Zwivel's Complete Guide to Chemical Peels
Chemical peels help improve the look and texture of your skin by reducing the appearance of fine wrinkles, blemishes, and enlarged pores. Though usually used for full facials, there are also certain peels that can be used for “spot treatments,” to remove stretch marks, or even help revitalize the skin on other parts of the body.
In a nutshell, a chemical formulation is applied to the skin and allowed to be absorbed by the tissue. Over the next day or weeks, depending on how deep the chemical is allowed to sink into the skin during your treatment, the outer layers of skin peel off. The idea is to cause superficial damage to certain parts of the skin so that new, healthy skin can grow.
This guide provides you with all the information you need to choose the right chemical peel for your skin type, as well as a series of preparation and recovery tips.
- 1 A Brief History of Chemical Peels
- 2 How Chemical Peels Work
- 3 The 3 Types of Chemical Peels
- 4 Common Peeling Agents
- 5 Top Chemical Peel Brands
- 6 Preparing for the Peel: 10 Tips to Follow
- 7 Recovery Timeline
- 8 After the Peel: 10 Recovery Tips
- 9 Chemical Peels vs Microdermabrasion
- 10 Chemical Peels vs Laser Resurfacing
- 11 Frequently Asked Questions
A Brief History of Chemical Peels
Chemical peels have been with us for thousands of years, with the first known uses dating at least as far back as Cleopatra’s reign over Egypt. In her time, Egyptians used alabaster, grape skin scrubs, and a variety of animal oils to improve the look of their skin. Women would also bathe in mild exfoliants such as wine or sour milk. Each of these ancient skincare routines use ingredients commonly found in modern chemical peels: lactic acid in sour milk, and tartaric acid found in grapes.
Modern chemical peels made their debut in the early part of the 20th century, when Dr. George Mackee began using phenol, a carbolic acid, as a chemical peel for acne scars. Around three decades later, during the 1930s, spas and health resorts started using phenol to remove facial wrinkles. Unfortunately, this experimentation left many patients scarred from the intense peel.
Through the 1950s, newer ingredients and modern peels were developed. Chemicals like resorcinol, trichloroacetic acid, and salicylic acid were mixed with phenol to create medium and deep chemical peels. Many of these products are still used today, along with newer ingredients, like glycolic and pyruvic acids.
In today’s world, chemical facial peels are among the most popular non-invasive cosmetic procedures. This is thanks to their nearly immediate results, affordable prices, and to the fact that they can be performed as a simple outpatient procedure.
How Chemical Peels Work
All chemical peels do the same thing: they work by removing the outermost layers of skin through what is called a “controlled injury.” The chosen chemical breaks down the bonds between dead skin cells, allowing them to peel and flake away. This process reduces wrinkles, evens out minor scars and blotchy patches, and can even help treat sun damage. Having peels done on a regular basis – every 6 to 8 weeks or so – can also help increase the production of collagen, one of the proteins responsible for maintaining the skin’s elasticity and structure.
There are at-home chemical peel products you can apply yourself, but you can also have the procedure done professionally, in a medical spa, doctor’s office, or surgical center. It’s always performed as an outpatient procedure, meaning you won’t need to stay overnight.
While chemical peels provide excellent results for many common skin conditions, there are also certain things they cannot do. Chemical peels are ineffective in reducing the appearance of blood vessels, keloid scars, or sagging skin. Furthermore, chemical peels usually aren’t recommended for discoloration in patients with darker skin tones.
The 3 Types of Chemical Peels
There are three distinct types of chemical peels and a variety of different peeling agents. Each type of peel penetrates the skin at different layers, depending on a number of factors. These include the strength of the acid used as the peeling agent, the number of coats that are applied, and the amount of time the acid is given to work before being neutralized. The deeper the peel, the more dramatic the results. That being said, deeper peels also carry a higher risk, are more painful, and take longer to heal.
These are the gentlest kind of peel available. In fact, superficial peels are so gentle that they are considered one of the few true “lunchtime” procedures – they only remove the very topmost layer of the skin, also called the epidermis. This results in skin that looks instantly brighter, smoother, and more even in texture. Light peels are often used to minimize the appearance of fine lines and wrinkles, sun damaged skin, minor and mild acne scarring, age spots, and dry or flaky skin.
Light peels can be used on all skin types, and usually contain a mild and diluted acid. This is ideal for people who want the benefits of a facial peel, but don’t want all the downtime and pain associated with deeper peels. They usually contain alpha hydroxy acids (AHAs), like glycolic, lactic, or certain fruit acids, or beta hydroxy acids (BHAs), like salicylic acid, and other simple organic acids found in fruits.
Medium depth peels offer a more dramatic end result than the shallower, superficial peels. Usually using trichloroacetic acid (TCA), these peels can soak deeper into your skin. This allows them to treat issues such as sun damage, discoloration, and wrinkles.
The downside, however, is that medium depth peels require a longer recovery time and can lead to unpleasant side effects. The face can become swollen, itchy, and reddened, with some patients reporting burning or stinging sensations that last up to an hour after the treatment. Medium peels can also cause patches of brown and white skin to appear on the face during the healing process. And in rare cases, medium depth peels have resulted in scarring.
In general, recovery from medium-strength peels can take about a week, but you might still be a little pink for as long as six weeks after treatment.
These are, by far, the strongest type of chemical peels available, penetrating far into the dermal layers of skin. Deep peels usually use carbolic acid (phenol) or a concentrated, high strength TCA.
While deep peels can provide amazing results for sun damaged skin, scarring, and deep lines and wrinkles, the procedure can be quite painful. You might also feel a bit unwell after a phenol peel, and might even need to be sedated during the procedure.
After a deep peel your face will look and feel as though it has been severely sunburned, and although you should be fully healed within a matter of weeks, the redness can last for months. The side effects can be quite dramatic: your face will remain swollen for days, after which itchy, peeling scabs will start to form. For some patients, a full two weeks of recovery are required before they feel comfortable going out in public.
The most common issues associated with deep peels are the development of permanent patches of white or bleached looking skin, and an increased risk of scarring.
Darker-skinned people, people who are sensitive to anesthesia, as well as those with heart problems make poor candidates. It’s also important to note that anyone who decides on a deep peel treatment should be prepared for a long, slow recovery.
Common Peeling Agents
All chemical peels rely on acidic solutions of various concentrations to rejuvenated the outer layers of the skin.
Alpha Hydroxy Acids (AHAs)
Alpha hydroxy acids (AHAs) are naturally occurring acids taken from sources like fruits, sugar, and sour milk, and are generally used for light and medium peels. AHAs include:
- Glycolic acid is the most commonly used peeling agent, and comes from the sugar cane. Its strength ranges from 30% to 90%, with different acidity levels. These determine how far into the skin it can be absorbed and how much peeling will occur after the treatment. Glycolic acid is used in both light an medium peels to treat sun damage and wrinkles, and to improve the skin’s texture.
- Lactic acid is found in milk, and naturally occurs in your skin. This is the least irritating of the AHAs, and even has a natural moisturizing effect. Lactic acid is perfect for brightening the skin, as well for treating discolorations, dry or dehydrated skin, sensitive skin, and rosacea.
- Malic acid is a weaker AHA than glycolic acid, and is found in apples and pears. This AHA is usually used for acne, mild sun damage, rosacea, superficial discolorations, and eczema.
- Citric acid comes from lemons and oranges, and work in the same way as malic acid. Citric acid is also commonly used to treat acne, mild sun damage, rosacea, superficial discolorations, and eczema.
- Tartaric acid is extracted from grapes, and is much less irritating to the skin than glycolic acid, while also providing the skin with hydration. This makes it a perfect mild exfoliant. Similar to both malic and citric acid, this AHA is used to treat acne, mild sun damage, rosacea, superficial discolorations, and eczema.
Beta hydroxy acids (BHAs)
Beta hydroxy acids (BHAs) are also simple organic acids taken from fruit sources. Though similar to AHAs, BHAs are a little different in their molecular structure, which means they act on the skin in a slightly different way. BHAs are also generally used in light peels.
Salicylic acid is by far the most common BHA used in today’s chemical peels. This chemical is somewhat unique among hydroxy acids because of its ability to penetrate much deeper into the oil glands. This allows for a high level of exfoliation without irritation, even in oily areas of the face and scalp, which makes it ideal for treating acne and oily skin.
Fruit enzymes are often used in light peels. Papaya, pineapple, pumpkin, or cranberry extracts can peel off the outer layer of the skin. These enzymes also have antibacterial properties, help cells replace themselves faster, and can break down oil and dead skin cells. They are best suited to treat acne, rosacea, dehydrated skin, and hyper-reactive or sensitive skin.
Retinoic acid is derived from Vitamin A, and is used for peels that need to penetrate deeper than either AHAs or BHAs. This peel is specifically used to remove scars, wrinkles, and dark spots. If you choose to undergo this procedure, you’ll leave the doctor’s office with the product still on your face. The peeling process will begin on the third day, and as with most chemical peels, your results will improve with multiples treatments.
Trichloroacetic Acid (TCA)
Trichloroacetic acid (TCA) is stronger than the hydroxy acids used in light peels. This chemical is able to penetrate much deeper into the skin, which makes it useful for medium depth and deep peels. That said, it’s often used in a lower concentration or combined with other acids for a milder peel. TCA is usually used to treat fine lines and wrinkles, acne scars, large pores, and hyperpigmentation.
Originally used by Hollywood stars in the 1920s to maintain their youthful appearance, carbolic acid is by far the strongest peeling agent available today.
Found in phenol peels, carbolic acid is only used for very deep peels, and is ideal for treating deep lines and wrinkles, scarring, and severe sun damage. Because these peels penetrate so deeply into the skin, they should only be performed by an experienced physician. As such, there aren’t any at-home brands phenol peels on the market.
Top Chemical Peel Brands
There are countless brand name products available for superficial and medium peels. Some brands that offer superficial peels include:
- MD Forte, which uses glycolic acid.
- SkinCeuticals Gel Peels, which uses both glycolic and lactic acids.
- Dermaceutic Milk Peel, which uses lactic acid.
- NeoStrata Anti-Aging Peel Solution, which uses a combination of hydroxy acids and fruit enzymes.
- Vivier Skin Peel, which uses beta hydroxyl and alpha hydroxyl acids.
Product brands that offer medium depth peels include:
- Obagi Blue Peels, which uses TCA.
- CosMedix Tomorrow Peel, which uses lactic acid as its main exfoliant.
- VI Peel, which uses a combination of TCA, salicylic acid, retinoid acid, phenol, and glycolic acid.
The exact recovery time required after a chemical peel depends mainly on the strength of the treatment.
These mild peels have virtually no down time, and you’ll be able to see results after only the first session. With each additional treatment you’ll see more improvement, until your skin is new, healthy, even toned, and smooth.
In the vast majority of cases light peels have no real recovery time to speak of. Your skin will likely be a little flaky, or even mildly irritated after a glycolic acid or other AHA chemical peel, but you’ll be able to go right back to work. If you had your peel done professionally, your provider will give you a set of guidelines to ensure the best results. Usually, patients are simply instructed to use a gentle cleanser, are given a recommended moisturizing lotion, and told to stay out of the sun.
Unlike deep chemical peels, which usually only require a single treatment, patients who opt for light peels will need to undergo about five to eight sessions to reach their ultimate goals. The formula and strength of the peel, the number of treatments needed, and how often treatments are administered will all be customized to you based on your own goals and skin characteristics.
After a medium depth TCA peel, a shallow crust forms over the treated area, and slowly flakes off over 3 to 7 days. The fresh new skin that is revealed might be a little pink or reddish for a few days, but should fade to your normal skin tone within a week. Full healing usually takes about a week. What’s left is new, younger-looking skin with amazingly improved texture, color, and appearance.
Some mild swelling is common and nothing to be worried about after a medium peel. There usually isn’t much pain, and any discomfort lingering after the treatment can be easily controlled with pain killers. Like with a light peel, you’ll be allowed to return to all your normal activities right away. That being said, there might be some leftover redness for about a week after the treatment, so many people choose to stay home until they are completely healed.
Everyone’s skin is different, and so your treatment plan will be unique to you, but most patients undergo at least a few medium depth peel treatments before meeting their goals. How many treatments you’ll need, and how far apart they’ll be spread will depend on your goals, the condition of your skin, and a number of other factors, including your medical history.
During your short recovery period, it’s important that you follow all the instructions given to you by your doctor. These will include precautions like limiting the amount of time you spend in the sun.
The chemicals used for the deepest peels are the most intense. This means that the new layer of skin can take a week or longer to appear, and complete healing might take more than two full months. However, only one treatment is usually need.
Deep peels are the most advanced and painful chemical peel treatments, and also have the longest recovery time. After a deep peel, your face will be swollen, red, and uncomfortable. A few days after your treatment, a crust will form over the treated skin. This crust will flake off within 7 to 10 days, revealing a new, healthy layer of pink skin. The pink shade usually slowly fades over 2 to 3 months, leaving you with a clear, smooth complexion.
If you decide on a deep phenol peel, it’s important to keep in mind that your new skin won’t have the ability to tan for a while. This means you’ll need to take extra special precautions against possible sun damage after your treatment. Avoid direct sunlight as much as possible, and always use a strong sunblock.
After all your healing is complete, your skin will be much clearer, have more elasticity, and deep wrinkles and severe discolorations will be remarkably improved. A deep chemical peel has the ability to make your face look younger, with results that can last decades, as long as you protect yourself from sun damage.
Chemical Peels vs Microdermabrasion
Both microdermabrasion and chemical peel treatments use exfoliation to maintain healthy skin by keeping it free of dead skin cells and other materials. The main difference between the two is the method of exfoliation.
Microdermabrasion uses physical exfoliation to literally scrub away dead skin cells, oil, and other debris from the surface of the skin. Chemical peels, on the other hand, rely on a chemical process that breaks down the bonds between dead skin cells, allowing the outer layer of skin to flake and peel off on its own.
In general, peels are able to penetrate much deeper into the outer layers of skin, allowing them to treat many conditions more efficiently than resurfacing techniques like microdermabrasion. Specifically, chemical peels are much better for treating and exfoliating thick, oily, and acne-prone skin. They also tend to be better for stubborn, deep hyperpigmentation, sun damaged skin, and a loss of collagen.
Blackheads and enlarged pores are commons skin concern that are usually most noticeable around the forehead area, nose, and in the cheeks. Unfortunately, neither microdermabrasion nor chemical peel treatments can actually shrink your pores, as their size is determined by the genes you inherited from your parents. However, both treatments can make them less prominent, while also clearing up any clogs and removing extra oil and other debris.
In the end, whichever treatment is better for you is something you can determine through a detailed conversation with your provider. It really depends on what you want to achieve and your budget.
Be sure to speak with your doctor or dermatologist to decide which treatment is better suited to your unique needs.
Chemical Peels vs Laser Resurfacing
Both options provide a refreshed look to your skin. They both can reduce the appearance of fine lines, minimize scarring, and fix skin coloration issues from sun damage. Either treatment is able to greatly improve the appearance, tone, and texture of your skin. The biggest difference between the two is the technique, but there are a few other important differences as well.
Rather than using a chemical reaction, or even physical exfoliation like microdermabrasion, laser resurfacing uses a specialized medical laser to break up dead skin cells, removing them from the surface of your skin. This causes the skin to immediately contract and tighten, which also helps encourage the production of collagen. Over the course of 6 to 12 weeks, the skin continues to improve on its own. The treatment usually takes between 30 and 60 minutes, depending on the size of the area to be treated. Multiple treatments are typically needed for the best results. Recovery usually takes about 5 days, during which you need to stay indoors, and shouldn’t use any makeup.
Other things to consider when deciding between these two treatments include the price, each treatment’s flexibility, their ability to treat acne, and their final results:
Light chemical peels usually are just a couple hundred of dollars, with the price increasing with the level of penetration each available chemical can provide. This can reach into the thousands for the deepest of peels, but the deeper the peel, the fewer treatments are usually needed. Laser resurfacing, on the other hand, can cost between $1,500 and $3,000, and can also require multiple treatments to reach your goals.
- Treatment flexibility
When it comes to the flexibility of these treatments, laser resurfacing has the advantage. Laser resurfacing is able to penetrate the skin to a very specific depth in one area, and a very different depth in another. This results in less pain during the treatment, and often a quicker recovery period. As for chemical peels, different strength acids aren’t usually combined for different parts of the face, and the depth of the acid’s penetration can’t be changed or adjusted during treatment.
Chemical peels can treat acne well, especially medium and deep peels. Laser resurfacing can’t. In fact, patients suffering from active acne make poor candidates for laser resurfacing as it can cause and aggravate infections.
Both deep chemical peels and laser resurfacing offer amazing and dramatic results, and patients of both treatments are usually quite happy with their outcomes. Laser resurfacing has the added bonus of continuing improvements to the skin over the course of the new few months. This is thanks to the laser’s ability to promote collagen production in the skin. Light and medium peels can also give fantastic results, but they usually require more than one treatment to correct certain skin imperfections or to maintain results.
Frequently Asked Questions
Are chemical peels safe?
Yes. In the vast majority of cases adverse reactions or negative side effects are extremely rare. However, it’s important to note that the risks and side effects increase as the chemicals penetrate deeper into the skin. Basically, the lighter the peel, the lower the risks of complications, while the deeper the peel, the higher the risks.
Is anesthesia required?
Light chemical peels, whether performed at a medi-spa, doctor’s office or at home, involve so little discomfort that no anesthesia is required, and no pain killers are needed afterwards. Medium peels also don’t usually require any anesthesia; some solutions even have a numbing effect all on their own. Sometimes a mild pain killer is given before the procedure begins, but it’s often not needed.
Deep peels, on the other hand, are a lot more uncomfortable, and often require sedation. The newest of the modern deep peel formulas can be performed under either oral or intravenous sedation, usually used in combination with local anesthetic injections to lessen the burning sensation. Modern deep chemical peels offer doctors a lot more options as far as how deep they penetrate into the skin, so it’s important to find out the specifics of your procedure, and discuss anesthesia option ahead of time.
Am I an ideal candidate for this treatment?
Generally speaking, people with fair skin and light hair make the best chemical peel candidates. That being said, patients with darker skin pigmentation can also achieve excellent results.
Smoking can have a negative impact on pretty much any cosmetic procedure, and chemical peels are no different. If you are a smoker, you will be asked to stop at least a couple of weeks before and after your treatment.
In most cases, current or former Accutane users should avoid chemical peels altogether. If you suffer from large or unusual scar formations, like keloids, chemical peels might not be the best option for you, and your practitioner might recommend a different treatment.
Be sure to discuss your medical history with your provider well ahead of your treatment to ensure that you are a good candidate for a chemical peel.
What are the side effects and risks of chemical peels?
In general, the deeper the chemical is able to penetrate into the skin, the higher the risk of complications and side effects. Chemical peel side effects are generally rare when the procedure is performed by an experienced practitioner, but they can include:
- A stinging and/or burning feeling. Most chemical peel treatments will result in at least a mild stinging or burning sensation. Even the lightest of light peels can cause temporary stinging. For most patients, this sensation isn’t usually painful, and some even like the feeling.
- Redness. This is a normal part of the post-peel healing process. Redness usually fades within a few hours for light peels, but might last as long as several months for medium and deep peels.
- Scarring. Though rare, chemical peels can cause scarring, usually on the lower half of the face. Antibiotics and steroids can be used to minimize these scars’ appearance.
- Crusting and skin irritation. A crust or scab might form on any areas treated with a chemical peel. This is your skin reacting to the mild trauma of the acid solution applied to it. The deeper the peel, the more likely a crust will form as the old layer of skin flakes away and the new skin appears.
- Flaking and peeling. These are perfectly normal side effects of most chemical peels and are usually mild and temporary. Make sure you don’t pick at this flaking and peeling skin, because that can lead to infections and scarring.
- Changes to your skin color. Chemical peel treated skin can become darker, resulting in something called hyperpigmentation. On the flipside, it can also become lighter than normal, an issue that is called hypopigmentation. Skin darkening is more common with lighter peels, while skin lightening is more common after a deep peel. Overall, changes in skin pigmentation are more common among patients with darker skin color. Unfortunately, these changes can be permanent.
- Infection. Chemical peels can cause a herpes infection to flare up, leading to a cold sore. Much more rarely, chemical peels can cause a bacterial or fungal infection as well. To reduce this risk, make sure you tell your provider about your history of cold sores, and follow post-treatment care instructions closely.
- Heart, kidney, or liver damage. Deep chemical peels use carbolic acid, which can cause an irregular heartbeat, and even damage the heart muscle itself. Carbolic acid can also cause damage to both the kidneys and liver. In order to limit your exposure to the chemical, deep peels are usually done in portions, broken into 10 or 20 minutes intervals.
Will my skin literally peel?
Yes. All chemical peels work by removing the outer layer of skin. After treatment, your skin will gradually flake and peel off, revealing the new, fresh layer beneath. That being said, it’s important that you don’t pick at or peel away any skin. It’s best to just allow the skin to flake and shed by itself; picking at it can cause scarring or hyperpigmentation problems.
How much do chemical peels cost?
Just like with every other detail regarding chemical peels, their cost depends on the type you choose to have.
- Professional light chemical peels usually run in the $150 to $300 range. While this is easily the lowest price range for the three types of professionally applied peels, light peels often needs to be repeated several times. Keep that in mind when calculating your final cost.
- Medium chemical peels usually cost between $1,000 and $2,000. Again, remember that medium peels often need to be repeated every two to three months.
- Deep peels are the most expensive of all three, but typically only need to be done once. Including consultation, anesthesia, and follow-up care, deep chemical peels typically cost $2,500 to $6,000.
- Chemical peel at home products are also an option. These are mostly light peels, so they need to be repeated often. Prices range from as little as about $10 to as high as $200 or more. It’s important that if you’re considering using a DIY chemical peel, you research about it thoroughly to make sure it’s suitable for you.
How do I know which peel is right for me?
With all the information available, and all the different kinds of peels to choose from, deciding on the right peel for you can be confusing. The very first thing you can do to figure out which peel will be the best option for your needs is to do a little research on chemical peels in general. This will give you a basic understanding of how each works, and what you can expect.
Secondly, you need to figure out why you’re considering a peel in the first place. Are you hoping to treat acne, age spots, discolorations, or perhaps just to maintain that youthful glow? Different chemicals used for the different peel depths have certain properties that may be better for your goals, so it’s important to know what you want the treatment for. For example, salicylic acid peels are usually better for oily and acne-prone skin, while glycolic acid is better for treating age spots, wrinkles, and fine lines.
Thirdly, it’s usually a good idea to start with the more mild chemical formulas. You won’t know what your skin can tolerate until the treatment begins, so it’s best to start light, and work your way up if necessary.
And lastly, speak with your provider. He or she will likely be the very best resource for information you’ll be able to find. A frank discussion regarding your goals as well as your medical history is usually enough information for them to be able to help you choose the best chemical peel.
Can chemical peels be used on areas other than the face?
Deep peels are only appropriate for use on the face, but the skin on any other part of the body can be treated with a mix of chemicals used for light and medium peels. In general, the chemical solution used for body chemical peels are made up of a combination of TCA, the main chemical used in medium peels, and glycolic acid, the principle ingredient in light peels. This solution is usually designed to be a little stronger than the solution used for light or medium peels, but more mild than the solution used for deep facial peels.
Just like with facial chemical peels, body peels can treat sun damaged skin, uneven coloration, and improve your skin’s texture. They’re also often used to lessen the appearance of stretch marks. Common areas that are treated include the hands and chest (décolletage). The stomach and upper arms may also be treated.
Is a chemical peel a facial?
Chemical peels and facials are two different things. While both are great for your skin, chemical peels contain medical grade ingredients that are designed to resolve specific complexion problems like fine lines, hyperpigmentation and roughness. Facials, on the other hand, don’t contain any medical grade ingredients nor do they resolve complexion issues. They’re just designed to relax you.
How long does a chemical peel last?
Generally speaking, the deeper the peel the longer lasting the results. The results of a chemical peel last for as long as the effects of the environment, aging and your lifestyle don’t take their toll. Healthy lifestyle habits will help to preserve your results. And remember — always protect your skin from the sun!
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