Generally speaking, chemical peels exfoliate the skin by dissolving the bonds between old skin cells, allowing them to shed, while also triggering a healing response that smooths and thickens skin over time.
The skin typically sheds dull dead skin cells every 28 days, but this process slows down with age and prolonged sun exposure. Chemical peels accelerate this natural cell turnover and stimulate the growth of new collagen.Â
Chemical peels typically fall into three main categories: superficial, medium, and deep.
Superficial peelsÂ
Ideal for first-timers and people with delicate skin, mild peels exfoliate the skin's outer layer. Superficial "lunchtime" peels typically use low-strength alpha hydroxy acids, like lactic and glycolic acid, to clear pores, smooth the skin, and give it a glow.Â
Superficial peels with pore-penetrating salicylic acid can treat active acne.Â
These peels are safe enough to be performed by aestheticians.
Doctors often suggest booking a series of light peels or ongoing monthly appointments for best results.Â
Medium peels
Affecting both the epidermis (surface layer of skin) and the upper layers of the underlying dermis, medium peels treat skin conditions like pigment irregularities, acne scars, and moderate sun damage, including fine wrinkles.Â
TCA, Jessner’s solution, and higher percentages of glycolic acid are frequently used for medium-depth peeling in derm and plastic surgeon offices.Â
Bear in mind, as a peel’s power increases, so too do its side effects. You can expect at least a week of flaking and redness after a medium-depth peel.
Deep peels
Sometimes administered under IV sedation (with local anesthesia) by a dermatologist or plastic surgeon, phenol-Croton oil based formulas can penetrate down to the deeper dermal layers to address severe sun damage, deep wrinkles, brown spots, and scarring (including acne scars) while tightening the skin.Â
According to Dr. Sterling, often only one or two areas of the face are treated with a phenol-Croton oil formula, typically around the eyes or mouth, where wrinkles are deepest. The rest of the face and neck are then commonly treated with a lighter TCA solution.Â
Phenol can affect heart functioning, so patients’ vitals must be monitored during the procedure if the entire face is treated. The kidneys and liver can also be negatively affected by phenol. To minimize exposure, toxicity, and overall risk, the phenol solution is applied to only one section of the face at a time, in a carefully timed fashion. A lot of doctors don’t offer phenol peels, because of the systemic risks and need for monitoring.
Unsurprisingly, deep peels come with more extensive downtime—a month or more of swelling, peeling, crusting, and oozing, followed by several additional weeks of persistent pinkness.Â
Skin sensitivity will be heightened post-peel, so strict sun avoidance and copious sunscreen (once tolerable) are a must. However, the results of a deep chemical peel can be transformative.Â
Related: Which Type of Chemical Peel Is Right for You?
RealSelf Tip: Some providers will ask you to avoid retinoids like Retin-A for roughly two days prior to certain peels, while others may have you pretreat skin with a retinoid (to boost a peel’s penetration and efficacy) or hydroquinone to control hyperpigmentation during and after a peel. Consult your doctor about which products to eliminate or add to your skin care routine prior to your treatment.
