Everything You Need To Know About Chemical Peels
How would you like to get your skin back to ‘amazing’? You may want to look into chemical peels.
Office-based chemical peels are essential for maintaining and restoring skin’s health and appearance. Performed by a skincare professional, a chemical peel (also known as chemexfoliation or dermapeeling) uses a chemical solution to remove layers of skin, revealing the more youthful skin underneath. Chemical peels can reduce or improve fine lines and wrinkles, acne, scars, uneven skin coloring and other skin imperfections. Different chemicals determine the depth of your peel and type of skin condition treated.
At PLEIJ we offer a range of chemical peels to help our client’s peel away dull, sun damaged skin, along with fine lines and wrinkles, brown spots and uneven skin tone, acne and large pores, as well as rosacea.
What is a Chemical Peel?
Our skin’s surface, known as the stratum cornium, naturally renews itself approximately every 28 days by replacing dead cells on the surface. This process slows over time due to the normal aging process as well as environmental damage.
Chemical peels are cosmetic treatments that involve using acids to rapidly exfoliate the skin.
The acid removes a uniform amount of damaged skin cells across the treatment area, typically the face and/or the neck. This controlled injury stimulates cells to produce more collagen and elastin restoring the skin texture, improved tone, and evening out the color.
When done appropriately, chemical peels produce exceptional results and are an indispensable and cost effective means of dramatically improving the skin’s appearance and texture. Chemical exfoliation is an effective treatment for creating beautiful skin any where on the body including the face, hands, neck, chest, back, and arms.
How do Chemical Peels work?
The peeling solutions used for chemical peels cause controlled kerato-coagulation (meaning it coagulates) and denaturation of the proteins within the epidermis and dermis, resulting in the release of proinflammatory cytokines and chemokines.1–7 This targeted inflammation activates the normal healing signal cascade, including stimulation, development and deposition of new dermal collagen and elastin, reorganization of structural scaffold proteins and dermal connective tissue, and regeneration of new keratinocytes.1–10 This results in rejuvenation and thickening of the epidermis and an increase in dermal volume.1–10 Simultaneously, the kerato-coagulation and subsequent exfoliation result in improvement in superficial and medium-depth dispigmentation.1–10
While there might be subtle variability between the types of chemical agents used and their intended cosmetic outcome (i.e., reduction of redness vs. dispigmentation vs. scarring), the general goal of a chemical peel is to improve the clinical appearance of skin by decreasing the quantity and quality of rhytides and/or acne scars, reducing inflammatory and noninflammatory acne lesions, improving dispigmentation, and producing an overall more youthful appearance.3
Chemical peels can affect two layers of the skin, the epidermis and the dermis. The epidermis is the visible outer layer, and the dermis sits just beneath. While all chemical peels remove a controlled amount of skin cells from the epidermis. A stronger peel may also remove a small part of the dermis.
What conditions does a Chemical Peel treat?
Chemical peels are used to treat certain skin conditions or to improve your appearance by improving the tone and texture of your skin.
Chemical peels are most commonly performed on your face, neck or hands. They can help reduce or improve:
• fine lines and wrinkles
• dullness
• rough texture
• acne
• unclogs oily, congested pores
• enlarged pores
• mild scarring
• redness
• rosacea
• hyperpigmentation including uneven coloring, sun spots, freckles and melasma
• laxity
• moisture balance – increases hydration
Sags, bulges, deep scars, deep facial lines and more severe wrinkles don’t respond well to chemical peels. If these are your concerns, other cosmetic surgical procedures, such as carbon dioxide laser resurfacing, a face lift, brow lift, eye lift or soft tissue filler will be better options. A dermatologic surgeon can help determine the best treatment for the fore mentioned concerns.
How are Chemical Peels performed?
You will work with your esthetician to determine the depth of your peel. This joint decision can vary depending upon the condition of your skin and the objectives of treatment.
During a chemical peel, your skin will be thoroughly cleansed with an agent that removes excess oils before the skincare professional applies an exfoliant acid — first to the thicker areas of skin, such as the chin, nose, and cheeks, and then to the thinner areas around the eyes and mouth.
Peeling solutions typically used include glycolic acid, trichloroacetic acid, salicylic acid, lactic acid or carbolic acid (phenol). The different types of acids cause a controlled injury, each penetrating through to a different skin depth, then peeling away to reveal a new layer of skin.
The different peeling solutions provide different results. The choice of acids depends on your goal. Again you will work with your skin care professional to determine the depth of your peel.
After the chemical peel, the professional may use cool compresses to remove any remaining exfoliant.
They may recommend various ways to help the skin heal, such as applying a weak vinegar solution or unscented emollient to the face for a few days after the treatment.
The process can cause swelling and peeling, which may take 1–2 weeks to go away, depending on the depth and intensity of the peel. It is important to keep the face dry and not shower or use face wash for the first 24 hours. Also, do not use makeup until the skin has healed.
Origins of Peeling Agents
Most chemical peeling agents have natural origins. The hydroxy acids used in light peels all come from food: tartaric acid from grapes, malic acid from apples, glycolic acid from sugar cane, and lactic acid from sour milk.
At PLEIJ we generally prefer to use a stronger peeling agent to remove sun damage and lines — trichloracetic acid (TCA). This acid is a modified synthetic chemical that is based in common vinegar and acetic acid.
Types of Chemical Peels
There are three types of chemical peels, based on how deeply they exfoliate the skin:
• superficial (light or lunchtime) peels
• medium-depth peels
• deep peels
The right choice depends on the type and shade of a person’s skin and what issue they are hoping to address.
Superficial peels
Professionals recommend superficial peels if skin issues only affect the top layer of the skin, the epidermis. This choice may be best if you have fine wrinkling, acne, uneven skin coloring or dry, rough sun-damaged skin to help promote a healthy glow.
Because superficial peels do not penetrate the deeper layers, they carry a lower risk of side effects and the skin tends to recover more quickly.
Superficial peels take 1–7 days to heal. It is important to wear sunscreen during this time.
Because superficial peels are the gentlest type, a person may need up to five sessions to see the results they desire. Superficial peels can be performed as frequently as every 2–5 weeks.
Medium-depth peels
Skin professionals may recommend medium-depth peels for:
• fine to moderate lines and wrinkles
• sun-damaged skin
• hyperpigmentation including uneven or moderate skin discoloring, age spots
• acne and/or minor acne scars
Medium-depth peels take 7–14 days to heal. They cause swelling that worsens for 48 hours after the treatment and may cause blisters.
The professional provides a solution that a person should use to help their skin heal. It is also important to avoid sun exposure during the recovery time.
People can wear makeup after 5–7 days but must avoid total sun exposure until the skin heals fully.
Deep peels
A deep chemical peel produces the most dramatic results. This chemical penetrates down to the lower middle layer of your skin. Recovery time is longer with a deep peel. This choice may be best if you have moderate lines and wrinkles, extensive sun-damaged skin, deep acne scars, blotchy skin, and/or precancerous growths called actinic keratosis. A deep chemical peel requires pretreatment for up to eight weeks. Your professional will provide specific instructions.
Skincare professionals do not usually use deep chemical peels. For issues affecting the deeper layers, laser therapy often provides better results.
Due to their strength, deep peels take 14–21 days to heal. A person needs to:
• Recuperate at home.
• Take antiviral medication for 10–14 days.
• Wash the skin with a special solution between four and six times a day.
• Apply an ointment for 14 days, then use a thick moisturizer.
• Avoid makeup for at least 14 days.
• Avoid sun exposure for 3–6 months.
Types of Acid
Chemical peels can contain different types of acid, including:
• Alpha-hydroxy acids: Some examples include glycolic acid, lactic acid, and citric acid. At-home exfoliating treatments often contain these acids.
• Beta-hydroxy acids: Salicylic acid is one example, and it is especially beneficial for acne-prone skin and enlarged pores.
• Trichloroacetic acid: Skin professionals typically use this in medium or deep chemical peels.
• Phenol: This powerful chemical agent is useful in deep peels.
Click here if you’re interested in learning more about the different types of Chemical Peels.
What is Chemical Peel Frosting?
Some chemicals in peels cause the skin to develop a white coating, which professionals refer to as “frosting.”
Frosting signals the end-stage of a peel. Its presence and extent helps the doctor tell whether the peel has been sufficiently effective.
There are three levels of frosting:
• patches of white coating over red skin
• a general white coating with redness underneath
• a complete coverage of white coating with almost no redness
How to prepare for your Chemical Peel?
To get the most out of a professional peel a thorough consultation should be performed. Your goals and what you have done to take care of your skin, up to this point, is important information which can affect the outcome of your treatment.
A supportive home skin care regime should be used to prep your skin for 10-14 days before your first treatment and proper care after is very important to maximize the results. Often times a patch test is done during the consultation to test for skin sensitivity. Following the treatment proper home care will enhance the results in the same way that having peels can improve product penetration. They work together to obtain the best results.
Most everyone and all skin types can benefit from a chemical exfoliation treatment. Contraindications would be Accutane use, Retin A use within 5 days, pregnancy or lactating, active sun exposure or tanning bed use, waxing services, recent injectables and any compromised surface condition such as eczema, scratches, wounds, cold sores and/or inflammation. The Fitzpatrick Scale is a classification used to determine the amount of melanin in the skin and guides the esthetician in choosing the best peel options for the desired outcome.
To prepare for your chemical peel, some general instructions include:
• Avoid tanning and direct sun exposure for two weeks before each treatment.
• Apply topical products (such as hydroquinone) as instructed before treatment to prepare your skin.
• Don’t use any products containing retinoids (such as tretinoin) one to two weeks before treatment, unless your professional advises otherwise.
• If you have been prescribed oral antibiotics or an oral antiviral medicine, start taking it at least 24 hours before your chemical peel.
• Peel areas must be free of any open sores, lesions or skin infections.
Your professional will give you specific instructions for your peel type and your unique skin condition.
What to Expect After a Chemical Peel?
What to expect varies depending on the depth of your chemical peel.
If you’ve had a light chemical peel:
• Expect a sunburn-like reaction to occur after your peel, meaning you’ll see redness followed by scaling that lasts between three and seven days.
• Apply lotion or cream as directed until your skin heals. After your skin heals, apply daily sunscreen.
• You can wear makeup immediately after treatment or the next day.
Additional peels may be repeated every two to five weeks until you achieve your desired results. Typically three to five peels are needed to achieve your goal.
If you’ve had a medium chemical peel:
• Expect some redness, swelling, stinging and flaking of your skin. Swelling may last and/or worsen for 48 hours. Blisters can develop and will break open. Skin will crust and peel off over seven to 14 days.
• Perform daily soaks as directed by your professional. Apply ointment after each soak. Apply lotion or cream daily. Don’t expose your skin to sunlight until completely healed.
• Antiviral medication will need to be taken for 10 to 14 days.
• You can wear makeup after five to seven days.
Additional medium-depth peels may be repeated at six to 12 months intervals, if needed, to maintain results.
If you’ve had a deep chemical peel:
• The treatment area will be bandaged. Your bandages will be removed in a few days. Expect a healing time of 14 to 21 days.
• Perform daily soaks as directed by your doctor. Apply ointment after each soak. After 14 days, apply moisturizer as directed. Don’t expose your skin to sun for three to six months.
• Antiviral medication will need to be taken for 10 to 14 days.
• Wait at least 14 days before using any makeup.
You can only have one deep peel performed on your face.
To get the best results, regardless of the depth of your peel, follow these tips:
• Don’t use a tanning bed or other type of indoor or even outdoor tanning while your skin is healing.
• After your skin heals, always apply a daily sunscreen.
• Apply a daily moisturizer, as directed, to keep your skin moist to prevent scarring.
Your new skin is fragile and more susceptible to complications. Your professional will provide you with post-treatment instructions to reduce the chance of developing abnormal skin color after your peel and other complications.
If your skin itches, swells or burns, call your doctor. Scratching your skin could lead to an infection.
Side effects
The side effects of a chemical peel can be mild. However, some people develop lasting adverse effects, such as:
• redness that lasts for months
• temporary dark patches of skin
• permanently lightened patches of skin
• scarring
The best way to avoid these is to visit an experienced skincare professional and follow their aftercare instructions carefully.
Chemical Peel Risks by Skin Color
Many skincare professionals use the Fitzpatrick scale when deciding on a type of peel to recommend. This scale classifies skin by six types:
1. white skin that always burns and never tans
2. white skin that usually burns and does not tan easily
3. darker white skin that may burn slightly and tans
4. moderate brown skin that rarely burns and tans easily
5. darker brown skin that very rarely burns and tans very easily
6. black skin that does not burn and tans very easily
People with skin types 1, 2, or 3 have a far lower risk of a chemical peel changing the color of their skin or causing scarring. This means that any type of peel may be safe.
People with skin types 4, 5, or 6 have a higher risk of a peel causing severe skin discoloration or scarring. For this reason, it is crucial to visit a skincare professional who has experience with chemical peels and skin of color.
In general, superficial chemical peels such as our Sensi Peel are safe for people with brown or black skin. However, the risk increases with peels of greater depth.
A skincare professional with experience will use extreme caution when giving a medium-depth peel to someone with brown or black skin. They should not recommend or perform deep peels, due to the high risk of skin discoloration and scarring.
At-home treatments
Many commercial products contain the same agents used in chemical peels. However, they contain much lower concentrations of acid and thus aren’t nearly as effective and take much longer to produce any noticeable results.
Products with the following ingredients may exfoliate the skin in a similar way to a professional peel, but with less dramatic results:
• Glycolic acid: This can treat surface-level pigmentation, mild signs of aging, fine lines, and sun damage.
• Lactic acid: This is also useful for minor sun damage, fine lines, and hyperpigmentation. It is similarly effective to glycolic acid.
• Mandelic acid: This acid is effective for treating superficial redness and an uneven skin tone.
• Salicylic acid: This can help with oily or acne-prone skin.
Professional vs. at-home treatments
It is important to choose a skincare professional who has experience with chemical peels. This is especially important for people of color, whose skin can be more prone to the side effects of chemical peels.
The professional will explain which type of peel may be best for a person’s skin and which products will support healing afterward.
People with more severe skin conditions may have better results from professional treatments, which contain higher concentrations of acid than over the counter, retail products.
However, cost can be a consideration. A superficial peel may cost at least $125, while a medium-depth peel is more expensive. According to the American Society of Plastic Surgeons, the average cost of a chemical peel is $519. Insurance companies do not cover the cost, as chemical peels are cosmetic treatments.
At PLEIJ Salon + Spa in Columbus, Ohio we offer a range of chemical peel services including our Revive (Express) Peel which is a great starting point for anyone who hasn’t been giving their skin the attention it deserves, the Resurfacing Peel w/Vitamin-Infused Mask which is a custom peel that is adjusted to your skin type, sensitivity and comfort level, as well as the Revitalizing Facial Peel which is our premium chemical peel service which uses the Environ “Cool” Peeling System which can be left on the skin longer for a stronger, and deeper peel.
At-home products are cheaper, but they contain weaker solutions of chemicals. These may be better suited for people with milder skin concerns, such as minor sun damage.
While these retail products require no downtime for healing, it is still important to avoid sun exposure.
Strong acids can cause serious side effects, therefore a person should never use professional-strength chemical peeling agents at home.
Even the less powerful ingredients in retail products can lead to burns. Use these with caution and follow the instructions carefully.
In Summary
You’ve got quite a few options depending on what your needs are and how sensitive your skin is. For the best effects, it’s important that you research the different types of chemical peels before you make your appointment. Or better yet, consult with one of our experienced Columbus, OH estheticians to determine the best type of peel for your skin. Skin care should not be taken lightly, so make sure you know as much as you can, especially when looking at a chemical peel solutions.
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