A woman's peeling face after a chemical peel

Everything You Need to Know About Chemical Peels

Recent advances in chemical peeling types and techniques have led to safer, more effective, and more versatile treatments for a variety of skin types and skin concerns. Here, we highlight everything you need to know about chemical peels: how they work, what conditions they treat, and which ones might work best for you.

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From at-home treatments to in-office procedures, chemical peels are becoming increasingly popular. New peeling types and techniques — backed by a growing body of research — has led to safer, more effective, and more versatile treatments for a variety of skin types and skin concerns.

Here, we highlight everything you need to know about chemical peels: how they work, what conditions they treat, and which ones might work best for you.

 

 

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How do chemical peels work?

A peel — whether it’s performed at home or in the dermatologist’s office, exfoliates the skin’s dead, outer layers to reveal newer, presumably younger-looking, skin beneath. Most peeling solutions are keratolytics — meaning they accomplish their effects by chemically breaking down the bonds that hold dead cells (aka corneocytes) together.

Chemical peels (also known as chemical exfoliation) have been around since ancient times: even Cleopatra is alleged to have bathed in donkey milk (a rich source of lactic acid). In the past century or so, many peeling solutions have been developed and proven to be effective for addressing a variety of skin concerns.

What conditions do chemical peels treat?

Dermatologists evaluate which type of peel to use based on a patient’s skin type and concerns. Chemical peels can address myriad skin conditions, including:

How deep do chemical peels go?

There are three depths of chemical peels:

  • Light/superficial: removes layers from the epidermis only, to varying degrees
  • Medium: removes the entire epidermis and into the papillary (upper) dermis
  • Deep: removes the entire epidermis, papillary dermis, and into the reticular dermis

The depth of a peel depends on a combination of factors, including:

  • Peeling agent
  • Concentration
  • Solution pH
  • Application technique
  • Duration of procedure (unless self-neutralizing)
  • Skin type + thickness
  • Skin health

 

How deep do chemical peels go

 

Which skin types benefit from chemical peels?

Decades of research has shown that certain types of peels work better for particular skin types. Generally speaking, there is a chemical peel solution and depth that works well for every skin tone, from very fair to very dark — so seek out a provider who specializes in your skin type and concern. Though it’s best to have a dermatologist evaluate your unique skin, rules of thumb include:

  • Darker skin tones should avoid medium and deep peels
  • Lighter skin tones can tolerate deeper peeling
  • People who tend to develop hypertrophic, keloid, or hyperpigmented scars should avoid medium/deep peels
  • People with skin conditions like melasma, rosacea, eczema and psoriasis should stick to lighter peels
  • Those taking isotretinoin and certain other medications should not undergo chemical peels
  • Anyone with active herpes virus (aka cold sores) should not peel

What are the most common kinds of chemical peels?

Different peel solutions can address varying skin concerns. Here, we break down the most common types of chemical peeling solutions. Note that not all concentrations/depths of peels are appropriate for all of the skin types listed here — it’s best to consult with a dermatologist who specializes in treating patients with your skin type.

Glycolic acid

Type: alpha hydroxy acid
Derived from: fruit (commonly sugarcane)
Concentration: 10-70%
Depth: light to medium (can go deeper)
Neutralization: basic solution required
Skin Type: Fitzpatrick I-VI
Best for: PIH, melasma, acne, superficial scarring, sunspots, uneven tone/texture

 

Salicylic acid

Type: beta hydroxy acid
Derived from: originally derived from willow tree bark, now also synthetically produced
Concentration: 10-50%
Depth: light to medium (can go deeper)
Neutralization: self-neutralizing
Skin Type: Fitzpatrick I-VI
Best for: PIH, melasma, acne, sunspots, uneven tone/texture

 

Tretinoin (aka retinoic acid peel)

Type: retinoid
Derived from: vitamin A
Concentration: 1-5%
Depth: light to medium
Neutralization: self-neutralizing
Skin Type: Fitzpatrick I-V
Best for: PIH, melasma, acne, sunspots, uneven tone/texture

 

Trichloroacetic acid (aka TCA)

Type: organic (carbon-containing) acid
Derived from: vinegar
Concentration: 10-35%
Depth: light, medium, deep (lighter tones only)
Neutralization: self-neutralizing
Skin Type: Fitzpatrick I-VI
Best for: fine lines, uneven tone/texture, melasma, PIH, sunspots

 

Jessner’s Solution

Type: blended acid
Derived from: lactic acid + salicylic acid + resorcinol (alternatively, TCA or citric acid)
Concentration: 14% of each acid
Depth: medium
Neutralization: self-neutralizing
Skin Type: Fitzpatrick I-III
Best for: fine lines, uneven tone/texture, melasma, PIH, sunspots, acne, superficial scarring

 

Baker-Gordon

Type: acid/oil blend
Derived from: phenol (aka carbolic acid) + croton oil (from plant seeds)
Concentration: varies, often 88% phenol and 0.05-1.0% croton oil
Depth: deep
Neutralization: self-neutralizing
Skin Type: Fitzpatrick I-III
Best for: fine lines/wrinkles, uneven tone/texture, PIH, sunspots, scarring

 

Can you do a chemical peel at home?

The short answer: it depends. There are many different superficial peels available at over-the-counter strengths, addressing everything from post-inflammatory hyperpigmentation to dullness. These are generally formulated to be safe and effective, when used as directed (and not too frequently). Check the product labeling for any contraindications for your skin type — and perform a patch test if you’re sensitive.

In between chemical peeling, or to get a feel for some of the ingredients used during a chemical peel, try experimenting with a product like SLMD AHA/BHA Swipes. These cotton rounds contain a solution of glycolic, lactic, and salicylic acids to gently exfoliate, clear out pores, and fade excess pigmentation — no neutralizing necessary.

It’s worth noting that while you can easily find medical concentrations of chemical peeling agents like glycolic acid and TCA online, it’s never safe to try deeper treatments at home.

What are the risks of chemical peels?

Even very superficial or at-home chemical peels can have side effects, particularly if you have darker skin and/or existing skin conditions — so it’s best to do your homework, and talk to a dermatologist if you have concerns. Definitely do not try the higher concentration peels that are readily available online and promoted on YouTube: you could end up permanently scarred.

After you get a professional chemical peel, you can expect to experience at least a few common side effects, including:

  • Sun sensitivity
  • Erythema (aka redness)
  • Peeling/flaking
  • Purging (temporary increase in acne)
  • Milia (white, cyst-like bumps)

Rarer and more serious complications can occur during or after a peel, like:

  • Infection
  • Blistering
  • Dyschromia (hyper and hypopigmentation, more common in darker skin)
  • Scarring
  • Temporary heart arrhythmia (during phenol peels)

How do you prepare for a chemical peel?

Your dermatologist will walk you through what to expect during and after your treatment, and will likely give you instructions to help prepare your skin for a chemical peel. Depending on your unique situation, these steps may increase the likelihood of a successful result with fewer complications:

  • Retinoids: boosting cell turnover prior to a peel can yield more even results.
  • Skin lighteners: fading hyperpigmentation first can provide more dramatic change.
  • Antivirals: depending on the peel depth, herpes virus medication may be given prophylactically.
  • Medication: certain drugs (including isotretinoin, antibiotics and oral contraceptives) may need to be stopped for a period surrounding the peel.
  • Sunscreen: preventing UV damage both before and after a chemical peel is crucial.

Dr. Lee’s last word

Dermatologists have been using chemical peels to treat things like acne, sun damage, and fine lines for decades. We perform a variety of peels at my practice, depending on your skin type and your goals. Many of these peel ingredients — like alpha and beta hydroxy acids — are the same actives I use in my SLMD Skincare.

—Dr. Sandra Lee

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