People have been using chemical peels since ancient times. Egyptian papyruses recorded the use of acids to brighten the skin. Greek and Roman physicians documented the use of fruit extracts for facial rejuvenation. In the 1990s, peels received renewed attention after the treatment left Samantha from Sex and the City with red and blistered skin. Yet, side effects with newer peels can be quite mild, depending on the depth of peel and individual skin type. Moreover, peels can be extremely useful at solving an array of skin problems—often at a much lower cost than most cosmetic procedures. Let’s delve a little deeper into how peels work and which skin conditions they can be used to treat.
So, what is a chemical peel exactly?
A chemical peel is a cosmetic procedure in which a medicated solution is applied to the skin to induce a skin reaction. The epidermis (top layer of skin) and sometimes, parts of the dermis (deeper layers of skin) peel off to reveal smoother and less-wrinkled skin. As the skin heals, new collagen is produced, leading to an improvement in texture and tone. Peels can be classified as superficial, medium-depth, or deep depending on how far the solution penetrates into the skin and the extent of the skin reaction.
What can I expect?
Medical-grade chemical peels may be performed in the dermatologist’s or aesthetician’s office. First, a trained clinician cleanses the face to remove any dirt, oil, or debris, which allows the peel to go on evenly. Then, the peeling solution is applied to the skin for a prescribed amount of time (usually 2-3 minutes). During the peel, you may notice:
- burning or stinging
- pain
- itching
- a tingling sensation
Typically, a fan is placed near the skin to improve comfort. Depending on the type of peel used, it is either neutralized with a special solution or left to remain on the skin. Sometimes, brightening or correcting serums are applied directly after the peel, boosting absorption of these ingredients into the skin.
Which skin problems do peels treat?
Acne
30% salicylic acid is often considered the “gold-standard” superficial peel for the treatment of acne. This acid is left on the skin after leaving the doctor’s office, where it lingers in the pores and continues to clean. It is gentle enough to be used every 2-4 weeks to clear up stubborn blackheads and cystic acne. It can also reduce the red spots that acne leaves behind on the skin. Glycolic acid and retinoic acid are other commonly-used peels for acne.
Scarring
In individuals whose acne has left behind scarring, peels can be an important part of the treatment plan. Medium-depth peels, such as 35% TCA (tri-chloroacetic acid) or 70% glycolic acid, are typically used to reduce scars. With these stronger peels, the top layers of skin are shed, smoothing out the appearance of scars, while also building collagen within the deeper layers of skin. Deeper peels can cause more discomfort and more downtime than their superficial counterparts.
Discoloration
Chemical peels are frequently reported in studies to be effective in treating discoloration disorders, such as melasma and sun spots. Melasma is a hormonal condition that causes brown patches to develop on the sun-exposed areas of the skin. In order to be effective, treatments for melasma MUST be combined with consistent daily sunscreen use and avoidance of direct sunlight, when possible. If melasma is brought on by certain medications, such as birth control pills, the condition will not resolve until the offending medication is discontinued.
Sun Damage
One of the ways the skin responds to the damaging rays of the sun is by thickening. Over time, this can lead to an irregular skin surface that reflects light unevenly, casting a dull appearance to the skin. Chemical peels cause the top uneven layer of skin to slough off, which creates a brighter and more radiant complexion. It also improves the absorption of topical treatments.
What to know after your peel
It is essential that you avoid sun for at least 24 hours after your peel. You will likely also be instructed to skip your topical medications for several days afterward, as they can be irritating to the skin during this time. Once your skin has had a chance to heal, it is important to start a topical anti-aging regimen. This will prolong the effects of the peel and give you better results. Because the anti-aging treatments no longer have to be absorbed through multiple damaged layers of skin, they can now work more effectively. See my post on anti-aging treatments to learn which daily treatments are right for your skin.
Peels really are the secret to beautiful skin
I am always surprised by how underutilized peels are in most individuals’ beauty routines. When performed properly, they can be an affordable and safe cosmetic procedure that can work wonders for your skin. See your dermatology provider to learn more about which peels are right for you.
References
American Society for Dermatologic Surgery. Chemical peel for acne scars. Available online at: https://www.asds.net/skin-experts/skin-treatments/chemical-peels/chemical-peels-for-acne-scars. Accessed 6/21/20.
Bolognia, J. L., Jorizzo, J. L., & Schaffer, J. V. (Eds.) (2012). Dermatology, (3rd Ed.). Philadephia: Elsevier Saunders.
Graham, P. & Elwyn, L. (2016). Chemical peels: Modern-day alchemy. Dimensional Dermatology Blog. Available online at: https://drpmg.com/2016/09/08/chemical-peels-modern-day-alchemy/. Accessed 6/21/20.
Monheit, G. (2004). Chemical peels. Skin Therapy Letter, 9(2).
Samargandy, S. & Raggio, B. (2020). Skin resurfacing chemical peels. StatPearls. Available online at: https://www.ncbi.nlm.nih.gov/books/NBK547752/. Accessed 6/21/20.
Sofen, B., Prado, G., & Emer, J. (2016). Melasma and post-inflammatory hyperpigmentation: Management update and expert opinion. Skin Therapy Letter, 21(8).
Soleymani, T., Lanoue, J., & Rahman, Z. (2018). A practical approach to chemical peels: A review of fundamentals and step-by-step algorithmic protocol for treatment. The Journal of Clinical and Anesthetic Dermatology, 11(8), 21-28.
Xue, F. (2020). The truth about peels: What your Derm won’t tell you. Byrdie. Available online at: https://www.byrdie.com/facial-peels. Accessed 6/21/20.
