Many know what exfoliation (scrubs and peels) can do for the skin – it removes the surface dead skin cells that tend to dull and roughen skin, leaving it soft and smooth to touch, and looking bright and radiant instantly. But chemical peels go beyond just surface removal of dead skin cells. It is a technique used by trained medical doctors at an aesthetic clinic to peel off layers of skin for total rejuvenation, reversing melasma and breakouts and allowing new skin to regenerate.
What Is Chemical Peel?
A chemical peel is a skin specialist technique using chemical solutions to remove the topmost layers of skin to improve its appearance on the face, neck and hands. The result of new, regenerated skin is one that’s smooth, line-free and glowing.
There are three types of chemicals that can be used; glycolic acid (alpha hydroxy acids or AHA), the more potent, trichloroacetic acid and the Jessners solution which contain lactic and salicylic acid.
The more superficial at-home peels also use similar exfoliants in lower concentrations such as 35 to 50 percent alpha hydroxy acids, lactic acid, beta hydroxy acids (BHA) as well as fruit enzymes from natural ingredients such as pineapple, apple, kiwi and papaya.
How Does Chemical Peels Work?
Less intense than in-clinic peels, DIY home peels work by exfoliating top layers of skin cells and help break down the "glue" that holds complexion-dulling dead skin cells together, as well as clear up clogged pores, breakouts, dark spots, and dry skin. Home peels are a good option in maintaining clear, bright, even tone and smooth skin between professional treatments. Skin may sometimes feel tingly afterward, but there should be no other side effects like flaking or peeling.
Professional in-clinic peels on the other hand are to be applied by medical practitioners or doctors who use highly concentrated chemical exfoliants. Depending on the strength of the peel, they tend to result in some redness, noticeable skin flaking, peeling or downtime. For best results, a series of peels are recommended over a six to 12-week period, followed by maintenance twice a year.
What Can Chemical Peels Do For You?
In light (superficial) chemical peel, it is used to remove the outer layer of skin (epidermis) to help reduce the appearance of fine wrinkles especially around the eyes and mouth, and for the treatment of acne like whiteheads and blackheads, uneven skin tone and dryness. This can be repeated every two to five weeks depending on your desired results.
In medium chemical peel, it is used to remove skin cells from the epidermis and from portions of the upper part of the middle layer of skin (dermis) for the treatment of uneven skin tone, mild superficial acne scars, and to minimize melasma (sun spots, age spots and freckles) due to pregnancy or from taking birth control pills. This can be repeated after three to nine months to maintain results.
In deep chemical peel, it is used to removed skin cells from the epidermis and from portions of the middle to lower layer of your dermis. This is recommended for the treatment of deeper wrinkles, hyperpigmentation, scars or precancerous growths. However, a deep chemical peel can only be performed once.
Procedure and post treatment
Before a chemical peel, ensure that you have not used any type of retinol or retin-A topical medication for at least 48 hours. For about a week before the peel, avoid waxing or using depilatory hair-removal products as well as bleaching, massages or facial scrubs. Do inform your skincare specialist or doctor about any medications that you are taking, and that you have not been on Accutane for at least six months.
Prior to procedure, your medical doctor or practitioner will assess you and your skin for suitability and decide which peel strength and type of solution is best. Skin will be cleansed and prepped with pre-conditioning cream. Your face will be cleaned, and eye protection like goggles or gauze may be applied. For acne, you may require two to four AHA sessions but more for the treatment of acne scars. For freckles, you may need one to three sessions but more for deep pigmentary problems.
During a light peel, a cotton ball, gauze, or brush will be used to apply the chemical solution (salicylic acid) to the area being treated. The skin will start to whiten and may have a slight stinging or burning sensation for several minutes. Once completed, the solution will be removed or a neutralizing solution will be applied.
In a medium peel, your doctor will use a gauze, special sponge, or a cotton-tipped applicator to apply the chemical solution (glycolic or trichloroacetic acid) to the treatable area. Sometimes a blue peel may be added to the trichloroacetic acid. The skin will begin to whiten, and you may feel a stinging or burning sensation for up to 20 minutes. No neutralizing solution is needed, but you may get a hand-held fan or cool compress to ease the discomfort. If you’ve had the blue peel, a blue coloring of the skin may be present and last for several days after the peel.
For a deep peel, numbing cream or a regional anaesthetic may be used to numb larger areas like face and neck. For deep peels, you’ll also be given an IV, and your heart rate will be closely monitored. The doctor will use a cotton-tipped applicator to apply carbolic acid (phenol) to small areas of your skin to limit the skin exposure to the acid and to create a controlled wound. This will turn your skin white or gray.
Your post-treatment after care is crucial so be sure to follow your doctor's directions by carefully cleansing, moisturizing and regularly applying protective ointments to the skin. Skip your regular anti-aging skincare regime for a week. Do not scratch, pick or peel off the scabs. As skin will be very sensitive during this time, avoid sun exposure as much as possible and use sunblock before going out.
Risks and Side Effects
After a light chemical peel, treated skin will be red, dry and mildly irritated. Your doctor might apply a protective ointment, such as petroleum jelly, to soothe the area. These effects are said to become less noticeable with each repeat treatment. Treated areas take about one to seven days to heal with new skin possibly appearing temporarily lighter or darker than normal (this colour change is more common in darker skinned individuals).
After a medium chemical peel, treated skin will be red, tight and swollen and you'll feel a stinging sensation. Protective ointment such as petroleum jelly or ice packs may be applied to soothe and cool the area. Over-the-counter pain-relieving medication and naproxen sodium may also help to reduce any discomfort. As swelling decreases, treated skin will begin to form a crust and might darken or develop brown blotches. Treated areas take about seven to 14 days to heal with redness sometimes lasting for months.
After a deep chemical peel, treated skin will be very red, swollen, burning, throbbing, and may result in blisters and even scars. A watertight dressing may be applied to the treated skin and painkillers prescribed. You will have to sleep in a semi-reclined position to help reduce swelling. New skin will surface within two weeks after a deep chemical peel but watch out for cysts or white spots that may appear.
Avoid unprotected sun exposure. It's important to consistently use sunscreen at least four weeks before the procedure to help prevent irregular pigmentation in treated areas.
A low risk of scars can develop and may start as scabs which can become infected.
Very rarely do chemical peels cause fungal or bacterial infections.
The phenol used in deep peels can damage the heart muscle, kidneys, and liver, and cause irregular heartbeats.
Who Is Not Suitable For Chemical Peels?