I've heard that most chemical peels are really painful. are some peels more painful than others?
Chemical Peel Pain
Doctor Answers 9
Chemical peel does not have to be painful
Superficial chemical peels are performed routinely by most aesthetician with mild-to-moderate discomfort. Medium-to-deep chemical peels, e.g. TCA 25%-70% must be performed by an aesthetic physician, preferably a board-certified dermatologist or plastic surgeon. TCA (trichloracetic acid) chemical peels are typically performed in sectors or small quadrants and will bring about an intense stinging sensation for 10-15 seconds until your physician neutralizes TCA with cool wet gauze. Some offices may apply topical numbing cream 30-60 minutes prior to chemical peel which can minimize discomfort associated with chemical peel.
Chemical peels generally are not that painful...
Chemical peels generally are not that painful.
Superficial chemical peels such as those bought 'over the counter' or those administered in spa environments just treat the outer layer of skin and may produce a light burning sensation at worst.
Deeper chemical peels such as TCA peels or phenol peels will be more uncomfortable but these are generally the physician administering the peel will also provide some type of pain medication. For phenol peels, heart monitoring must be done and an IV started. This allows for administration of intravenous sedation at the same time.
After the actual peel is done, pain is usually minimal. The worst part that some patients complain of is itching while the skin is healing, but not in all cases.
Chemical Peel Pain
Medium depth or deeper chemical peels can cause slight stinging and redness (often described as a “sunburnt” look), which might last for several days.
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Are chemical peels painful?
Most chemical peels cause mild, temporary discomfort--usually a stinging or burning sensation. It usually lasts just a few minutes--if that. This can often be relieved by the use of a hand fan during the procedure. Most patients tolerate the brief this discomfort without pain medicine or anesthesia. Medium depth peels such as 30-70% TCA tend to be more painful. Phenol peels, which are deep peels, are painful, but are rarely done and which should certainly be avoided in patietns with dark skin (as they can cause depigmentation). Although superficial, pure salicyclic acid peels tend to cause more noticable stinging than even stronger peels such as Jessner's.
Some peels are more painful than others...
Chemical peels vary in their levels of discomfort depending on the type of peel.
Solutions such as glycolic or lactic acid usually feel itchy and stingy when applied to the skin. Most patients find this sensation to be tolerable, with only mild discomfort.
Stronger solutions like TCA , Phenol and Jessner peels can be very uncomfortable as they cause the skin to feel increasingly hot as layers of the acid are applied.
The VI peel is a blend of TCA, Phenol, Salicylic acid, Retin-a and Vitamin C that also contains a numbing agent.
Despite the intense strength and effectiveness of this peel, once the first layer is applied to the skin the numbing agent takes effect and the skin feels cool and tingly as though peppermint oil has been applied. Even though the first layer feels hot and stingy, most patients feel that the numbing takes effect so quickly they find the VI peel to be only minimally uncomfortable.
Chemical peels can be uncomfortable but depends on the depth of peels
Chemical peels can be uncomfortable but depends on the depth of peels. Superficial peels can even be uncomfortable and many times I will use a hand held fan in my practice. The other doctors mention that chemical peels don't really hurt. I would tend to disagree based on my experience.
Jessner's peels are superficial but they are uncomfortable but tolerable. Anything using TCA 20% or more will cause discomfort that will need oral sedation or IV sedation, in my opinion, for patient's comfort, along with topical anesthesia. Glycolic peels are more superficial than Jessner's peels but they are still uncomfortable in my experience. I've done these myself on myself. So make sure to ask your doctor what they do to make you feel more comfortable. There are things that can be done!
Pain after Peel Relates to Lack of Occlusion
Pain associated with medium or deep chemical peels is generally related to a lack of occlusion. In other words, if the peeled area is left exposed it will weep and crust, leading to a sense of contraction and discomfort. However, if the peeled area is effectively occluded, the patient remains fairly comfortable. In my experience Vaseline works well, acting as a form of petroleum gel band-aid. There are many other options available for occlusion; Vaseline happens to be inexpensive and quite effective.
Only deep Chemical peels are painful
Only the deep peels like 70% TCA, Phenol peels are painful. Not the superficial or even medium peels. If you had pain following a peel return to the peeling doctor ASAP! This allows this doctor to determine if you are having a reaction or allergy, plus whether the peeling solution was mixed correctly, applied to thickly, etc.
Prevention is the best answer if you are having immediate pain after a peel. If it is later pain again go see the doctor or even call. Local care treatments can help, as well as PO medication.
Hope that helps.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.