Chemical peels

Chemical peel (Superficial)

The chemical peel is one of the oldest cosmetic procedures in the world, and was performed in ancient Egypt, Greece, and Rome to help people achieve smoother, more beautiful skin. Today, chemical peels are popular because they offer nearly immediate results and can be performed as an outpatient procedure.

What is Chemical peel?

A chemical peel is a treatment in which an acid solution is used to remove the damaged outer layers of the skin. Chemical peel enhances and smoothen the texture of the skin. It is an effective treatment for facial blemishes, wrinkles, active acne, acne scarring, stretch marks and uneven skin pigmentation. Even if you don't have any skin problem it simple rejuvenate the skin in general.
The chemical peel produces a controlled partial thickness injury to the skin. Following the insult to the skin, a wound healing process ensues that can regenerate epidermis from surrounding epithelium and adnexal structures.


Broadly speaking, chemical peels can be divided into several categories based on the depth of penetration in the skin.

Superficial Chemical peels

Superficial chemical peels create an injury to the epidermis - the outermost layer of the skin. As such, they are recommended for the treatment of skin conditions that primarily affect the epidermis.
Conditions such as acne, actinic keratosis, superficial (epidermal) melasma, mottled skin pigmentation, superficial wrinkling as well as mild photo-damage can greatly benefit from properly selected and applied superficial chemical peels.
Some of the most common examples of superficial chemical peels include a variety of alpha-hydroxy acids (AHA,) salicylic acid as well as low concentration trichloroacetic acid (10% - 25%.)
The most commonly used superficial chemical peels are members of AHA. Alpha-hydroxy acids is a group of compounds derived from food products including glycolic (from sugar cane,) lactic (from sour milk,) malic (from apples,) citric (from fruits) and tartaric acid (from grape wine.)
Glycolic acid
Glycolic acid (GA) is a clear winner amongst the AHA as its small molecular weight allows it to penetrate into the skin and exert its influence on living and non-living (outermost layer) cells. These properties account for the popularity of this product in both cosmetic as well as medical preparations.
In low concentrations, 5 - 10%, GA lends itself to daily personal use as a monotherapy or a part of a broader skin care management for such conditions as acne, photodamage, and wrinkling as well as selected cases of melasma.
In higher concentrations, 50 - 70% applied for 3 to 8 minutes under the supervision of a physician, GA promotes separation between the cells and can be used to treat acne, photodamage (such as mottled dyspigmentation, superficial melasma or fine wrinkles) as well as superficial scars. The benefits from such short contact application depend on the pH of the solution, the concentration of GA, the length of application and prior skin conditioning such as prior use of topical vitamin A acid products.
Although single application of 50 - 70% GA will produce beneficial results, multiple treatments every 2 to 4 weeks are required for optimal results.
Salicylic Acid
Salicylic acid is a member of beta-hydroxy acid group. Because of its improved lipid solubility compared to the AG, it is particularly effective in the treatment of acne and melasma. Though closely related to alpha hydroxy acids, beta hydroxy acids differ slightly in their molecular structure, and rejuvenate the skin in a slightly different way. The most common beta hydroxy acid, salicylic acid, has been used for decades as an acne remedy, and salicylic acid chemical peels are especially effective in eliminating acne. Beta hydroxy acids are helpful because they can exfoliate oily skin and deeply penetrate the skin with no irritation.
Low concentration TCA - trichloroacetic acid (10% - 25%) can also be used to treat the conditions affecting superficial epidermis.
As such, physician supervision is required for all peels except low concentration glycolic acid (up to 35%) and salicylic acid peels (below 20%.) This precaution is necessary to prevent inadvertent worsening of the skin condition as well as scarring.

How it is done?

Some aspects of the chemical peel procedure differ according to the type of peel (light, medium, or deep) being administered. However, all skin peel procedures follow the same basic protocols:
• The chemical peel is a office procedure.
• Patient’s skin is cleansed.
• Chemical peel solution is applied then. This solution is formulated according to each patient's specific needs and goals. It is common for the patient to feel a tingling or stinging sensation as the chemical peel is applied.
• After the skin peel solution has been on the skin for the prescribed amount of time, it is washed off with water. A soothing ointment / Sun screen is then applied.
• Depending on the patient’s skin condition and the depth of the chemical peel, multiple treatments may be necessary to achieve the desired results.

How many sessions?

Although in some instances only one superficial peel can accomplish desired effects, in most cases a series of peels is recommended to achieve optimal results.


Chemical peels rarely result in serious complications, but certain risks do exist. These risks include scarring, infection, swelling, changes in skin tone, and cold sore outbreaks. You can reduce the risks associated with facial peels by following all of the doctor’s instructions completely and by providing your doctor with a complete medical history.
Stinging and Burning Sensation
A chemical peel will cause a stinging or burning sensation to the treated skin upon contact with the AHA, TCA, or phenol solution. Even the lightest AHA peel can result in temporary stinging. Most patients do not find the stinging and burning sensation painful, and some patients even describe it in positive terms.
Temporary Redness
The strength of the solution used for the chemical peel will determine how much redness will occur, and how long the redness will last. An AHA skin peel may cause no redness at all for some patients, whereas a TCA can be expected to result in some redness.
Crusting and Skin Irritation
Crusts or scabs may develop on areas treated with any type of chemical peel as the skin reacts to the "trauma" of having a mild acid solution applied to it. Crusting should not to be removed and should be protected with sunscreen.
Flaking and Peeling
Flaking and peeling are normal chemical peel side effects that are temporary and relatively minor. A patient must not pick at the flakes and peeling skin because pulling off peeling skin before it is ready can result in infection and scarring. The treated skin will heal at its own rate, and the result will be fresher, younger-looking skin.
Changes in Skin Color
Among the more serious and undesirable chemical peel side effects are changes in skin color. It is rare to develop hyperpigmentation or hypopigmentation after a chemical peel. Hyperpigmentation is increased color of the skin. For example, the new skin that develops after a deep chemical peel may turn darker than the untreated skin near it (especially if sunscreen is not used sufficiently after the peel). Hypopigmentation is depleted skin color. This condition is often temporary.

Other than the face

Different body areas like arms, legs, back etc can be treated by chemical peel. The solution for body chemical peels is typically formulated to be slightly stronger than the chemical solution used for light or medium facial skin peels. As with facial chemical peels, body peels address the effects of sun damage, even out skin pigmentation, and improve skin texture. Chemical peels can also be used on the body to minimize stretch marks.


The recovery time after a chemical peel depends on the type of peel administered, because each type of peel affects the skin to a different degree.
Light chemical peels : These mild peels require virtually no recovery time. Though the skin may be mildly irritated after the peel, patients can return to their daily activities immediately after treatment.

Deep Chemical peels

Medium chemical peels are an effective way to correct acne scars, address uneven pigmentation, improve the texture and tone of the skin, smooth out fine lines, and more. Medium chemical peels provide more dramatic results than light chemical peel, and they don't require the extended recovery time of deep chemical peel. A medium chemical peel can be used to treat any area of the body and take only few minutes to complete.

What is Medium depth
chemical peels:

Medium depth chemical peels create an injury that extends through the epidermis and affecting the superficial portion of the dermis (upper reticular dermis). This category of peels includes M Y peel, higher concentration of TCA peels (35% - 50 %,) Jessner's solution and carefully applied 88% phenol. In proper hands, these peels are very effective for the conditions that affect the epidermis as well as superficial portion of the dermis.

How it is done?

Skin preparation prior to medium depth peel
Optimal patient's skin preparation prior to medium depth peel will improve healing time, decrease the chances of complications as well as improve the final outcome. As such, most patients can benefit from vitamin A acid derivative applied to the skin for several days prior to the medium depth peeling. This preparation enhances skin healing and decreases the chances of altered pigmentation following such peel.
It is performed on an outpatient basis, usually in the setting of a doctor’s office. Depending on the concentration of acid used and the patient’s preferences, light sedation might be utilized, though no local anesthesia is needed.
Medium chemical peels are applied in the same way as light chemical peels or deep (phenol) peels. The skin is first cleansed in preparation for treatment. Then the chemical solution is applied. As with any chemical peel, the specific chemical formulation depends on the patient. This chemical solution is left on the skin for an appropriate amount of time; then the physician washes it away with water and applies a soothing ointment.
Depending on the size of the area being treated, a medium chemical peel may take from 15 to 60 minutes to complete, though most treatments can be completed within 30 minutes.

Use along with Cosmetic
surgery and Other cosmetic

Chemical peels are also an excellent addition to other aesthetic procedures. They can be used with the ongoing home personal treatment with lower concentration glycolic acid or vitamin A acid derivatives. Furthermore, they are an excellent addition to facial procedures such as Blepharoplasty, face lift and laser skin resurfacing. It is frequently the combination of treatments that produces desired results as each facial concern is addressed with appropriate modality.

Where it can be useful?

Substantial improvement can be achieved in acne, actinic keratosis, scars, mild to moderate facial wrinkling and, in selected cases, in melasma.
The therapeutic effects of medium depth chemical peels go far beyond what can be achieved with superficial peels and as such are selected for patients who desire substantial results. Unlike following superficial chemical peels, there is partial or complete removal of the epidermis following medium depth peels. This leads to the initiation of skin healing mechanisms that are partly responsible for achieving final therapeutic and aesthetic results. Such impressive results do not come without increased risks.


Skin irritation, infection, scarring, worsening of the treated problem (mostly seen with melasma) as well as pigmentary abnormalities are the most common problems that are seen following mid depth chemical peels.


Medium chemical peel is not without possible side effects. Some mild swelling is common after this type of skin peel. Patients do not typically experience much pain, and any discomfort can be controlled by prescription pain reliever.
You should wash your face twice daily with gentle face wash and water followed by application of moisturizing lotion. It is important to avoid drying of the skin. Your face will initially appear red. Within a few days, your superficial layers of skin will turn dark, become stiff, and resemble leather. They will then crack, flake, and peel. Flaking is usually complete in four to seven days. There will be no open wounds and no scabs. Once your old skin has sloughed, your new skin will be bright and flushed. Once your skin has finished peeling, you may begin wearing makeup. You will physically be able to return to work immediately, but your appearance may preclude this. Most patients are able to comfortably return to public within seven days.
You should resume your skin care program within two weeks of your procedure. Your flushed appearance will fade slowly over several weeks. In addition, sun protection in the future is advisable to help prevent pigmentary complications and maintain results.

Can it be repeated?

Although one medium depth chemical peel can achieve desired affect in most patients, repeated treatments may be needed to optimize the desired results. Most women who choose medium chemical peels as the mainstay of their facial rejuvenation have a repeat peel every six to twelve months.

Concluding Thoughts on
Medium Peels

When compared to all simple and serious treatment options, medium chemical peels provide an intermediate level of improvement at an intermediate cost and impose an intermediate period of recovery. They are ideal for the woman who wants more than a superficial peel, but cannot afford the expense or recovery time of a deeper treatment.