Beauty Blog

Can someone please help me understand chemical peels?

We call chemical peels "chemical peels" because no one has come up with a better name for them. Sometimes you peel, sometimes you don't. Sometimes you turn red, sometimes you flake. All the time you end with a glow. Chemical peels often remove dead and damaged skin cells, which accounts for some of the peeling. They exfoliate the skin’s surface to reduce discoloration, smooth texture and enhance radiance. They amp up cell turnover and improve the appearance and health of the skin. The action of a medical-grade chemical peel is much greater than any exfoliating scrub.

As you probably guessed, there are different strengths of peels ranging from light and superficial to deep and penetrating. The strength of the peel used depends upon the specific client, their skin, their goals and their tolerance for downtime. Like many aesthetic treatments, the purpose of a chemical peel is to create a small, controlled injury, which forces the skin to repair itself and create fresh, new skin.

The common peel categories/ingredients are alpha hydroxy acids (AHAs), beta-hydroxy acids (BHAs), and trichloroacetic acid (TCA). AHAs (most often lactic and glycolic acids) are generally the lightest peels and work by breaking up the “glue” between the cells. They react with the outermost layer of the skin to dissolve the bonds that attach the dead cells to the surface. These peels need to be neutralized a few minutes following application. BHAs (pretty much always salicylic acid) are a bit stronger and are often used to treat skin concerns such as blemishes, large pores and uneven texture. Salicylic acid denatures the protein and kills the cell. Each time a layer of peel is applied, it penetrates deeper until it encounters a new sebum (oil) pocket and neutralizes itself. Jessner peels are a combination of lactic acid (an AHA), salicylic acid (BHA) and resorcinol (a brightener). (We use SkinCeuticals Advanced Corrective Peel as our Jessner peel.) This peel penetrates still deeper and many clients will experience peeling or even sloughing. TCA is the deepest peel that we (and most med spas) offer. It treats more advanced signs of aging and discoloration. Deep chemical peels (conventionally performed with phenol) penetrate past the epidermis into the dermis. They are extremely aggressive and are no longer very common.

(Note: Cosmelan® Depigmentation Peel is based on the inhibition of tyrosinase, which is an enzyme that helps create melanin. This is the peel we generally use for our stubborn melasma clients and doesn't necessarily fall into the above classification system.)

With even the lightest peel, you may feel a tingling sensation during application. Once skin becomes acclimated to the use of acids and resurfacing agents (see our JAN2023 blog on resurfacing), it will begin to tolerate stronger formulations. A superficial peel may cause some redness (similar to a mild sunburn) for a few days. The more intense peels (Jessner and TCA) may result in redness, swelling, and/or peeling for up to two weeks.

The frequency at which a chemical peel should be performed is dependent mostly upon the strength of the peel. Superficial peels can be part of your monthly skin maintenance routine (hello, membership!). Medium-depth peels are usually performed in a series of three to six, spaced one month apart.

As chemical peels can remove the outermost skin cells, the skin will be more vulnerable following treatment. It is imperative to slather on a broad-spectrum sunscreen and avoid sun exposure (or at least keep it to a minimum).

Harvard Medical School
Phone: 830.488.7389

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