A chemical peel is a means of erasing skin problems like acne scars, sun damage, wrinkles, and other problems caused by aging, sun exposure, and other issues. Chemicals are used to dissolve layers of skin cells to reveal newer, healthier layers below. Some may create more collagen. There are different types of peels depending on the chemicals used. A glycolic acid peel is mild; a carbolic acid (or phenol) peel is deeper. Retinoid acid peels fall between the two. The more harsh the peel, the longer the recovery and the higher the chance of undesired side effects. Follow-up appointments are usually required for all but the mildest treatments. Chemiclal peels may also be referred to as chemexfoliation or chemabrasion.
Chemical Peels
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2 AnswersA
RealAge answeredSee All 2 AnswersIn a chemical peel, the depth of the peel removes superficial to deep layers of skin, depending on concentration, type, and application of acid.
What it's best for:
- Superficial peels correct minor pigment irregularities and remove dead, dry skin cells.
- Medium peels improve texture and remove areas of hyperpigmentation, freckles, and sun spots.
- Deep peels improve wrinkles, furrows, lesions, and pigment irregularities.
Number of treatments:
- Superficial peels give best results when repeated every few weeks.
- Medium peels may be repeated every 6 months.
- Deep peels are typically done once, but may be repeated years later.
- Superficial peels require no healing time, although skin may be red and itchy for 48 hours.
- Medium peels cause redness and swelling for about a week.
- Deep peels create crusting, so careful wound care for the first week is essential.
- Antibiotics, analgesics, and antiviral drugs are usually prescribed for medium to deep peels.
- Pinkness may persist for months. Medium to deep peels may cause pigment irregularities and scarring.
- Infections may occur after a medium to deep peel if wound care is not meticulous.
Inside scoop: Medium to deep peels of the entire face are rarely done today, because of the risks of scarring. Peels of the upper lip can lighten skin, leaving the appearance of a white "mustache."
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1 AnswerA
HealthyWomen answeredChemical peels carry some risks. Your skin may remain stark white after some deeper peels, although properly preparing the skin can reduce this risk. Other risks include scarring, infection, cold sores and long-term redness. Some people also develop acne after a peel or small cysts from blocked oil glands. -
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Dr. Michael Roizen, MD , Internal Medicine, answeredSee All 2 AnswersAny peel can cause scarring, and the deeper the peel, the more likely scarring will occur. If you have a tendency to scar, you shouldn't have peels deeper than the TCA peel. And the deeper peels can cause lightening of the skin, so if you have darker skin, there's danger in peels deeper than those that use glycolic acid. Make sure a doctor performs any peel using anything stronger than 10 percent glycolic acid; aestheticians and other assistants don't have enough knowledge to properly analyze skin and treat the occasional complications. Those plastic surgeons haven't quite figured out which of those lighter "non-ablative" lasers really do the trick. So, stay tuned; the technology of peels is still evolving. -
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Dr. Mehmet Oz, MD , Cardiology (Cardiovascular Disease), answeredSee All 4 AnswersChemical peels are often used to treat scars, pigmentation, and photodamage on the skin's surface. Chemical peels help to minimize the signs of skin damage by sloughing away the superficial surface layers of the epidermis, stimulating the healing process and the generation of fresh, new cell layers. This new cell generation leads to a rejuvenated skin appearance. Salicylic acid, lactic acid, and alpha-hydroxy acid are common agents in chemical peels.
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Dr. Ellen S. Marmur, MD , Dermatology, answeredSee All 2 AnswersMost chemical peels work on a superficial level to exfoliate (by burning off) the top layers of skin. Peels can go down to the papillary dermis, which is the top part of the dermis. By doing so, a peel removes surface pigmentation (such as brown spots and melasma), smoothes the texture, decreases acne, and even helps firm the skin and reduces the appearance of fine lines. A strong peel, for example a 40% TCA peel, can go deeper into the dermis and cause enough inflammation to set up a wound healing response that can stimulate collagen formation.
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Dr. Ellen S. Marmur, MD , Dermatology, answeredSee All 4 Answers
There are many types of peels - glycolic acid, retinoic acid, trichloracetic acid - and each has a different interaction with skin proteins and have varying specializations. TCA works on melanocytes; retinoic acid zones in on the sebaceous glands; lactic acid blows up keratinocytes and is an effective exfoliating agent; glycolic also exfoliates but has less risk of causing hyperpigmentation. Your dermatologist will choose the appropriate kind, and the concentration that will be safest and most effective for your particular skin type and conditions.
A higher concentration of acid will go deeper into the skin, disintegrating cells as it moves through. A lot of dermatologists do combination peels, combining two different acids at milder concentrations, rather than doing one super-intense peel, which can cause side effects or complications.
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Dr. Ellen S. Marmur, MD , Dermatology, answeredSee All 4 Answers
TCA is "melanotoxic," destroying melanosomes that make pigment, so this kind of peel is ideal for treating melasma or superficial discoloration. A moderate chemical peel (20% to 30% TCA or 40% to 70% glycolic acid) is a less expensive way to improve your complexion with almost immediate gratification. It's the poor man's (or woman's, as the case may be) laser. Chemical peels are an effective way to tackle fine lines, dull skin, and sun damage with lots of brown spots. But only a robust (at least 30% TCA) peel will make significant changes to extremely sun-damaged skin with a loss of elasticity.
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Dr. Ellen S. Marmur, MD , Dermatology, answeredSee All 2 Answers
The sensation during a 30% TCA type of peel (which is moderate to more extreme) rises like a crescendo - like going up a roller coaster, getting to the top, and then making a dramatic descent. The peel has a slow onset; then you begin to feel pinprick tingles, which intensify more and more into thousands of tiny, sharp stings for about six minutes until it gradually calms down. At its worst point, people describe it as feeling like a hot curling iron hitting your face repeatedly.
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Dr. Ellen S. Marmur, MD , Dermatology, answeredSee All 3 Answers
With a 30% TCA peel, the skin is lobster red for three or four days; then it becomes extremely dry and itchy; and finally it peels for about four days. A milder glycolic peel will leave small, dry, flaky areas, which will wash off in the shower.