Chemical peels range in depth from very superficial to quite deep. You can choose a peel to target a wide variety of skin flaws from fine lines to acne scars. Facial peels are a popular adjunct to other cosmetic treatments including face lifts, microdermabrasion and laser resurfacing.
Chemical peels are a popular option for skin rejuvenation. This non-invasive cosmetic procedure is designed for patients who want to achieve a more even complexion quickly. This treatment typically involves:
- Gently cleansing the skin
- Applying a layer of acid-based exfoliating solution
- Allowing the active ingredients to penetrate for a specific amount of time
- Neutralizing the acid
- Removing the solution along with the exfoliated skin cells
- Applying a soothing ointment
Patients may be advised to pre-treat and follow up with a specific regimen of skin care products to make the peel more effective. Some facial peels are performed several times over a period of several months for maximum results.
Why Get a Chemical Peel?
Most patients seek a chemical peel to address one or more cosmetic problems caused by sun damage:
- Leathery or rough skin texture
- Uneven skin tone (dark patches)
- Fine lines or wrinkles
Cosmetic surgeons may also recommend a chemical peel to reduce the appearance of mild acne scars or to remove pre-cancerous lesions called actinic keratoses. Candidates for treatment should be in overall good health and not allergic to the ingredients used in chemical peels. Patients with a history of herpes simplex (cold sores) may need a course of antiviral therapy along with a peel to prevent a flareup.
How to Choose a Chemical Peel
You should choose a chemical peel based on:
- Your skin type (your cosmetic surgeon will discuss appropriate peels for your skin color, tendency to tan or burn, level of oiliness, etc.)
- The type of skin problems you desire to correct
- The degree of improvement you expect to see after treatment
- How much downtime you can afford to take
- Your tolerance for side effects
- Whether you are willing to undergo multiple treatments
Types of Chemical Peels
Facial peels come in dozens of varieties with different formulas and ingredients. However, they are generally classified as light, medium or deep. These categories are based on how deeply the acid penetrates into the skin. A light or superficial peel affects only the top layers of the epidermis — particularly the stratum corneum (the outer layer of dead skin cells). Many mid-depth peels use the same ingredients as light peels but at a higher concentration to remove more layers of the epidermis and penetrate into the first layer of the dermis. A deep peel goes much further and impacts several layers of the dermis to stimulate maximum collagen regeneration while eliminating areas of melanin buildup.
Here are a few popular types of chemical peels:
- AHA (alphahydroxy acid such as glycolic acid or lactic acid)
- BHA (such as salicylic acid)
- TCA (trichloracetic acid)
- Jessner’s Peel (dihydroxy-benzene, salicylic acid and lactic acid in an ethanol base)
- Phenol (such as the Croton Oil or Baker’s peel)
AHA and BHA peels are generally mild. They are designed for patients with minimal sun damage who want a fresher, smoother appearance for their skin. The procedure takes less than half an hour including prep and cleanup. Your skin may feel tingly or itchy during the treatment. Patients can return to normal activities right away. Side effects include dryness, redness and peeling over a period of several days.
TCA and Jessner’s peels range from light to medium depth. They rejuvenate skin at a slightly deeper level and may be helpful for correcting fine lines and blotchy skin (hyperpigmentation). They usually take only slightly longer than a light peel (the acid is just more concentrated). With a moderate peel, you may feel a stinging sensation during the application. Side effects can include some mild swelling and irritation. Your skin may also ooze, scab over, or become scaly during healing. Your skin will begin to look normal again within a couple of weeks.
Phenol peels are very intense and are designed for deep skin remodeling to remove lines and give skin a much smoother, even appearance. A plastic surgeon may recommend a phenol peel for the full face and neck or only for specific problem areas. This procedure can take more than an hour. Patients are sedated or placed under general anesthesia during this procedure; but most return home the same day.
The healing period for a phenol peel is lengthy compared to lighter facial peels. Significant discomfort, swelling, oozing and scabbing are normal side effects. Redness may persist for many months. A deep peel offers the most dramatic improvement and the results typically last for many years. However, deep chemical peels also have the highest rate of complications including scarring and unwanted changes in skin pigment. They are not suitable for patients with a dark complexion.
Maintaining Your Results
If you choose a light or medium peel, you will probably want to make chemical peels a regular part of your skin care routine. A deep peel is usually only done once with potential touchups for areas that are resistant to the initial treatment. With each type of chemical peel, proper sun protection and an ongoing regimen of moisturizing is essential for preventing problems. Newly exfoliated skin is extremely sensitive to sunlight. It can develop patches of discoloration from even mild sun exposure during the healing period. Patients must stay out of the sun until the peeling stage is finished and use a strong sunscreen after that. The longer you keep practicing good sun protection, the lon