Chemical peels are skincare treatments typically used to improve the appearance of the skin on the face, chest, neck, and hands. It describes the controlled wounding of the skin for aesthetic purposes. Chemical peels have been used for centuries, dating to ancient Egyptian times, to improve the signs of aging and involve the application of a chemical solution that causes exfoliation of the skin, which then peels off. When new skin is regenerated, it is usually smoother, more uniformly pigmented, and has fewer wrinkles
Chemical peels vary in depth from superficial to deep, with different chemicals used for each level of depth, such as tretinoin and alpha and beta-hydroxy acids (AHAs & BHAs) for superficial peels, trichloroacetic acid (TCA) for medium peels, and phenol-croton oil for deep peels. The depth of the peel is directly related to the degree of expected improvement and to the number of complications that can occur.
Why are chemical peels used in skincare?
- Fine lines and wrinkles
- Hyperpigmentation, such as sun spots and dark patches (e.g. melasma), and uneven skin tone
- Textural issues
- Acne and acne scars
- Infraorbital hyperpigmentation (dark circles under the eyes)
What are the benefits of chemical peels?
The benefits of chemical peels include:
- Subtle and natural results
- Brighter, more even skin tone
- Reduction of dark spots and hyperpigmentation
- Improved skin texture and tightening
- Stimulated collagen production for firmer, more youthful appearing skin
- Reduction of fine lines, wrinkles
- Improved acne and reduced scarring
What does someone need to do to prepare for a chemical peel?
- Consult with a dermatologist or other skincare professional to determine the best type of peel
- Use pre-treatment products to prepare the skin, if recommended (e.g. topical tretinoin to improve penetration and decrease healing time)
- Avoid certain medications and skincare products as advised
- Prophylactic antiviral, antifungal and antibiotic medications (depending on peel depth)
What can someone expect during a chemical peel? (such as – how long does it take, what will be happening, potential sensations, etc)
- The skin is cleansed
- The chemical solution is applied with brushes, gauze or cotton-tipped applicators, causing a sensation that can range from tingling to a burning
- The chemical solution is left on the skin for a few minutes up to half an hour or more, depending on the type of peel
- The chemical solution is then washed off or neutralized
- A cooling agent may be applied to soothe the skin
- Cardiac monitoring and intravenous fluids may be required for full-face deep peels
- The entire process can take anywhere from 30 minutes to 90 minutes, depending on the type of peel
What do aftercare and recovery look like following a chemical peel?
- For swelling and mild discomfort, ice packs can be used
- Avoid direct sunlight and heat for at least two weeks, as this can trigger rebound hyperpigmentation
- Sun protection is paramount. Regularly apply mineral-based (physical v chemical) sunscreens when outdoors, and reapply every 1-2 hours as needed
- Use gentle skin care products and avoiding makeup for the first few days
- Keep the skin moisturized
- Expect some degree of redness, peeling, and sensitivity, which varies with the peel’s depth
- Peeling skin should not be picked or pulled off as this can lead to scarring
- Recovery time can range from a few days for superficial peels to several weeks for deep peels
What kind of results can someone expect?
- Smoother, more youthful looking skin
- More even skin tone with reduced hyperpigmentation
- Less severity of wrinkles and fine lines
- Improved skin clarity and diminished acne
- For deep peels, dramatic improvements in skin appearance, including the reduction of deep wrinkles and severe acne scars
How often do chemical peels need to be repeated for the intended results?
- Superficial peels may be repeated every 4-6 weeks
- Medium peels can be done every 6-12 months, as recommended by a skincare professional
- Deep peels are usually a one-time treatment with results that can last for many years!
Are there any safety considerations, risks, or side effects people need to know about?
- Superficial peels have minimal risks, mainly slight redness and irritation
- Medium and deep peels carry higher risks, including infection, scarring, and permanent pigmentation changes
- Medium-depth and deep peels are not recommended for darker skin types because of the risk of rebound hyperpigmentation
- Deep peels, especially those using phenol, have the highest risk profile and require careful post-peel care and monitoring
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Brandon Kirsch, MD, FAAD, is a board-certified dermatologist specializing in clinical drug development and medical innovation. He is the founder of Kirsch Dermatology in Naples, Florida and is also the Chief of Dermatology at the Naples Community Hospital.