Chemical Peel

A chemical peel is a solution that is applied topically to the skin. The solution 'injures' the topmost layers of the skin, causing them to peel away. New skin then regenerates, which has improved texture and tone.

A chemical peel can be used to treat various problems such as discolouration, fine lines, and light wrinkles and scars. It is typically applied to the face but can also be used on the hands, neck, and other parts of the body.

Various chemicals are used that can reach different depths of the skin and the depth you want to reach will depend on what issue you want to address with the peel.

Light Chemical Peel

• Can address: acne, fine wrinkles, dryness, or uneven discolouration.

• Chemical agents used: alpha-hydroxy acids and beta hydroxy acids, such as salicylic acid, glycolic acid, lactic acid, citric acid, malic acid, or tartaric acid.

• Layer of skin affected: epidermis (the uppermost layer of skin).

Medium Chemical Peel

Can address: slightly deeper wrinkles, acne scars, and uneven skin tones. Chemical agents used: trichloroacetic acid (TCA), glycolic acid, or Jessner’s solution (14% salicylic acid, 14% lactic acid, and 14% resorcinol in 95% ethanol). You may see Jessner’s solution advertised as a Jessner peel. Layer of skin affected: epidermis and the upper part of the dermis (the middle layer of skin).

Deep Chemical Peel

Can address: deeper, coarse wrinkles, acne scars, blotchiness, sun-damaged skin, skin discolouration, or pre-cancerous growths. Chemical agents used: phenol oil (carbolic acid) or trichloroacetic acid. Phenol oil may also be mixed with croton oil, water, soap, or olive oil to increase its effectiveness. Layer of skin affected: epidermis and the mid to lower layers of the dermis.

How Do I Know If I Can Have a Chemical Peel?

It is important to have a consultation first to determine if you’re a good candidate for a chemical peel. A chemical peel or certain types of chemical peels may not be appropriate for you.

It is a good idea to review your medical history, especially if you have ever had any heart, kidney, or liver conditions, as these conditions are contraindicated for a deep chemical peel. Your specialist will also want to know about any medication or vitamins you take or have taken that can make your skin sensitive to the sun, if you have used any retinoid creams, and if you have had any other cosmetic procedures.

Some other contraindications for certain types of chemical peels include:

• Darker complexions

• Abnormal skin pigmentation

• A history of keloid scarring (ridged areas caused by scar tissue overgrowth)

• A history of frequent and/or severe cold sore outbreaks

• Using certain acne medications within the last 6 months (isotretinoin)

You will also want to discuss what outcome you hope for by doing a chemical peel. Then your specialist can advise if it is possible, what type of peel will work best, and how many treatments you might need.

What Are the Steps of a Chemical Peel?

Preparation

Chemical peels are generally done as an outpatient procedure so you can leave shortly after it is finished. Before your procedure starts, your specialist will prepare your face. Your face will be cleaned and your lips and eyes will be protected by applying either ointment, tape, or gauze or goggles for your eyes. They may also protect your hair if it can fall on your face.

Usually, you will not need pain relief for a light chemical peel but you may be given the option of taking a sedative or painkiller for a medium peel.

For a deep chemical peel, the specialist will give you either local anaesthesia along with a sedative, a regional anaesthesia, which numbs a particular region of the body; or even general anaesthesia. Along with the sedative and/or anaesthesia, intravenous (IV) fluids may also be administered and your heart rate monitored.

Also, for a deep chemical peel, you may be given a pre-treatment to apply for up to eight weeks before treatment. This can include using a prescription retinoid cream or gel. The pre-treatment thins out your skin’s surface layer, which will allow the chemical solution to penetrate more deeply and also then help speed up the healing process.

Applying the Peel

Light chemical peel:

1. The chemical solution is applied to your face with either a brush, cotton ball, sponge, or gauze. 2. It will be left on your face for a few minutes to allow it to work. You might feel some mild stinging and the skin will begin to whiten. 3. The solution is then washed off your skin or a neutralising solution is applied.

Medium chemical peel:

1. The chemical solution is applied to your face with a cotton-tipped applicator or gauze. 2. It will be left on your face for a few minutes and the treated areas of your face may turn a whitish-grey colour, called 'frosting'. 3. After those few minutes, cool saline compresses will be applied to your skin and you may be given a hand-held fan to help cool your skin as well. No neutralising solution is applied and the peeling solution stays on your skin. 4. You might experience some stinging and burning for up to 20 minutes.

Deep chemical peel:

1. The chemical solution is applied to your skin with a cotton-tipped applicator or sponge. Your skin will begin to 'frost' (turn white or grey). The solution is then neutralised with water. 2. Your specialist will apply the peel in 10 to 20-minute intervals and/or to one section of your face at a time to limit your exposure to the chemical solution. 3. You will have either adhesive bandages, gauze or ointment applied to your face to protect it as it heals. 4. You may continue to experience some frosting for about an hour after treatment.

What Should I Expect After a Chemical Peel?

Light chemical peel:

You may have some stinging, flaking, redness, or skin irritation just after the peel, but these side effects may occur less after repeat treatments. You’ll be instructed on washing your face afterwards and which moisturisers or ointments to apply.

Your skin will typically heal one to seven days after the peel, although the new skin may be temporarily lighter or darker than usual. You will be advised to wear high-factor sun cream after any peel. It’s possible for hyperpigmentation or brown blotches to occur after a light peel if sun cream isn't used.

Medium chemical peel:

Your skin may turn a red or brown colour in the days after the peel. The peeling process usually starts about 48 hours after your peel and lasts about a week, although the skin can take up to 14 days to heal and redness can last for a few months. It’s important to keep your skin moisturised during this process and you’ll be instructed on how to best wash and moisturise your face.

You may also experience red, tight, or swollen skin and some stinging. Often ice packs, the breeze from a fan, and over-the-counter pain medication can help ease the discomfort. You will need to use sun cream afterwards but keep in mind that it is still possible for hyperpigmentation to occur while using sun cream after a medium chemical peel.

Deep chemical peel:

You’ll likely experience some pain, swelling, redness, oozing, crusting of the skin, and burning after a deep chemical peel. Your eyes may swell shut. Most of these symptoms will subside over seven to 10 days but the redness will fade more slowly over months. You may want to take up to two weeks off from work to recover, but can return to your normal activities after those two weeks.

Your skin will stiffen and peel within days after the procedure and new skin will appear in one to two weeks. The treated area will always appear paler compared to the rest of your skin and will be much more sensitive to sun exposure than your untreated skin. The skin often loses its ability to tan after a deep chemical peel, so it is vital to always use sun cream to protect the skin.

When Can I See Results From a Chemical Peel?

Light chemical peel:

Your skin will usually heal one to seven days after the peel. New skin may be temporarily lighter or darker than usual.

Medium chemical peel:

Your skin usually starts to peel about 48 hours after your procedure. It typically lasts about one week, although the skin can take up to 14 days to heal and redness can last for a few months.

Deep chemical peel:

Your symptoms will likely subside over 10 to 14 days but the redness can take months to go away. Your skin will peel within days after the procedure and new skin should cover the treated areas in about two weeks.

How Long Do the Results From a Chemical Peel Last?

Light chemical peel:

A light chemical peel can be repeated as often as every two to five weeks depending on the results you wish for.

Medium chemical peel:

You can repeat a medium chemical peel after three to nine months to maintain your results.

Deep chemical peel:

You can only do a deep chemical peel once but the results from the peel can last up to 10 years.

Chemical peels can produce dramatic results - especially a deep peel - but keep in mind that you may acquire new lines and wrinkles as you age and any new sun damage can cause pigmentation changes and reverse your results.