Chemical Peel

Overview

A chemical peel is a procedure for skin resurfacing where a chemical solution is applied to the skin to remove its top layers. The new skin that forms post-peel is typically smoother and more youthful in appearance.

Chemical peels are effective for treating wrinkles, skin discoloration, and scars, primarily on the face. They can be performed alone or in conjunction with other cosmetic treatments.

Chemical peels vary in depth—light, medium, or deep—depending on the desired outcomes. Each type utilizes a specific chemical solution, with deeper peels offering more pronounced results but requiring longer recovery periods.

Why it’s done

A chemical peel addresses a range of skin concerns, and the depth of the peel chosen depends on the specific issues being targeted:

Light chemical peel: Removes the outer layer of skin (epidermis), treating fine wrinkles, acne, uneven skin tone, and dryness. Repeat treatments can occur every two to five weeks based on desired results.

Medium chemical peel: Removes skin cells from the epidermis and portions of the upper dermis. It’s effective for wrinkles, acne scars, and uneven skin tone, with potential for repeat treatments every three to nine months.

Deep chemical peel: Removes skin cells from the epidermis and deeper into the dermis. Recommended for deeper wrinkles, scars, or precancerous growths, it’s a one-time treatment due to its intensity.

Risks

Chemical peels carry potential side effects, including:

Redness: Normal post-peel healing involves redness of treated skin, which can persist for several months after medium or deep peels.
Scarring: Rarely, peels can lead to scarring, typically in lower facial areas, managed with antibiotics and steroids.
Changes in skin color: Hyperpigmentation (darkening) or hypopigmentation (lightening) of treated skin can occur, more common in individuals with darker skin tones and potentially permanent.
Infection: Chemical peels can trigger flare-ups of the herpes virus or, rarely, bacterial/fungal infections.
Organ damage: Deep peels using phenol can impact the heart, kidneys, or liver, requiring careful management during treatment.

Chemical peels cannot reduce pore size or eliminate deep scars or wrinkles.

Not everyone is a candidate for chemical peels, particularly if you:

Have taken isotretinoin in the past six months.
Have darker skin tones or a history of keloids.
Experience abnormal skin pigmentation or frequent cold sore outbreaks.

How you prepare

EVALUATING CANDIDACY

Before scheduling a chemical peel, your doctor will:

Review your medical history, focusing on heart, kidney, or liver conditions for deep peels. Disclose medications, especially those increasing skin sensitivity to sun, and past cosmetic procedures. Mention use of retinoid creams, like tretinoin.
Conduct a physical exam to assess skin condition and determine the most suitable peel type based on skin tone, thickness, and desired outcomes.
Discuss expectations, motivations, and potential risks, ensuring understanding of treatment frequency, healing duration, and expected results.

PRECAUTIONARY MEASURES

If proceeding with a chemical peel, you may:

Take antiviral medication if prone to oral herpes, before and after treatment.
Use a retinoid cream before a light or medium peel to expedite treatment and healing.
Apply a bleaching agent (hydroquinone) and retinoid cream to prevent skin darkening.

SAFETY PRECAUTIONS

Protect skin from sun exposure using sunscreen for at least four weeks pre-treatment, minimizing irregular pigmentation risks. Avoid waxing, depilatory products, and certain cosmetic treatments the week before a peel.

Arrange transportation post-treatment if sedation is involved.

What to expect

PRE-PROCEDURE

Chemical peels occur in an office-based setting or outpatient facility. Before treatment, your face is cleansed, with eyes protected by ointment, gauze, tape, or goggles. Hair may also be shielded.

Pain relief is unnecessary for light peels. Medium peels offer sedation and pain relief options, while deep peels involve local anesthetic and sedation/regional anesthesia.

DURING THE PROCEDURE

Light chemical peel:

A brush, cotton ball, or sponge applies a chemical solution (e.g., glycolic or salicylic acid), causing skin whitening.
Mild stinging may occur, followed by application of a neutralizing solution.

Medium chemical peel:

Application of trichloroacetic acid via cotton-tipped applicator or gauze causes skin whitening.
Cool compresses soothe skin, with no need for neutralizing solution.
Stinging/burning sensations may last up to 20 minutes.

Deep chemical peel:

Intravenous fluids and heart rate monitoring accompany phenol application.
Skin whitens progressively over 90-minute intervals to limit phenol exposure.
Treated areas may be dressed with water-tight dressing and require pain relief.

POST-PROCEDURE

Follow post-peel care instructions regarding cleansing, moisturizing, and protective ointment application.

Light peel: Mild redness, dryness, and irritation resolve within one to seven days, with temporary skin lightening/darkening.

Medium peel: Redness, tightness, and swelling, with stinging sensations, improve over seven to 14 days. Crusting and pigmentation changes may persist for months.

Deep peel: Severe redness/swelling, burning/throbbing sensations, and temporary eyelid swelling, improving over two weeks. Persistent redness and potential skin color changes necessitate lifelong sun protection.

Results

Light peel: Improves skin texture, tone, and fine wrinkles subtly, with enhanced results after multiple treatments. Avoid sun exposure until skin fully heals.

Medium peel: Noticeably smoother skin post-procedure, with extended sun avoidance recommended for months.

Deep peel: Dramatic skin improvement, addressing deep wrinkles/scars. Lifelong sun protection prevents skin color changes.

Remember, results from chemical peels may not be permanent, requiring ongoing sun protection to maintain skin health and appearance.

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