Chemical Peels: Everything You Need to Know Before Getting One

Chemical peels are the third most popular non-invasive cosmetic procedure in the United States. These procedures involve applying chemical solutions to the skin to facilitate the growth of smoother skin and make the skin appear more youthful and rested. They aim to improve the look of wrinkles, sun damage, scars, or discolored skin by stimulating not only new skin growth but also collagen production and a more even distribution of melanin. The process involves removing the top layers of the skin.

Chemical peels differ based on depth

Chemical peels fall into different categories — light, medium, and deep — all of which involve addressing different depths of the skin.

1. Light. Light chemical peels(superficial chemical peels) remove only the outermost layer of the skin. These peels gently exfoliate the skin using mild acids such as glycolic acid. Removing this skin — the epidermis — can be performed as frequently as every two weeks and helps to address dryness, fine wrinkles, uneven skin tone, and acne.
2. Medium. Medium chemical peels remove both the epidermis and part of the dermis, which lies underneath. Medium chemical peels address similar issues as light chemical peels but provide more significant results and may not need to be repeated as often to produce the same effects. These peels, which use glycolic acid or trichloroacetic acid, remove more damaged skin cells compared to light chemical peels.
3. Deep. Deep chemical peels remove skin deeper in the dermis and may, unlike light and medium chemical peels, be recommended for precancerous growths, deep wrinkles, or more severe scars. To achieve their more dramatic results, deep peels often use the chemical phenol.

Downsides of chemical peels

Chemical peels do not tighten skin and cannot completely remove deep wrinkles or deep scars. Chemical peels are also notorious for leaving skin looking red and swollen, which is a normal reaction to the removal of skin layers and can also include scabbing. With medium and deep peels, face redness can last for months.

There are some other risks associated with chemical peels, including changing the color of the skin to a darker or lighter tone and scarring. When scars occur, antibiotics can often be used to reduce their severity. The complications that occur with chemical peels are more common in people with darker skin. The risk of complications is also higher when people are exposed to the sun or certain peeling agents.

Avoid chemical peel complications

In some cases, chemical peels lead to infections, which may be bacterial, viral, or fungal. The carbolic acid that is used in deep chemical peels is also capable of affecting the heart, causing an irregular heartbeat, or damaging heart muscle. Normally, this complication is avoided by doing short intervals of deep chemical peels at a time.

In general, complications from chemical peels can be avoided by evaluating each patient’s risk and conducting peels at the appropriate depth that balances risk with desired results. Some people at heightened risk from chemical peels are people who develop keloids, those who cannot tolerate sunscreens, and those with pregnancy-induced hypertension (PIH).

What to avoid after a chemical peel

Light chemical peels are superficial enough that they tend not to require much downtime. Most people recover from light chemical peels within a week and often as quickly as four days. However, recovery from medium and deep chemical peels can take up to three weeks.

It is important to follow your physician's recommendations after all chemical peels, and it is particularly important after deep chemical peels. Staying out of the sun is important until the skin has fully healed. Your doctor will also likely advise you to avoid cosmetics and will let you know the best way to wash and moisturize your face and give you pain relief instructions. Nonsteroidal anti-inflammatory agents (NSAIDs) are often helpful for both pain and swelling that occur following chemical peels.