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Chemical Peel for Face: Tips for Choosing the Right One

I have trouble understanding all the names and concentrations for chemical facial peel. TCA, AHA peels, Jessner peel, Obagi, etc.  How do you know what's best for the face?

Doctor Answers (8)

The right chemical peel depends on what your goals are...

+10

The right chemical peel depends on what your goals are for your skin. Chemical peels differ in the depth of penetration.

For instance, if the goal of the peel is simply to exfoliate the skin, a superficial chemical peel can be used. For pigment irregularities (age spots, melasma), medium depth chemical peels are beneficial. On the other hand, if the goal is to combat wrinkles, a problem in the deep layers of the skin, a deep chemical peel must be used.

In general, non-medical providers, such as aestheticians, can only apply superficial chemical peels. Superficial peels are outlined in other answers in this section. Superficial peels are generally very safe, and some are even available over the counter. Permanent scarring and skin burns are rare to non-existent.

Medium depth peels, such as 15-35% TCA (trichloroacetic acid) are excellent at taking care of sun damaged skin. It is important to have these administered by an experienced physician who is able to discern a true sun spot from something more ominous, such as a skin cancer. TCA peels do require a short recovery time and should be done by experienced physicians, as side effects can occur.

For deeper skin layers, deeper chemical peels, such as a phenol peel, are necessary. This chemical peel will cause what amounts to a severe sun burn and should only be administered by trained physicians who are experienced with facial peels and can deal with any possible outcomes. It can significantly improve facial lines and wrinkles and produces very nice results when done properly.


Dallas Facial Plastic Surgeon
4.0 out of 5 stars 12 reviews

Chemical peels are an extremely effective way in which...

+6

Chemical peels are an extremely effective way in which to not only achieve healthy skin but also maintain it. To choose the most appropriate peeling agent, several factors should be considered, including degree of damage, allowable downtime, and budget. Taking all of these factors into consideration, we can design a program for you that will meet your goals and leave you with healthy, youthful looking skin for years to come.

  • For clients with minimal sun damage and/or fine lines and wrinkles, a light glycolic, mandelic, or AHA peel would be appropriate.
  • If a patient presents with more pronounced facial aging and wants the quickest results, we will lean more towards a TCA peel.
  • Although phenol peels are an excellent way in which to address facial aging, they have historically been associated with an overall lightening of the skin and so their popularity has waned in the last ten years.

Gregory A. Buford, MD, FACS
Denver Plastic Surgeon
5.0 out of 5 stars 2 reviews

Traditional Chemical Peels & The Punctuated Phenol Peel Work Well For Wrinkles, Crepey Skin, & Blotchy Pigmentation

+2

Chemical peels have been a reliable mainstays of the cosmetic physician's toolbox for well over a century. Trichloroacetic acid (TCA), Jessner's solution, salicyclic acid, glycolic acid and phenol have all been used in varying concentrations and protocols for treating acne scarring, pigmentary problems, wrinkles and other unwanted manifestations of photoaging for many decades before lasers came on the scene.

Although quite a number lasers and light treatments have come and gone in the past fifteen years, chemical peels have not only remained an important treatment tool, but have actually been experiencing a kind of renaissance. In experienced hands, they offer reliable and reproducible results.

Chemical peels are typically divided into three categories: light, medium and deep peels. Light peeling agents include low concentrations (10-25%) TCA, glycolic acid, salicylic acid and Jessner's solution. Light peels are good for skin maintenance, and for fading mild hyperpigmentation and softening very fine wrinkles. Light peels are accompanied by little downtime and make great lunchtime beauty fixes.

Medium peeling agents include TCA 50%, and Jessner's solution or  glycolic acid 70% followed by 35% TCA. Medium peels can help with more stubborn pigmentation and more pronounced photoaging.  They typically are associated with more prolonged healing times and downtimes of seven or more days.

Deep peeling often meant the use of a combination product known as Baker's Phenol. Deep peels were quite useful for more severe wrinkling and skin laxity, but entailed, much like surgery, nearly two weeks of downtime, required strong sedation to perform and possessed signicant risks for the developing permanent loss of skin pigmentation and even scarring. For this reason, despite its efficacy, deep peeling fell in considerable disfavor in the last twenty years.

The most recent advance in chemical peeling technique has been called the "Punctuated Phenol Peel." This novel approach to peeling is sure to put chemical peeling squarely back on the map and in competition with the more expensive, more heavily hyped, laser and light-based therapies currently intensively marketed to consumers.

The procedure is actually simple, requires no sedation, and has little or no downtime. Using 88% plain phenol, fine lines and crinkles are treated in punctuated (i.e. fractionated or pixelated)  fashion. Employing a very finely pointed applicator, the chemical is applied in a serial spot fashion with each site separated from surrounding treatment areas by approximately one-quarter inch. The use of serial spot coverage, rather than coverage of whole areas, the more traditional approach to peeling, allows for rapid recovery as healing takes place from the intervening non-treated areas. It is precisely the same rational as for the use of fractional lasers.

The "Punctuated Phenol Peel" technique is a novel approach to rejuvenation that limits the overall potential for toxicity and downtime of traditional deep peels while constituting focal spots of more intense peeling. Wrinkle lines and crepeyness can be traced in this punctuated fashion, and treatment sessions can be repeated at monthly intervals if necessary until the desired result is obtained. When appropriate, hyperpigmentation and acne scarred areas may likewise be treated in a punctuated fashion.

The choice of peeling solution, depth of peel and technique of application should be made by a cosmetic physician experienced in the use of all available modalities.  Consultation is an absolute must for ensuring that the correct approach is pursued to achieve the most gratifying results.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

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Tips For Chemical Peels

+1

The best way to know what type of peel is best for your face is to have a consultation with a skin care provider who can discuss with you what you'd like to achieve, and what specifically bothers you about your skin.  Some peels require downtime so you want to discuss post procedure expectations during your consultation.

Jeffrey W. Hall, MD
Austin Plastic Surgeon
4.5 out of 5 stars 11 reviews

Choosing the best chemical peel

+1

The best way to know which chemical peel type is best for you is to have  a consultation with the doctor as he/she will know which specific type of chemical peel is right for you.  There are light, medium, and heavly chemical peels, and several listed under each of them. In general, light peels cause little or know "down time" and several are needed for the best effets. Medium peels have significantly more  "dome" (needed to recover) and more pronounced peeling, but ultimately more skin improvement.  Heavy peels often take 2 week or longer to recover,  cost significalntly more, but produce the most noticeable change and incredbile improvement. For first timers,  trying a test area out usually is a good idea. 

Peter Goldman, MD
Los Angeles Dermatologic Surgeon
5.0 out of 5 stars 1 review

Picking which peel is best for you

+1

Depending on degree of sun damage, acne, scarring, risk of hyperpigmentation, skin sensitivity, climate..the list can go on...like all things in medicine, they ar best tailored to you specifically. The small sample photo shows some acne and hints at pigment irregularities. There is a need for treatment (acne) and prevention (sun block/protection) to ensure continued good results. You would most likely benefit from a good maintenace home regiman in conjunction with an in office peel.

Marcy Alvarez, DO
Miami Beach Dermatologist

Choosing the right chemical peel for you

+1

Hi there-

The best way to determine what type and concentration of a chemical peel that is best for you is to have a consultation with a professional at a Plastic Surgery or Dermatology office.

Choosing the right chemical peel is based on an individual analysis of skin type, skin tone and your goals.

In our practice we offer several different types of chemical peels for addressing different problems- our para-medical aesthetician can advise you as to what will be the best course of treatment for you.

Armando Soto, MD, FACS
Orlando Plastic Surgeon
5.0 out of 5 stars 102 reviews

Get good chemical peel advice

+1

Hello,

The best peel for an individual depends upon goals, preferences, and skin type. You need to have your skin examined to help figure this out.Then a menu of options can be presented for your consideration.

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 23 reviews

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.