Chemical peels improve the look and texture of your skin by reducing the appearance of fine wrinkles, blemishes, and enlarged pores.
Though usually used on the face, there are also certain peels that can be used for “spot treatments” to remove stretch marks, or even help revitalize the skin on other parts of the body.
In essence, a chemical formulation is applied to the skin and absorbed by the tissue. Over the next day or weeks, depending on how deep the chemical is allowed to penetrate the skin during treatment, the outer layers of skin peel off.
The objective is to cause superficial damage to these outer layers so that new, healthy skin can grow.
How chemical peels work
All chemical peels perform the same function: they work by removing the outermost layers of skin through what is referred to as a “controlled injury.” The chosen chemical breaks down the bonds between dead skin cells, allowing them to peel and flake away.
This process reduces wrinkles, evens out minor scars and blotchy patches, and can even help to treat sun damage.
Undergoing peels on a regular basis — every 6 to 8 weeks — can also help to increase the production of collagen, one of the proteins responsible for maintaining the skin’s elasticity and structure.
Chemical peels offer optimal results when performed by a dermatologist or in a qualified professional’s clinic. While there are at-home chemical peel products you can apply yourself, these cannot reach the level of depth that a specialist can administer.
While chemical peels provide excellent results for many common skin conditions, there are also certain things they cannot achieve.
For example, chemical peels are ineffective in reducing the appearance of blood vessels, keloid scars, or sagging skin. Furthermore, chemical peels aren’t usually recommended for discoloration in patients with darker skin tones.
The 3 main types of chemical peels
There are three distinct types of chemical peels, and a variety of different peeling agents. Each type of peel penetrates the skin to different depths.
The degree of depth achieved by the peel depends on the strength of the acid used as the peeling agent, the number of coats that are applied, and the amount of time the acid is given to work before being neutralized.
The deeper the peel, the more dramatic the results. That being said, deeper peels also carry a higher risk, are more painful, and take longer to heal.
Light peels
These are the gentlest variation of peel available. In fact, superficial peels are so gentle they are considered one of the few true “lunchtime” procedures — they only remove the very uppermost layer of the skin, also called the epidermis.
Light peels minimize the appearance of fine lines and wrinkles, mild acne scarring, age spots, and dry, flaky or sun damaged skin. This results in skin that looks instantly brighter, smoother, and more even in texture.
They usually contain mild alpha hydroxy acids (AHAs) or beta hydroxy acids (BHAs), and other simple organic acids found in fruits. They can be used on all skin types, and are ideal for people who want the benefits of a facial peel but don’t want all the downtime and pain associated with deeper peels.
Medium peels
Medium depth peels offer a more dramatic end result than shallower, more superficial peels. Generally using trichloroacetic acid as an active agent (TCA), these peels soak deeper into the skin. This allows them to treat issues such as sun damage, discoloration, and wrinkles.
The downside, however, is that medium depth peels require a longer recovery time and have in some cases been linked to unpleasant side effects. The face can become swollen, itchy, and reddened, with some patients reporting burning or stinging sensations that last up to an hour after the treatment.
Medium depth peels can also cause patches of brown and white skin to appear on the face during the healing process. And in rare cases, medium depth peels have resulted in scarring.
In general, recovery from medium-strength peels take about a week, but you might still be a little pink for as long as six weeks after treatment.
Deep peels
These are, by far, the strongest type of chemical peels available, penetrating far into the dermal layers of skin. Deep peels usually use carbolic acid, also known as phenol,or a concentrated, high strength TCA as their active agent.
While deep peels can provide amazing results for sun damaged skin, scarring, and deep lines and wrinkles, the procedure can be quite painful. You might also feel a bit unwell after a phenol peel, and may even need to be sedated during the procedure.
After a deep peel your face will look and feel as though it has been severely sunburned. While you should be fully healed within a matter of weeks, the redness can last for months.
The side effects can be quite dramatic: your face will remain swollen for days, after which itchy, peeling scabs will start to form. For some patients, a full two weeks of recovery are required before they feel comfortable going out in public.
The most common risks associated with deep peels are the development of permanent patches of white or bleached looking skin, and an increased risk of scarring.
Darker-skinned people, people who are sensitive to anesthesia, as well as those with heart problems, make poor candidates. It’s also important to note that anyone who decides on a deep peel treatment should be prepared for a more lengthy recovery.
Ideal candidates
Generally speaking, people with fair skin and light hair make the best chemical peel candidates. That being said, patients with darker skin pigmentation can also achieve excellent results.
Smoking can have a negative impact on almost any cosmetic procedure, and chemical peels are no different. If you are a smoker, you will be asked to cease smoking at least a couple of weeks before and after your treatment.
In most cases, current or former Accutane users should avoid chemical peels altogether. If you suffer from large or unusual scar formations, like keloids, chemical peels might not be the best option for you, and your practitioner might recommend a different approach.
Be sure to discuss your medical history with your provider well ahead of your treatment to ensure that you are a good candidate for a chemical peel.
How do I know which peel is right for me?
With all the information available, and the range of peels to choose from, determining the right peel for you can be overwhelming. The first thing you can do to decide which peel will be the best option for your needs, is to carry out some research on chemical peels in general. This will give you a basic understanding of how each works, and what you can expect.
Secondly, you need to consider why you’re considering a peel in the first place. Are you hoping to treat acne, age spots, discolorations, or perhaps restore a youthful glow? Different chemicals used for the different peel depths have certain properties that may be better for your goals, so it’s important to know what you want the treatment for.
For example, salicylic acid peels are usually better for oily and acne-prone skin, while glycolic acid is better for treating age spots, wrinkles, and fine lines.
Thirdly, it’s usually a good idea to start with the more mild chemical formulas. You won’t know what your skin can tolerate until the treatment begins, so it’s best to start light, and work your way up if necessary.
And lastly, speak with your provider. She or he will likely be able to advise you on what is most suitable given your needs. A frank discussion regarding your goals as well as your medical history is usually enough information for them to be able to help you choose the most appropriate chemical peel.
Common peeling agents
All chemical peels rely on acidic solutions of various concentrations to rejuvenate the outer layers of the skin.
Alpha hydroxy acids (AHAs)
Alpha hydroxy acids (AHAs) are naturally occurring acids taken from sources such as fruits, sugar, and sour milk, and are generally used for light and medium peels.
- Glycolic acid is the most commonly used peeling agent, and comes from sugar cane. Its strength ranges from 30% to 90%, with different acidity levels. It is used in both light and medium peels to treat sun damage and wrinkles, and to improve the skin’s texture.
- Lactic acid is found in milk and naturally occurs in the skin. This is the least irritating of the AHAs and even has a natural moisturizing effect. Lactic acid is perfect for brightening the skin, as well as treating discolorations, dry or dehydrated skin, sensitive skin, and rosacea.
- Malic acid is a weaker AHA than glycolic acid and is found in apples and pears. This AHA is usually used for acne, mild sun damage, rosacea, superficial discolorations, and eczema.
- Citric acid comes from lemons and oranges and works in a similar way to malic acid. Citric acid is also commonly used to treat acne, mild sun damage, rosacea, superficial discolorations, and eczema.
- Tartaric acid is extracted from grapes. It is less irritating to the skin than glycolic acid while also providing hydration and mild exfoliation. Similar to both malic and citric acid, this AHA is used to treat acne, mild sun damage, rosacea, superficial discolorations, and eczema.
Beta hydroxy acids (BHAs)
Beta hydroxy acids (BHAs) are also simple organic acids taken from fruit sources. Although similar to AHAs, BHAs are somewhat different in their molecular structure, and therefore act on the skin in a slightly different way. BHAs are also generally used in light peels.
Salicylic acid is by far the most common BHA used in today’s chemical peels. This chemical is somewhat unique among hydroxy acids because of its ability to penetrate much deeper into the oil glands.
This allows for a high level of exfoliation without irritation, even in oily areas such as the face and scalp, which makes it ideal for treating acne and oily skin.
Fruit enzymes
Fruit enzymes are often used in light peels. Papaya, pineapple, pumpkin, or cranberry extracts can effectively peel off the outer layer of the skin.
These enzymes also have antibacterial properties, help cell regeneration and can break down oil and dead skin cells. They are best suited to treat acne, rosacea, dehydrated skin, and hyper-reactive or sensitive skin.
Retinoic acid
Retinoic acid is derived from Vitamin A and used for peels that need to penetrate deeper than either AHAs or BHAs. This peel is specifically used to remove scars, wrinkles, and dark spots.
If you choose to undergo this procedure you’ll leave your doctor’s office with the product still on your face. The peeling process will begin on the third day, and as with most chemical peels, your results will improve with multiple treatments.
Trichloroacetic acid (TCA)
Trichloroacetic acid (TCA) is stronger than the hydroxy acids used in light peels. This chemical is able to penetrate the skin deeply, which makes it useful for medium depth and deep peels.
That said, it’s often used in a lower concentration or combined with other acids for a milder peel. TCA is usually used to treat lines and wrinkles, acne scars, large pores, and hyperpigmentation.
Carbolic acid
Originally used by Hollywood stars in the 1920s to maintain their youthful appearance, carbolic acid is by far the strongest peeling agent available today.
Found in phenol peels, carbolic acid is only used for very deep peels, and is ideal for treating deep lines and wrinkles, scarring, and severe sun damage.
Because these peels penetrate so deeply into the skin they should only be performed by an experienced physician. As such, there aren’t any at-home phenol peels available on the market.
Top chemical peel brands
There are countless brand name products available for superficial and medium peels. Some brands that offer superficial peels include:
- MD Forte, which uses glycolic acid.
- SkinCeuticals Gel Peels, which uses both glycolic and lactic acids.
- Dermaceutic Milk Peel, which uses lactic acid.
- NeoStrata Anti-Aging Peel Solution, which uses a combination of hydroxy acids and fruit enzymes.
- Vivier Skin Peel, which uses beta hydroxy and alpha hydroxy acids.
Product brands that offer medium depth peels include:
- Obagi Blue Peels, which uses TCA.
- CosMedix Tomorrow Peel, which uses lactic acid as its main exfoliant.
- VI Peel, which uses a combination of TCA, salicylic acid, retinoic acid, phenol, and glycolic acid.
Recovery timeline
The exact recovery time required after a chemical peel depends on the strength of the treatment.
Light peels
These mild peels have virtually no down time, so you’ll be able to see results after only one session. With each additional treatment you’ll notice more improvement, until your skin is new, healthy, even-toned, and smooth.
In the vast majority of cases light peels have no real recovery time to speak of. Your skin will most likely feel a little flaky or even mildly irritated after a glycolic acid or other AHA chemical peel, but you’ll be able to return to work immediately.
If you had your peel carried out professionally, your provider will give you a set of guidelines to ensure the best results. For example, patients are often instructed to use a gentle cleanser and a recommended moisturizing lotion, and to stay out of the sun.
Unlike deep chemical peels, which usually only require a single treatment, patients who opt for light peels will need to undergo about five to eight sessions to reach their goals.
The formula and strength of the peel, the number of treatments needed, and the frequency at which treatments are administered will all be customized based on your own goals and skin characteristics.
Medium peels
After a medium depth TCA peel, a shallow crust forms over the treated area, and slowly flakes off over 3 to 7 days. The fresh new skin that is revealed might be a little pink or reddish for a few days, but should fade back to your normal skin tone within a week.
Full healing typically takes one week, at which point new, younger-looking skin is revealed with significantly improved texture, color, and appearance.
Some mild swelling is common after a medium peel and should not be a cause of concern. There isn’t usually much pain, and any discomfort lingering after the treatment is easily controlled with pain medication. As in the case of a light peel, you’ll be allowed to return to all your normal activities right away.
That being said, there might be some remaining redness for up to a week after treatment, so many people choose to stay home until they are completely healed.
Everyone’s skin is different, and your treatment plan will be unique to you. However, most patients undergo at least two or three medium depth peel treatments before meeting their goals. The number of treatments you’ll need, and how far apart they are spread, will depend on your goals, the condition of your skin, and a number of other factors, such as your medical history.
During your short recovery period, it’s important that you follow all the instructions provided by your doctor. These will include precautions like limiting the amount of time you spend in the sun.
Deep peels
The chemicals used for the deepest peels are the most intense. This means that the new layer of skin can take a week or longer to appear, and complete healing might take more than two full months. However, only one treatment is usually required.
Deep peels are the most advanced and painful chemical peel treatments, and also have the longest recovery time. After a deep peel, your face will be swollen, red, and uncomfortable. A few days after your treatment, a crust will form over the treated skin. This crust will flake off within 7 to 10 days, revealing a new, healthy layer of pink skin.
The pink shade usually slowly fades over 2 to 3 months, leaving you with a clear, smooth complexion.
If you decide on a deep phenol peel, it’s important to keep in mind that you will need to avoid exposure to the sun for awhile. This means you’ll need to take extra special precautions against possible sun damage after your treatment. Avoid direct sunlight as much as possible, and always use a strong sunblock.
After all your healing is complete, your skin will be much clearer, have improved elasticity, and deep wrinkles and severe discolorations will be remarkably improved. A deep chemical peel has the ability to make your face look younger, with results that can last decades so long as you protect yourself from sun damage.
Protip: While deeper peels offer more drastic results, they use harsher peeling agents, which increase both recovery time and the potential risk involved. Read: After The Chemical Peel: 10 Recovery Tips
Risks and complications
In general, the deeper the chemical is able to penetrate into the skin, the higher the risk of complications and side effects. Chemical peel side effects are generally rare when the procedure is performed by an experienced practitioner, but they can include:
- A stinging or burning feeling. Even the lightest peels can cause temporary stinging. For most patients, this sensation isn’t usually painful, and some individuals even like the feeling.
- Redness. This is a normal part of the post-peel healing process. Redness usually fades within a few hours for light peels, but might last as long as several months for medium and deep peels.
- Scarring. Though rare, chemical peels can cause scarring, usually on the lower half of the face. Antibiotics and steroids can be used to minimize the appearance of scars.
- Crusting and skin irritation. The deeper the peel, the more likely a crust will form as the old layer of skin flakes away and new skin appears.
- Flaking and peeling. These are perfectly normal side effects of most chemical peels and are usually mild and temporary. Make sure you don’t pick at this flaking and peeling skin.
- Changes to your skin color. Skin darkening is more common with lighter peels, while skin lightening is more common after a deep peel. Overall, changes in skin pigmentation are more common among patients with darker skin color. Unfortunately, these changes can be permanent.
- Infection. Chemical peels can cause a herpes infection to flare up, leading to cold sores. More rarely, chemical peels will cause a bacterial or fungal infection as well.
- Heart, kidney, or liver damage. Deep chemical peels use carbolic acid, which can cause an irregular heartbeat and even damage the heart muscle itself. Carbolic acid can also cause damage to both the kidneys and liver.
Protip: While chemical peels are largely considered a low risk treatment, especially at the hands of a professional, it’s best to take all available precautions before underdgoing one. Read: Preparing For Chemical Peels: Top 10 Tips To Follow
How much do chemical peels cost?
The cost will depend on the type of chemical peel you choose to have.
Professional light chemical peels are usually priced between $300 and $500
While this is easily the lowest price range for the three types of professionally applied peels, light peels often needs to be repeated several times. Keep this in mind when calculating your final cost.
Medium chemical peels usually cost between $800 and $1,500
Again, remember that medium peels often need to be repeated every two to three months.
Deep chemical peels typically cost $2,500 to $6,000
They are the most expensive of all three types, but typically only need to be performed once. This price includes consultation, anesthesia, and follow-up care.
At home products are also an option
These are mostly light peels, so they need to be repeated often. Prices range from as little as $10 to as high as $200 or more. It’s important that if you’re considering using a DIY chemical peel to research it thoroughly and make sure it’s suitable for you.
Frequently asked questions
Are chemical peels safe?
Yes. In the vast majority of cases adverse reactions or negative side effects are extremely rare. However, it’s important to note that the risks and side effects increase as the chemicals penetrate deeper into the skin. Basically, the lighter the peel, the lower the risk of complications, while the deeper the peel, the higher the risk.
Will my skin literally peel off?
Yes. All chemical peels work by removing the outer layer of skin. After treatment, your skin will gradually flake and peel off, revealing the new, fresh layer beneath.
That being said, it’s important that you don’t pick at or peel away any skin. It’s best to just allow the skin to flake and shed by itself; picking at it can cause scarring or hyperpigmentation.
Is anesthesia required?
Light chemical peels, whether performed at a medi-spa, doctor’s office or at home, involve so little discomfort that no anesthesia is required, and no pain medication is needed afterwards.
Medium peels do not usually require any anesthesia; some solutions even enact a numbing effect. Sometimes a mild pain medication is given before the procedure begins, but it’s often unnecessary.
Deeper peels, on the other hand, can cause some discomfort, and often require sedation. The newest of the modern deep peel formulas can be performed under oral or intravenous sedation, usually used in combination with local anesthetic injections to lessen the burning sensation.
Modern deep chemical peels offer doctors more options with respect to how deeply they penetrate the skin, so it’s important to find out the specifics of your procedure, and discuss sedation options ahead of time.
Is a chemical peel a facial?
Chemical peels and facials are two different things. While both are great for your skin, chemical peels contain medical grade ingredients that are designed to resolve specific complexion problems like fine lines, hyperpigmentation and roughness.
Facials, on the other hand, don’t contain any medical grade ingredients nor do they resolve complexion issues.
Can chemical peels be used on areas other than the face?
Deep peels are only appropriate for use on the face, but the skin on any other part of the body can be treated with a mixture of chemicals used for light and medium peels.
In general, the chemical solution used for body chemical peels are made up of a combination of TCA, the main chemical used in medium peels, and glycolic acid, the primary ingredient in light peels. This solution is usually designed to be a little stronger than the solution used for light or medium peels, but more mild than the solution used for deep facial peels.
Similar to facial chemical peels, body peels can treat sun damaged skin, uneven coloration, and improve your skin’s texture. They’re also often used to diminish the appearance of stretch marks. Common areas that are treated include the hands and chest (décolletage). The stomach and upper arms may also be treated.
How long does a chemical peel last?
Generally speaking, the deeper the peel, the longer lasting the results. The results of a chemical peel last for as long as the effects of the environment, aging and your lifestyle are mitigated. Healthy lifestyle habits will help to preserve your results. And remember — always protect your skin from the sun!
The Bottom Line
Skin peels are an excellent way of treating wrinkles and blemishes with minimal downtime.
The first step in your chemical peel journey is deciding if you need a light, medium, or deep peel. This decision is based on a number of factors, including the severity of the issue you’re trying to treat, the risk you’re willing to take in order to correct it, and the amount of recovery time you’re willing to live with.
While lighter peels offer little downtime and risk, they also require repeat treatments and provide less obvious results. Conversely, deep peels offer drastic results in only one application, but may lead to three months of redness, require extensive sun protection following treatment, and while rare, can sometimes sponsor serious life threatening complications.
The best way to determine which peel is right for you is to speak with a certified dermatologist with experience in chemical peels.
Find a Chemical Peel Specialist
While basic peels can be performed at home, for safety reasons many of the peeling agents used for them are restricted. The limited light peels that are performed at home can still be effective when targeting minor blemishes like fine line and mild acne scarring, but more severe scarring and skin issues require medium or deep peels performed by a dermatologist.
Deeper peels require expert knowledge and experience, and should ideally be performed by a dermatologist. Further, working with a professional will yield optimal results whether you are looking for a light, medium, or deep peel.
Sources
- Anitha B. (2010). Prevention of complications in chemical peeling. Journal of cutaneous and aesthetic surgery, 3(3), 186-8. ncbi.nlm.nih.gov/pmc/articles/PMC3047741
- Arif T. (2015). Salicylic acid as a peeling agent: a comprehensive review. Clinical, cosmetic and investigational dermatology, 8, 455-61. doi:10.2147/CCID.S84765 ncbi.nlm.nih.gov/pmc/articles/PMC4554394
- Chandrashekar, B. S., Ashwini, K. R., Vasanth, V., & Navale, S. (2015). Retinoic acid and glycolic acid combination in the treatment of acne scars. Indian dermatology online journal, 6(2), 84-8. ncbi.nlm.nih.gov/pmc/articles/PMC4375771
- Kornhauser, A., Coelho, S. G., & Hearing, V. J. (2010). Applications of hydroxy acids: classification, mechanisms, and photoactivity. Clinical, cosmetic and investigational dermatology, 3, 135-42. ncbi.nlm.nih.gov/pmc/articles/PMC3047947
- Puri N. (2012). Comparative study of 15% TCA peel versus 35% glycolic acid peel for the treatment of melasma. Indian dermatology online journal, 3(2), 109-13. ncbi.nlm.nih.gov/pmc/articles/PMC3481880
- Ravikiran, S. P., Sacchidanand, S., & Leelavathy, B. (2014). Therapeutic wounding – 88% phenol in idiopathic guttate hypomelanosis. Indian dermatology online journal, 5(1), 14-8. ncbi.nlm.nih.gov/pmc/articles/PMC3937479
- Sharquie, K. E., Al-Dhalimi, M. A., Noaimi, A. A., & Al-Sultany, H. A. (2012). Lactic Acid as a new therapeutic peeling agent in the treatment of lifa disease (frictional dermal melanosis). Indian journal of dermatology, 57(6), 444-8. ncbi.nlm.nih.gov/pmc/articles/PMC3519251
