A personal note from Dr. Adamson: 

I am very passionate about the Phenol-Croton Peel (and fat grafts). In my opinion it is the closest thing we have to magic in plastic surgery and maybe the whole of medicine. It by far outperforms any laser or energy platform in skin remodeling and rejuvenation - reliably erasing decades of aging of the skin. The controlled chemical burn stimulates healing by the fibroblasts (skin healing cells). They lay down collagen and elastin thereby thickening the dermis and thus improving wrinkles, tone and elasticity. It also dramatically decreases blemishes and discolorations (dyschromias) and it is thought that it may also reduce precancerous lesions and UV induced DNA damage that precede skin cancers.

The peel is a challenging recovery, but patients get through it fine with proper preparation. I often describe the recovery to patients as similar to being burned in a house fire (I know that is not very compelling marketing). That sounds dramatic but that is the reality. “Big recovery – Big Result”.  For some reason that is not yet understood, the phenol croton peel is not nearly as painful for nearly as long as a thermal burn from a laser. The phenol peel tends to be painful for the first 12 to 24 hours whereas the CO2 laser burn tends to hurt for a week. The postoperative care is straightforward mostly consisting of applying Vaseline/ointments and Silvadene until it is healed. This can sound daunting and overwhelming, but know that we are in this together until you are healed. The results are dramatic and patients tend to be exceedingly satisfied with their results. The first week is the toughest. Plan on being out of the public eye for 2-3 weeks. Makeup can be applied after 3 weeks to calm the appearance to the redness. Expect your face to be red like a sunburn for the next month and then it will fade to pink over the next several months.  The red and pink are due to increased blood flow for healing and building the dermal thickness. It is beneficial.

You can see from the untouched, unedited photos of my patients above how significant the results can be. To me it is as if the phenol croton peel “shrink wraps” the face (results may vary as the lawyers say). Most of these patients also had fat grafting of the face concurrently with the peel.

What Concerns Does It Treat?

Individual results vary. A personal consultation determines candidacy and expected outcome.

Phenol Peel vs. Laser Resurfacing

Bottom line: For patients who want the most dramatic singlesession improvement, the phenol croton peel consistently outperforms lasers—especially around the mouth, eyes, and on weathered skin.

Am I a Candidate?

You may be an excellent candidate if you:

• Have fair to lightmedium skin tones (Fitzpatrick I–III)¹
• Are bothered by deep wrinkles, “smoker’s lines” (non-smokers get these too), or severe sun damage
• Can commit to the prescribed aftercare and sun protection
• Do not have active skin infections, uncontrolled medical conditions, or a history of abnormal scarring

¹Darker skin types require a customized approach; alternative resurfacing options will be discussed during consultation.

A Brief History & Science

Performed initially by a few non-medical “lay peelers” in Hollywood in the 1920s on the rich and famous and later brought to the medical world in the 1960s and further refined in the early 2000s, the modern phenol croton oil formulas use precisely measured percentages of croton oil to control peel depth. Phenol and croton oil work together to modulate penetration and create the controlled chemical burn into the deep (reticular) dermis. Phenol also acts as a local anesthetic numbing the skin during application. The concentration of croton oil can be varied to affect both penetration and burn depth. Multiple clinical studies confirm its superiority for deep rhytid reduction and longterm collagen remodeling.

Common histologic improvements:

• Dermal remodeling: sun-damaged, elastotic collagen is replaced by a vertically thicker, horizontally organized band of Type I collagen with a new elastic-fiber network.
• Epidermal reset: dysplastic keratinocytes and disarrayed rete ridges are normalized; melanocyte count preserved but activity ↓, explaining long-term pigment blending.
• Depth control by croton oil: animal and human data confirm that even tiny croton-oil concentrations markedly increase depth and subsequent collagen deposition.
• Longevity: collagen remodeling documented up to 20 years post-peel with minimal regression, supporting the “once-in-a-lifetime” marketing claim.

The Procedure: StepbyStep

1. Pretreatment Prep – In some cases a customized skinconditioning regimen (retinoids, antiviral prophylaxis) for 2–4 weeks.
2. Day of Peel – Performed only by Dr. Adamson (not PAs, nurses or any other providers) in our office or the accredited surgical center with anesthesia (performed by board certified anesthesia providers) and cardiac monitoring for comfort and safety. 

Wash skin with soap and water and do not apply any moisturizers, sunscreen or makeup prior to the procedure. Anything on the skin can prevent peel penetration.

1. Application – The peel solution is painted in zones to achieve uniform frosting. Takes 1-2 hours.
2. Dressing – A soothing occlusive ointment barrier is applied to support healing.
3. PostPeel Care – Detailed instructions and followup are coordinated. Ointment and Silvadene are applied until healing is completed. Moisturizers and sunscreen are used thereafter. 
4. Most patients experience significant swelling for 7 days, followed by sheetlike peeling between days 2–10. Expect significant redness for the first 6 weeks that fades to a healthy pink glow for the next several months.

Recovery Timeline

Most patients feel comfortable appearing in public with makeup by week 3.

Safety & Possible Risks

When performed by an experienced, boardcertified plastic surgeon in a monitored setting, complications are rare. Potential risks include:

• Prolonged redness (which overall is beneficial and indicates ongoing healing and remodeling)
• Pigment changes especially hypopigmentation. Hyperpigmentation also possible
• Infection or delayed healing
• Cardiac arrhythmia (phenol can affect heart rhythm—why we monitor continuously)
• Scarring (very uncommon)

Dr Adamson’s meticulous dosing protocol and stateoftheart monitoring have produced an impeccable safety record.

Expected Results & Longevity

• Smoother, tighter skin with a luminous, even tone
• Often described as a “onceinalifetime reset” for the face
• Results typically last 10-20 years when combined with diligent sun protection and medicalgrade skincare (Repeat peeling is sometimes desired earlier than 10 years to further optimize results)

Complementary Procedures

Many patients pair a phenol croton peel with:

• Fat transfer for volume restoration
  This combinations can be performed in a single operative session, streamlining recovery.

Frequently Asked Questions

Does it hurt? The peel itself is tolerable thanks to phenol’s numbing effect and the option to use sedation or anesthesia.

Will I look “overpeeled”? Our controlled, zonebased technique avoids the waxy or overly pale look seen with outdated formulas and lasers.

Can it treat the neck or chest? In selected cases, yes—though depth is modified to match thinner skin in these areas.

How much does it cost? Fees vary with treatment zones; your personalized quote includes all pre and postcare. The price can range from $8,000 to $18,000 with the Peel performed in the office priced at $8,000 and a peel plus fat grafting under anesthesia in the accredited surgery center just under $18,000 (Peel $8000, Fat grafts $5500, Anesthesia $910, Surgery Center $2700).

Schedule Your Private Consultation

Ready to see what a Phenol Croton Peel can do for you? Call (941) 343-9900 or request an appointment today. Dr Adamson will evaluate your skin, discuss goals, and create a tailored plan to reveal a fresher, more confident you.

“My only regret is not doing it sooner.” —M.J., peel patient

Disclaimer

This information is educational and not a substitute for a personalized medical consultation. Individual results vary.