Anesthesia
Light chemical peels like AHA and glycolic acid peels are usually done in medical offices. There is minimal discomfort so usually no anesthetic is given because the patient feels only a slight stinging when the solution is applied. No pain killer is needed.
Medium peels like TCA are also performed in the doctor’s office or in an ambulatory surgery center as an outpatient procedure and are a bit more painful. Frequently, the combination of a tranquilizer like diazepam and a pain pill usually suffice. TCA peels often do not require anesthesia even if the solution itself has - at the contrary of phenol - no numbing effect on the skin. The patient usually feels a warm or burning sensation.
Phenol is the classic deep chemical peel. Old phenol peel solutions are very painful and most practitioners will perform it under either general anesthesia, administered by an MD-anesthesiologist or nurse anesthetist. More recent formulas easily allow a simple heavy sedation, usually intravenous. Recent phenol peel formulas can be applied locally (chemical blepharoplasty or cheiloplasty)without any kind of anaesthesia.
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