Well it has become winter and since I will be spending less time outside it is time for chemical peels!!!! One of my favorite times of the year! But let’s start at the beginning….
To start out, not all chemical peels are made equal! Benefits of chemical peels depend on how deep the peel goes. So a superficial peel will have fewer benefits as a deeper peel. I refer you to my post about the layers of the skin. Peels are basically using acid to “Burn” off layers of skin in a controlled way to reveal new layers of skin and increase skin turn over.
Superficial Chemical Peels:
There are gentle over the counter versions that are relatively safe. These are typically low percentage (concentration) salicylic, glycolic, citric, lactic or other similar acids. Sometimes these acids come in toners, facial cleansers, or lotions. These stay in the most superficial layer where the dead skin cells are found. As we age, skin turn over happens more slowly and the dead layer of skin becomes thicker, which can make the skin appear more “dull.” These acids help make the skin appear brighter but removing some of the dead skin that has not naturally fallen off. They can also help with acne. These are temporary changes however because they are only interacting with the dead skin layer. However, since this layer protects the skin from the outside environment and keeps moisture in people can have more sensitive skin and the skin can become more dry. Usually there is no time that you are too ugly to go out in public associated with these types of peels, but redness can last 3-5 days.
Medium Depth Peels:
These should be done by a medical professional. They are available online, but that does not mean they are safe. Permanent damage can be done to the skin. These affect the superficial and deep layers of the epidermis and can also affect the topmost portions of the dermis. Because they go to the deep layers of the epidermis where the living cells and melanocytes are found, they can help with irregular pigmentation such as in solar damage and melasma. Because a medium depth peel can reach the superficial dermis fine lines around the eyes and cheeks can be improved. A medium depth peel does not improve deep wrinkles because they live deepest layers of the skin. Care needs to be taken with people with darker complexions as skin can become permanently depigmented or even heal with darkening of the skin. Often, patch tests are completed on these skin types prior to a full peel. Down time varies from person to person but 7-14 days with redness lasting 15-30 days.
Deep Peels:
You will see the trend here. Deep peels go into the deep dermis. Because they go so deep they can improve deep wrinkles and cause permanent skin lightening because this is where the melanocytes live (remember they make the skin pigment). These typically need to be done in the OR and sometimes need monitoring after for wound care. They are not done all that frequently as lasers typically are used for this purpose. Down time is 14+ days with redness lasting 30-90 days.
Side Effects:
While the more superficial peels’ side effects are usually minimal they include redness, itchiness, peeling, burning and sensitivity to sun (wear your sunscreen!). Medium to deep peels can cause permanent lightening or darkening of the skin in people with more pigmented skin. Occasionally, people can have allergic reactions to peels or develop breakouts. Some providers will recommend patch testing before a full peel. Activation of herpes is also possible from deeper peels. Your provider should ask about this and may prescribe medication before a peel is done. Scarring is always possible which is why these peels should only be done by trained professionals and never at home.
After Care:
Will vary on which peel is done but will usually include a protective moisturizer to keep the skin hydrated. Provider will give instructions for facial cleanser. Sun screen is a must. Some providers will do a pretreatment with tretinoin be sure to let your provider know the products you use on your face. Hydroquinone is sometimes used after deeper chemical peel in those at risk of increased pigmentation.
Recap:
- There are many kinds of different peels. Deeper the peel the more risks but also the more benefit
- Gentle peels can be done at home but beware of deeper peels than can cause permanent damage.
- Sun screen. Foundation of skin care.
Additional Reading :