Chemical peels first gained popularity in the 1960s when skin-care options were few and far between. Chemical peel treatments have remained a favorite because they can resurface and refresh the skin by diminishing the appearance of fine lines, wrinkles, sun damage, enlarged pores, hyperpigmentation and acne scars. Today, chemical peels are often coupled with other skin-enhancing treatments for maximum benefits. It is extremely important that the person administering these treatments is an experienced skin practitioner. If the peel is not left on long enough there will be no effect on the skin; if it is left on for too long, it can cause damage to the living cells.

Most acid peels work by disrupting the bonds between dead skin cells. The speed and depth of exfoliation is determined by the specific acid used, its acidity or pH, the concentration of the solution, and the amount of time it is left on the skin. Once the skin is injured by the peel, the skin begins to naturally repair itself. The dead skin flakes away to reveal new, fresh skin.

Chemical skin peels can range from superficial to medium or deep. Superficial peels are generally recommended in a series of at least six, while a deeper peel may be a one-time treatment. Deeper peels may require significant downtime. Deeper chemical peels are all cosmetic skin treatments that remove the outer layers of the skin, leaving you with fresh, pink, healthier-looking skin once healing is complete. Some local numbing cream may require and procedure normally takes 30min to 1 hour. Average treatment cost starting at $450 per session with little to no downtime. One word of caution: While using these high-strength treatments, diligent sun protection with an SPF of 30 or more every day is A MUST for two reasons – First, sun exposure can trigger production of the pigment you are trying to eliminate, and second, chemical peels increase sun sensitivity.

Glycolic Acid Peels (one of many alphahydroxy acids) a light peel.

Salicylic Acid Peels (an ingredient also found in a Jessner’s Peel) a light to medium peel.

TCA-based Peels (Obagi Blue Peel) a medium peel.

Phenols (croton oil-based) a deep peel.


Glycolic Peels – Light Peels

Glycolic acid peels (formulated from sugar cane) are virtually downtime-free skin treatments, which come with mild redness or irritation as the only likely after-effect. Glycolic acid peels, in particular, contain alphahydroxy acids (AHAs) that gently exfoliate the skin to unclog oil-filled sebaceous glands. Peels that utilize AHAs penetrate the skin and help remove layers of dull, dry skin. A series of 5 in-office peels, spaced 3 weeks apart, can be effective for alleviating minor skin spots and blemishing.

Alphahydroxy acids (AHAs) in concentrations of 30% or more are applied for 2 to 5 minutes (or more) to slough away the upper layer of dead skin cells as well as penetrate into the upper layers of the dermis to soften fine lines, promote a rosy glow, improve the appearance of excess pigment by exfoliating the upper layers of the skin where some pigment resides, encourage better penetration of other skin-care products or even dry an acne flare up.

If your skin is sensitive or if you suffer from a condition like rosacea, talk to your aesthetician about a lactic acid peel. Lactic acid peels have similar effects to glycolic peels, although lactic acid is generally milder. Plus, lactic acid peels, which are derived from sour milk, offer up a subtle lightening effect.


Salicylic Peels – Betahydroxy Acids

Jessner’s Solution is the common name often used for a deeper chemical peel solution made from resorcinol and lactic and salicylic acids. Salicylic peels are often applied after a glycolic peel of 30 to 50% concentration.

Although not appropriate for anyone with an active breakout, this type of peel can also provide rejuvenating benefits such as the reduction of fine lines and discoloration, and can stimulate new collagen production. Although TCA varies in concentration, it is most often a deeper peel that requires about 2 full weeks of downtime and diligent sun protection both during and after treatment.

Named after New York dermatologist Max Jessner, MD, who invented it, Jessner’s Solution is layered on the skin to treat uneven pigmentation, acne, acne scarring and other skin irregularities. You can expect aggressive peeling and occasional crusting forms within 2 to 4 days after the peel has been applied. Redness and swelling may last a week or more. Results are visible with new, clearer skin within 7 to 10 days, but redness or other pigment changes may persist for several weeks.

Betahydroxy acid peels are good for oily skin, acne, uneven skin tone, fine lines and wrinkles. Salicylic acid peels, which are similar to low-strength alphahydroxy acid peels, are best for fighting blackheads, whiteheads, clogged pores, fine lines, wrinkles and uneven skin tone.

Salicylic acid peels have effects limited to the epidermis because the acid does not penetrate deep within the skin no matter how long it is left on for. If your skin is dry or normal, a salicylic acid peel, which is the main type of betahydroxy acid peel, may be too harsh for you.

Chemical peels exfoliate the top layer of skin, causing the natural cell turnover process to speed up. Salicylic and glycolic acids are two of the most commonly used ingredients in light peels. They refresh the skin by removing discolored skin cells. Plus, they work wonders on acne-prone skin’s oil production is minimized, pores are unplugged, and blemishes, blackheads and whiteheads shrink in size.


TCA-based Obagi Blue Peels – Medium Peels

Medium-strength Trichloroacetic acid (TCA) peels are best for those with fair skin (since post-inflammatory hyperpigmentation is possible) looking to tackle extreme pigment problems like melasma. TCA peels should only be performed by an experienced physician, since the concentration of acid and duration of contact are critical in determining the peel’s effect. Since TCA peels are medium strength, they always cause stinging and redness. Stronger concentrations of TCA can penetrate into the dermis and create significant peeling and redness that may last for more than a week. TCA peels can soften acne scarring, erase surface wrinkles and eliminate hyperpigmentation.

There are a variety of peels that are effective for brown spots, such as the Obagi Blue Peel, which can only be found in doctors offices. Obagi Blue Peel, requires one cycle of pre-peel prepping to prevent hyperpigmentation from occurring during the actual peel. The Obagi Blue chemical peels are good for reducing fine lines, improving skin texture and even softening sun-damaged skin. The peel is designed to prevent over-exfoliation of the skin using a special blue tint that usually washes off in 12 to 24 hours.

Most TCA-based peels are a one-time treatment and require one to two weeks of downtime until crusting heals to reveal smoother, younger, clearer pink skin. While treatments vary, the skin’s surface must be rejuvenated to get rid of the sun-damaged cells and stimulate the body to make more collagen.

Usually just one TCA peel, which takes about 10 to 15 minutes, will reduce medium to deep discoloration but in some cases, more than one treatment is needed to achieve the desired results.

Before the peel, your doctor will probably apply a topical anesthetic; otherwise you may feel some stinging. Post-peel, your skin will crust or scab and your face may be swollen for a few days. And while the results are not permanent, once your skin is fully healed (within about seven to 10 days after the treatment), it will still be able to produce pigment. To prevent hyperpigmentation from returning, make sure to stay out of the sun for the first few months after your peel and wear an SPF daily.


Phenol Acid Peels – Deep Peels

Phenol peels are the strongest type of chemical skin peel available. They penetrate deep within the skin to treat severe wrinkles, sun damage, lines and wrinkles. Even though this is a major treatment, it offers profound benefits for wrinkles and uneven pigmentation.

Phenol peels offer the most dramatic results because the skin is forced into creating new, thicker collagen. But because deep peels are so strong (they are always performed with anesthesia and your doctor will prescribe pain medication to take at home after your peel), they usually are only used on the face since they can cause scarring on the neck and other parts of the body. Keep in mind that phenol peels, which are generally performed only once, can cause a demarcation line on your skin, regardless of your skin type, and require a healing time of at least 2 weeks.

There are some risks associated with phenol peels. Always consult with your doctor to achieve a complete understanding of any side effects or complications from its use.

Regardless of the type of peel that you eventually decide on with your doctor, your skin may appear red and irritated for a few days after the treatment and will peel for at least one week or more before fresh, new skin is revealed. Any deep peel or laser may produce permanent pigment changes in some patients.

Patients with deep wrinkles around the eyes and mouth are candidates for CO2 laser or erbium laser skin resurfacing at the time of their face-lift. I will post everything you need to know about lasers in my next post.

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