the peel is applied.
The peel is left in place for 3-5 minutes based on tolerance and skin response.
The peel will be washed off with your treatment provider and a toner mist will be applied with an after-peel oil free moisturizer.

The At Home Peel System can also be purchased as a way to support the benefits of your in office treatments.

The easy to use at home regimen is divided into AM and PM treatments that are applied after cleansing and drying the skin.
Three gentle exfoliant strengths are available: Mild, Plus, and Max.
These should be gradually introduced into a skin care regimen without the use of other topical keratolytic products being used in combination (retinoids, lactic acid, glycolic acids and others) to avoid excessive skin irritation.
We recommend starting with nighttime use 2-3 nights per week. Then gradually increasing to nightly and even adding on a morning and evening treatment as desired.
If new to the product, we recommend everyone begins with the Mild and increase strength based on tolerance.

This is a technique of chemical peeling used to treat deep acne scars, such as ice pick scars. TCA, or Tri-Chloroacetic Acid, applied at a high concentration stimulates collagen formation from the bottom of a deep acne scar. This collagen formation is gradual, and over the course of treatments, collagen fills up from the depths of the scar. TCA is placed in focal areas of acne scarring and not applied to the entire facial area. This process elevates the scar so that it may be more effectively treated, perhaps along with other types of scarring, by way of laser resurfacing and microneedling. As with many other acne scar treatments,
multiple sessions are advised for the best results. We encourage patients to complete at least 2-3 sessions, spaced between 4-8 weeks apart.

How long will I take to recover from TCA cross chemical peels?

Immediately following TCA cross, the treated skin turns white. Over a few hours, the area becomes much redder than the surrounding skin. Pin-point areas surrounding the treated area may peel over the next 3-4 days. The skin slowly returns to its normal color over 8-21 days. In darker skin patients, pigmentation changes may be more prolonged. It is essential that sun exposure is avoided in all patients for at least 2 weeks following a TCA chemical
peel. TCA cross can be used to treat acne scars in all skin types. Darker skin patients may develop slight darkening of the treated skin (1-2mm areas), but this typically fades over a period of weeks. Occasionally post treatment darkening may last a few months. The use of sunscreen after this procedure is very important.

Preparing for your appointment:

Products to avoid one week before your appointment:

  • Retinol products and prescription retinoids, such as Retin-A (Tretinoin), Differin, or Tazorac.
  • Products containing hydroxy acids, such as glycolic acid (AHA), salicylic acid (BHA), or benzoyl peroxide.
  • Any exfoliating products that might be drying or irritating.
It is not safe to pursue TCA Cross if any of the following apply to you:
  • Open wounds, excessively sensitive skin, or inflammatory rosacea.
  • Herpes Simplex (cold sores or fever blisters). An anti-viral medication may be necessary prior to treatment.
  • Chemotherapy or radiation treatment.
  •  Autoimmune disease (such as rheumatoid arthritis, psoriasis, lupus, multiple sclerosis, etc.) or any condition that may weaken the immune system.
  • History of keloids.
  • Lengthy sun exposure or tanning 3 days prior and 3 days post treatment.
  • Accutane use within 1 year prior.
  • Use of depilatories, electrolysis, or waxing of the treated area in the past 7 days.
  •  Aggressive peels and ablative treatments within the past 6 months.
  • Pregnancy/lactation.
  • Patients who have had Botox injections should wait until the full effect of their treatment is seen before treatment.
Post-TCA Skin Care Treatment:
  • Sun avoidance is the is of utmost importance (Sunscreen SPF 60 every 2 hours, hat, shade, indoor activities) for at least 2 weeks following the procedure.
  • Wash face as per usual with a gentle cleanser.
  • Scabs will form over treated sites within 3-5 days post procedure. Do NOT PICK OFF these scabs. This will increase your risk of pigmentary changes (dark or light spots). Allow them to naturally fall off.
  • Use a facial moisturizer such as cetaphil, CeraVe, Toleraine or Cicaplast gel regularly.
  • You may apply make-up over the areas as long as it is unscented (mineral based makeup if possible).

Book an Appointment

For a Medical consultation with Dr. Botkin please have your physician fax a referral letter direct to our clinic at fax number: 204-505-5990.

For Cosmetic consultation please call to book an initial assessment with our nurse, Kristina by calling 204-615-0088.

Book a Consult