Chemical peels are cosmetic procedures used to improve the appearance of the skin on the face and body. Peels can be performed on almost any area covered by skin. The procedure involves the application of a chemical solution, usually an acid, to the surface of the skin. The solution will cause the outer layer of the skin to exfoliate or peel completely. The newly regenerated skin is usually smoother, less wrinkled, and may have a more even tone.

Types of Peels:

1. Superficial peels are the mildest acid peels that can cause peeling or exfoliation of the outer layer of the skin (epidermis). They include alpha-hydroxy acid, beta-hydroxy acid, salicylic acid, and lactic acid as well as several other acid types in combination. Superficial will improve the texture of the skin and treat mild discoloration. They are safe for all skin types and can be applied by a nurse, physician assistant, or nurse practitioner. Generally, the effects of a superficial peel are temporary. Some offices use a superficial peel to prep the skin for a deeper peel or before acne treatment.
2. Medium peels penetrate the skin more deeply using stronger acids or acids in a higher concentration. These include trichloroacetic and glycolic acids. They are effective for treating deeper skin problems such as acne scarring. They are used to diminish wrinkles, fine to medium lines, and moderate sun damage. The effects of medium peels are more permanent though skin changes occur throughout your lifetime.
3. Deep peels use stronger acids or similar acids to medium peels but in higher concentrations. These include phenols and higher-concentration trichloroacetic acid peels. These peels penetrate more deeply into the skin and are used to treat more severe skin issues, such as deep vertical lip lines. The effects can be permanent, but the recovery time is the longest with deep chemical peels.

The benefits of chemical peels include a reduction in lines and wrinkles, improvement in skin texture, and the removal of sun damage including age spots, sun spots, and other forms of hyperpigmentation. Chemical peels injure the skin in a controlled fashion allowing the natural healing process of the skin to occur. This will result in the production of new collagen promoting firmer and younger-looking skin.

The procedure is performed in the office with no anesthesia, topical anesthesia, or intravenous or general anesthesia. The deeper the peel, the more likely a deeper form of anesthesia is used. The skin is thoroughly cleansed before the chemical solution is applied. The solution is left on the skin for a specific amount of time. If awake, patients may feel a slight tingling or burning sensation. In some cases, the solution is neutralized or washed off.

The recovery time will depend on the type of peel: superficial peels can limit the recovery to 3-5 days. Medium peels may require a week or more for the skin to fully heal. Deep peels may involve significant downtime and may require several weeks or months for the skin to fully recover. The usual recovery will involve some degree of redness, peeling, temporary discoloration, swelling, and sensitivity. With the deeper peels, there is a risk of either PIH (post-inflammatory hyperpigmentation) or hypopigmentation.

It is very important to follow all post-treatment instructions provided by your doctor or nurse. Most practices will provide you with the proper “kit” which may include a soothing balm, moisturizer, regenerative skin nectar, and antibiotics and antivirals. Sun protection is essential in the immediate post-recovery phase but should be considered during any period of sun exposure.

Chemical peels can range in price depending on the depth of the peel and whether a form of anesthesia is necessary. The results can be quite transforming for the skin in both texture and pigmentation providing a more youthful appearance to the skin.