A chemical peel is a facial skin resurfacing treatment done to improve the skin’s appearance. Mild chemical agents are applied to the skin, which makes it blister and promotes eventual peeling of the superficial layers of skin. The basic principle of skin resurfacing is to promote the new generation and reorganization of the superficial layers of the skin, thereby improving the color, texture, and smoothness of the skin. This is done by removal or intentional injury of the most superficial layers of the skin, which stimulates the growth of new layers of skin. The new skin is usually smoother and less wrinkled than the old skin.
Multiple different preparations can be used to alter the depth of penetration and thereby the degree of skin remodeling achieved. Anesthesia depends upon the type of peel used but varies from ice applied prior to peeling, to moderate or general sedation.
Men and women who have fair skin and/or light hair are ideal candidates for chemical peels, as there is less chance for uneven skin tone after the procedure. Whereas men and women with darker skin may have good results depending upon the type of problem being treated, but they have a higher risk of uneven skin tone after the procedure.
Normally, chemical peels are recommended for men and women who have fine wrinkles in the skin of the face due to sun damage, cigarette smoking, and aging. Those who have more severe wrinkles, skin sags, and bulges may not benefit from chemical peels and may need other kinds of cosmetic surgical procedures, such as laser resurfacing, a face lift, brow lift, eyelid lift, or soft tissue filler (Hyaluronic acid, e.g. Juvederm™, etc. or fat transfer).
Chemical peels can be done on the face, neck, or hands. They can be used to:
- Reduce fine lines under the eyes and around the mouth
- Treat wrinkles caused by sun damage and aging
- Improve the appearance of mild scars
- Treat certain types of acne
- Reduce age spots, freckles, and dark patches (melasma) due to pregnancy or taking birth control pills
- Improve the look and feel of skin
- Improve areas of sun damage
During your consultation, you should tell your doctor if you have any history of scarring, cold sores that keep coming back, use of Accutane or facial X-rays.
Before your chemical peel, your doctor may also ask you to stop taking certain drugs and ask you to prepare your skin by using other medications, such as Retin-A, Renova, or glycolic acid. Your doctor may also prescribe antibiotics or antiviral drugs.
The depth of your peel will depend upon the condition of your skin and your goals for treatment. You and your doctor will determine the depth of your peel before treatment.
At this time, you should also address any questions you may have with your doctor including whether or not you will need someone to drive you home after your peel.
A chemical peel is done in a doctor’s office or surgery center on an outpatient basis (meaning there is no overnight stay).
After your face is cleaned thoroughly, one or more chemical solutions, such as glycolic acid, trichloroacetic acid, salicylic acid, lactic acid, or carbolic acid (phenol) will be applied to small areas of your skin. This is done to create a controlled wound, letting new skin take its place.
Most people tolerate treatment with minimal discomfort. During a chemical peel, you may feel a burning sensation that lasts about 5 to 10 minutes, followed by a stinging sensation. Putting cool compresses on the skin may ease that stinging. For a deeper peel, you may need pain medication during or after treatment.
Recovery includes a variable amount of redness immediately after treatment although discomfort is usually minimal. Peeling usually involves redness as well followed by scaling that ends within 3 to 7 days. Medium-depth and deep peeling may result in swelling as well as blisters that may break, crust, turn brown, and peel off over a period of 7 to 14 days.
After treatment, you may need bandages for several days on part or all of the skin that was treated.
After a chemical peel, your skin is more sensitive to the sun, so you should wear a broad-spectrum sunscreen (SPF 30 or above) that protects against the sun’s UVA and UVB rays for several months after treatment. You should also limit your time in the sun, especially between the hours of 10:00 a.m. and 2:00 p.m., and wear a wide-brim hat when you are in the sun.
Some skin types are more likely to develop a temporary or permanent color change in the skin after a chemical peel, especially if you take birth control pills, if you are pregnant, or if you have a family history of brownish discoloration on the face.
Overall, there is a low risk of scarring in certain areas of the face, as the removal/injury is superficial enough to prevent scarring while stimulating the deeper skin cells to grow, thus resurfacing the skin.
For people with a history of herpes outbreaks, there is a small risk of reactivating cold sores. Your doctor can prescribe medication to prevent or treat that.
In general, the depth of skin that is injured or removed will determine the overall improvement as well as the recovery time.
For mild peels, you may get additional treatments at 1 to 4-week intervals to get the look you are after. Medium-depth peels may be repeated within 6 to 12 months after the initial treatment.