PEELS

NATURE OF THE PROCEDURE

Peels remove designated layers of skin. Based upon the type of acid or herb, the strength or concentration, the pH, and the method of application, various depths can be achieved. The depth is generally determined by the intent of the peel - peels are used for acne, skin surface imperfections, fine wrinkling, pigment, and sometimes even specific lesions such as flat warts, or precancerous actinic keratoses.

It is critical that a patient receiving a peel be examined and then diagnosed by someone who is unbiased regarding the need for the peel, and more importantly, properly trained and qualified. Only in a dermatologist’s office can you find a physician who has been trained in the structure and function of the skin. Sometimes the diagnosis of the underlying skin condition is even more important than the type of peel itself. Being told “you need a peel” at a salon is not good enough.

Generally after a peel you can expect a period of frank peeling or at least mild to intense exfoliation. Dr. Coverman’s office offers the following types of peels:

Light acid peel - this is often referred to as a Jessner peel and employs a combination of lactic and salicylic acids. It is used for acne, fine wrinkling, pigment, and mild surface abnormalities such as bumps, old scars, and so forth. Expect 3-7 days of mild to medium peeling of the kind that won’t be too severe but will show through your make-up.
Numbered peels - Dr. Coverman has developed a system to add stronger medicines such as phenol and trichloracetic acid (TCA) to the regular light acid peel and there is a step-wise progression from #1 through #7. Each of these is progressively stronger and will be determined by your reaction to the last one. These are similar to “Blue” peels. Dr. Coverman does not add any unnecessary artificial colors.
Vitalize Peel - Improvement is seen with a single treatment, but cumulative benefits are seen with multiple treatments (3-6) each three weeks apart. This peel is used to treat fine lines, acne, photoaging, and hyperpigmentation. This is gentle enough to be used on all skin types. Expect light flaking with each treatment.
Deep herbal - This is a unique peel offered at our office - a series of herbs are applied one day (usually a Monday) followed by fairly significant and visible peeling for the next five days. You will return at the 5th day (typically Friday) to have the peel “neutralized” and then be ready to enjoy the weekend.
Glycolic peels - Glycolic peels are tricky - it is critical to understand the strength of the peel, the pH of the material, and preparation of the skin. These are particularly good for acne and pigment.
Red peel - Dr. Coverman was the first doctor to bring the new Red Peel to Austin. This was developed in the United Kingdom in combination with the Omnilux LED device. Both are used concomitantly. The Red peel is performed in four stages, and we recommend a series of four treatments - 2-4 weeks apart. This is the first time this peel has been brought to Austin, and can replace other peels such as the Obagi blue peel. In addition, in combination with the Omnilux LED device, which is also new to Austin, you will be getting the best of both peeling and photodynamic therapy.

Step 1 - Hydragel Reticule - This is a complex bio-material that regulates cutaneous permeability, allowing better penetration.
Step 2 - The Red peel. This is a neutralized glycolic acid-based peel which contains an intracellular anti-oxidant. This prevents intracellular free radial formation and damage. It contains 70% partially neutralized glycolic acid at pH 1.9 with DMEA and L-Carnitin.
Step 3 - Skin Rejuvenation Lift Enhancer - This is another hydragel matrix that is soothing and stimulates regeneration of supportive matrices.
Step 4 - Omnilux Revive - This involves exposure to the Omnilux LED device for 20 minutes. This produces a wavelength at 830 nanometers and reduces inflammation. It will stimulate healing, reduce redness from the peel and allow you to enjoy all the results of the peel without so much of the down time of traditional peels.
Step 5 - Reapplication of the Skin Rejuvenation Lift Enhancer for ultimate rehydration and soothing.

This is the first use of this European developed peel in Austin, and Dr. Coverman was the first to bring the Omnilux LED device to Austin. With this you will have the optimum peel with the best results combined with the quickest healing and least down time. This is a unique treatment that has never been offered before.

FEES

All fees are subject to change. The fee is always what is current at the time of your actual treatment. Old fee schedules, handouts, or web site fees do not apply. Any quoted fees must be in writing and are only good for six months. No "verbal" quotes are accepted.

SCHEDULING

All patients receiving peels must be seen by Dr. Coverman or Jennifer Jordan, PA-C the first time in order to diagnose your condition, talk to you about previous treatments, assess what type of skin you have, and certainly give you the option to enjoy other beneficial medical treatments in addition to or instead of the peel. You will not be met by a salesman, a "closer" or anyone else just working on commission. If you don’t need a peel, you will be told.

There is a fee for a consultation with Dr. Coverman or Jennifer, and they may recommend further visits with them before, during or after your series of peels depending upon your need. You will always be told what the schedule is.

There is a $150 non-refundable fee for missed appointments without a 24 hour notice.

PRETREATMENT

Do not use any acne or aging products for at least 3 nights before the peel. This will include Retin A, Differin, Tazorac, Renova, or anything similar. Don’t use any benzoyl peroxide products nor items to strip and clean your pores such as Biore and so forth. Do not have any type of hair removal including waxing, layering, sugaring, lasering and so forth. Do not sunburn or tan prior to the procedure - use common sense!

If you come to our office and for any reason we think you are too red, too inflamed, or too dry, we will schedule your peel for another day. Please understand that you must leave this up to our judgement and this is only in your best interest. Likewise, do not use any of these products after the peel - we will tell you what to do. You may continue any oral medications including your medicines for acne.

If you have ever had herpes or think you may have (cold sores or fever blisters), inform Dr. Coverman or our staff prior to scheduling your appointment. We will give you a series of anti-herpes pills to take the day before the treatment, the day of, and the day after. This should help or suppress or prevent herpes from flaring, but there are no guarantees. A herpes flare could cause pain, pigment, infection, and scarring.

TREATMENT DAY

Please do not wear make-up prior to your treatment session - it will have to be removed anyway. You may bring it with you, and reapply it immediately after we are finished (in most cases). You may go right back to work, school, or your normal daily activities. Please don’t sunburn the rest of that week or that weekend - it might give you adverse results. Never schedule this procedure just prior to a golf or fishing tournament or a vacation snow skiing or at the beach.

POST TREATMENT

In many cases you may actually apply make-up right after the peel and go right back to work. Since the peeling almost never starts right away on the first day, you can expect to be back to normal activities. Plan your work, travel, social and school vacations around this. Avoid sun exposure for at least one week.

COMPLICATIONS

Please understand that any such treatment is "ablative." This would include dermabrasion, microdermabrasion, laser, and so forth. Some of the superficial epidermal layers of the skin will come off, and because of this there may be some complications may be but are not limited to: dryness with visible peeling, inflammation, some level of discomfort, and remotely scarring. There could be color changes, whether darker or lighter or both (mottling), but if this happens, it generally tends to fade, and bleaches can augment the clearing.

Acne generally gets better after these peels, but theoretically and temporarily it could get worse.

No guarantee of percentage of improvement per area per session or overall can be promised or guaranteed.

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