When it comes to beauty, a general rule of thumb is "the less the pain, the less dramatic the gain." Keep this in mind if you're looking for big results. For instance, if you'd like to create a satiny-smooth finish on pockmarked skin, eradicate moderate lines, or restore firmness to a slack area of the face, the quick "lunchtime" procedures we have just described probably won't give you what you want. However, there are more intensive procedures available.

Not all big-deal treatments are performed in hospital. In fact, many are done in a dermatologist's in-office surgery suite.

TCA peels

With the advent of laser resurfacing, PhotoFacials, and microbrasion treatments, the TCA peel has waned in popularity. Named after its active ingredient, trichloroacetic acid, the TCA peel is a medium-deep treatment that "freshens" the skin, removes some sun damage and rough scaly patches, reduces freckles and irregular pigmentation, and softens fine wrinkles. There is some evidence that it may also reduce the risk of skin cancer by destroying precancerous cells. The treatment involves painting trichloroacetic acid onto clean skin until the skin whitens.

During the 24 hours following the procedure, your skin will be slightly swollen and red. Over the next few days, the treated skin dries to a crispy brown; to keep things moist, your doctor may suggest coating your face with a thick layer of Vaseline. Things get uglier: between days 5 and 7, the leathery skin begins peeling in large sheets.

As irresistible as picking at skin is after a skin treatment, let it peel at its own pace: pulling it can cause deep scars and infections. As soon as "lour face is done shedding, you can return to your regular skin-care routine.

Jessner's peel

The Jessner's peel resembles the TCA peel: a medium­deep treatment that is designed to remove the top layers of skin, thus evening pigmentation, improving the skin's texture, and minimizing fine lines. Instead of containing trichloroacetic acid, however, the Jessner's peel consists of a mixture of salicylic acid, lactic acid, and resorcinol.

The Jessner's peel solution is applied to clean skin. Immediately afterward, your skin will be red and slightly swollen, and after 3 or 4 days, it will become dry and tight. At this point it should begin to crack and peel; to keep things moist, your doctor may suggest coating your face with a thick layer of petroleum jelly. After 5 to 7 days, skin should be healed enough for you to return to your regular skin-care routine.

On dark skin, olive-toned skin, or skin that scars easily, chemical peels, laser treatments, and dermabrasion can cause scarring, light­ colored patches, or dark patches. Do not consider any of these resurfacing treatments before getting a dermatologist's evaluation.