What are chemical peels and how do they work?

Chemical peels remove layers of damaged skin to improve your complexion. The practitioner — typically an esthetician or dermatologist — applies a solution to the face, which can include glycolic acid, trichloroacetic acid (TCA), salicylic acid, lactic acid, carbolic acid or Jessner’s Solution (a combination of resorcinol, lactic and salicylic acids). Chemical peels vary in strength and intensity, including:

• Mild peels use alpha hydroxy acids (AHAs) or dry ice. They work on surface layers of skin and are appropriate for acne, acne scars, discoloration and fine lines, writes dermatologist Eric F. Bernstein, M.D., medical director of the Mainline Cosmetic Laser Center. He notes that the same ingredients are available in different concentrations. Usually, side effects are mild, including redness or irritation.

• Medium peels work on deeper skin levels, usually with TCA, which may be combined with other ingredients, to deliver a tightening and resurfacing effect and to reduce blemishes and brown spots. Brian Zelickson, M.D., dermatology professor at the University of Minnesota Medical School, writes that “TCA peels are typically the most common type of chemical peel.” The strength or concentration of the TCA will determine how deep the peel works, notes Dr. Zelickson. TCA peels can cause pigmentation changes.

• “Deep peels penetrate several layers of skin and cause a second-degree burn,” writes Maria G. Essig on WebMD. Phenol is used in deep peels, typically reserved for severely aged skin with deep wrinkles, notes Dr. Bernstein. It’s a very strong, acidic solution that dissolves cells. Phenol peels also have a high risk for creating hyperpigmentation or cardiac problems. They can require a week or more of healing time.

  Depending on the depth of the peel, you may feel heat, stinging and pain for a few minutes. These sensations can be minimized with cool compresses, pain medication or sedation. The process can take anywhere from 10 minutes to 90 minutes, depending on the peel.

  Afterwards, skin begins to redden, flake and peel off — similar to a sunburn. Your skin reacts as if it’s been wounded or injured and then begins the healing process. This leaves behind a new, smoother layer of skin, with refined texture, clarity and improved tone. Results usually occur within one to 14 days, depending on the peel’s strength and depth.

What can peels treat?

Chemical peels treat a variety of skin concerns. Many men and women opt for peels to refresh and brighten dull or tired skin. Peels are also effective for treating more serious skin issues, such as:

• Hyperpigmentation and hypopigmentation

• Sun damage (i.e., age spots, freckles)

• Acne

• Fine lines around the eyes and mouth

• Scars

What can’t peels treat?

Although effective, chemicals peels can’t improve:

• Sagging skin

• Bulges under the skin

• Deep wrinkles

Who’s an ideal candidate for a chemical peel?

In general, ideal candidates include fair-skinned and light-haired patients, according to MedicineNet. Also, patients with darker complexions can have good results.

How do I care for my skin after a chemical peel?

Post peel, skin will need extra TLC. Your dermatologist will give you special instructions on how to treat your skin following the peel. These typically include:

• Applying bandages or dressings for a few days.

• Using thick moisturizer daily to protect fragile skin as it regenerates. Try pH Advantage Basics Moisturizing Recover Cream to soften, hydrate and protect against damage.

• Slathering sunscreen to shelter skin from further UV and environmental damage. Peels make your skin more vulnerable to sunburn, so it’s especially important to be diligent about sun protection. Oil-free and fragrance-free, Z-Silc SPF 30 by ProCyte provides broad-spectrum UV defense for sensitive skin.

What are the side effects?

Side effects will depend on the ingredients and concentrations of the peel. In general, the deeper the peel, the greater the risk for side effects. Talk to your doctor about which type of peel you’ll be having and any potential risks. These include:

• Flaking

• Scaling

• Redness

• Sun sensitivity

• Infection. As skin heals, it can become infected, which may require medical treatment. Your doctor may prescribe antibiotics before your peel to reduce the chance of infection.

Other side effects can include:

• Temporary or permanent pigment changes

• Scarring

• Swelling

• Cold sores

To reduce these risks and help prepare the skin for a peel, your physician may recommend that you stop taking certain medications and start a skincare regimen that includes glycolic acid or other AHAs.

What results can I expect?

Your results depend on your skin condition and the depth of the peel. Overall, deeper peels at higher concentrations produce more dramatic results, especially for deeper lines. But there are exceptions. For example, peels with AHAs and salicylic acid are relatively mild, but can improve acne. Yet, TCA peels at higher concentrations produce little improvement for acne.

What do chemical peels cost?

Chemical peels can range from $150 to $6,000, according to DocShop. The price depends on the chemicals used and whether anesthesia, medication or hospitalization is necessary (as with deeper peels). AHA peels (such as glycolic acid) are the least expensive, followed by TCA peels and then phenol peels. According to The Patient’s Guide to Chemical Peels, the average costs are:

• AHA peel: $188

• Glycolic acid peel: $186

• TCA peel: $378

• Phenol peel: $1,100

Who should avoid chemical peels?

Chemical peels aren’t appropriate for:

• Anyone with a heart condition

• Pregnant or lactating women

• People with eczema, lupus, psoriasis, rosacea or those who bruise easily

• Patients with weakened immune systems

• Individuals taking Accutane, other acne drugs or those who use Retin-A

• People with very dry or sensitive skin

• Anyone who’s had herpes or cold sores in the past. Chemical peels can trigger outbreaks.

What is the appeal?

Aside from an improvement in skin’s appearance and texture, chemical peels offer many advantages. Chemical peels:

• Are convenient and highly effective in a short amount of time. They can be performed at a spa (usually milder peels) or at the doctor’s office as an outpatient procedure.

• Can be tailored to your particular skin type and needs. A follow-up regimen is designed specifically for each patient to maintain the peel’s results for as long as possible.

• Have less down time and side effects than inpatient cosmetic surgery.

Learn everything you need to know about anti-aging skincare in our Anti-Aging Handbook.