All About Skin Peel Treatments

With so many cosmeceutical and medical grade peels promising highly desirable results such as wrinkle reduction, skin tightening, acne treatment, and pigment brightening, it’s no wonder people are confused and overwhelmed by the options available. In an effort to help dispel some of the confusion around chemical peels we’ve created a short but informative article breaking down the topical agents that have been shown to improve skin quality and reduce visible signs of aging.

What is a chemical peel?

Chemical peeling is the process of administering chemicals topically to the skin to destroy the protein binding that causes them to adhere. When that binding is broken, the normal process of desquamation (exfoliation) is accelerated revealing a smoother, more youthful complexion. The ultimate goal of chemical peeling is to reduce actinic changes, eliminate fine lines, reduce wrinkles, and lighten pigmentary irregularities. Peel depth is determined by what layers of the skin the chemical is able to effect. 

Light/Superficial peel

Often referred to as the “lunchtime peel”, these peels are the gentlest option available and are a great choice for younger patients and those new to skin peeling. Typical acids used are glycolic, lactic, salicylic, malic, and retinoic acid. Light peels are recommended for overall skin brightening, reduction in acne breakouts and treatment of hyperpigmentation. Light peels require little to no downtime and are suitable for most skin types/conditions. A good example of a light peel or superficial peel is a lactic acid peel. Lactic acid is derived from milk and is historically one of the best tolerated, gentlest types of chemical peel. It's a great option for patients with dry or sensitive skin as it works only on the cells of the outer layer of the epidermis and doesn’t penetrate deeply enough to cause erythema, swelling, or excessive peeling. Bonus, lactic acid is a natural humectant so it helps to hydrate the skin post peel.  

Medium Depth peel

Medium-depth peels can reduce senile lentigines (small brown patches), and mixed melasma. Additionally, they can stimulate collagen synthesis helping to reduce visible fine lines and wrinkles. They penetrate the outer and middle layers of skin to help remove damaged skin cells and increase new cell formation. Because medium depth peels require the application of a strong acid, they’re safest when applied in a medical setting. The three most commonly useds acids for medium-depth peels are salicylic, glycolic, and trichloroacetic acid used at concentrations of 35% or less. In these concentrations the skin will be (temporarily) red and raw feeling until re-epithelialization occurs. Patients must apply a protective ointment frequently, avoid sun exposure and  for at least one week. Recovery time ranges anywhere from 5-10 days and patients must comply with post-peel care to ensure a positive result.

Deep Peels

The deepest chemical peels are intended to treat significant skin issues such as hypertrophic acne scarring, loss of skin elasticity, excessive sun damage, and dermal pigmentation. Trichloroacetic acid (in higher concentrations) or phenol is applied topically to deeply penetrate the mid-layer (dermis) of the skin. The result is a significant improvement in the overall appearance of the skin. Deeper peels are not usually recommended for medium to darker skin tones as they can induce both hyper and hypo pigmentation. Similarly to medium depth peels, post-peel-compliance is critical to ensure a positive result. Downtime is usually 10-14 days but can take longer depending on the individual. It’s worth noting that deeper-peels come with great risks such as post-inflammatory-hyperpigmentation, prolonged erythema, and skin sensitivity. 

What you need to know beforehand

It’s important to have realistic expectations when understanding what results chemical peels can achieve. Often peels can be done in a series of four, spaced out one month apart, to provide full skin regeneration. Contraindications to chemical peeling include poor healing, radiation, diabetes, pregnancy, and use of isotretinoin. The treated areas should be kept protected with a petrolatum-based product and often we recommend a topical hydrocortisone cream to reduce itching and sensitivity. Patients must avoid direct sun exposure, heavy exercising, and sweating for at least 1-2 days. Once re-epithelization has occurred, skincare regimens, sunscreen, and normal daily activities can be resumed. 

Read more about all the chemical peels that we offer here and book a chemical peel by clicking here!

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