Deep chemical peel before and after photo courtesy of Dr. Sanjay Grover, a board-certified plastic surgeon in Newport Beach, California. This 78-year-old patient was treated with a combination of croton oil and phenol. Results may vary.
Deep chemical peel before and after photo courtesy of Dr. Sanjay Grover, a board-certified plastic surgeon in Newport Beach, California. This 78-year-old patient was treated with a combination of croton oil and phenol. Results may vary.
Deep chemical peel before and after photo courtesy of Dr. Sanjay Grover, a board-certified plastic surgeon in Newport Beach, California. This 78-year-old patient was treated with a combination of croton oil and phenol. Results may vary.
Deep chemical peel before and after photo courtesy of Dr. Sanjay Grover, a board-certified plastic surgeon in Newport Beach, California. This 78-year-old patient was treated with a combination of croton oil and phenol. Results may vary.
Deep chemical peel before and after photo courtesy of Dr. Sanjay Grover, a board-certified plastic surgeon in Newport Beach, California. This 78-year-old patient was treated with a combination of croton oil and phenol. Results may vary.
Deep chemical peel before and after photo courtesy of Dr. Sanjay Grover, a board-certified plastic surgeon in Newport Beach, California. This 78-year-old patient was treated with a combination of croton oil and phenol. Results may vary.
In a chemical peel treatment, an acidic solution is applied to the skin to remove damaged top layers, speed cell turnover, and boost collagen growth for a brighter, more even-toned complexion. By creating a controlled injury at a specific depth, chemical peels stimulate new skin growth, to improve skin texture and make it look more radiant.Â
“A chemical peel is often the single best treatment to achieve complete facial rejuvenation,” says Dr. Barton Sterling, a board-certified dermatologist in Spring Lake, New Jersey. The right peel can effectively treat common skin concerns like acne, acne scars, age spots, melasma, hyperpigmentation, rough skin, sun damage, and fine lines.
Though primarily for the face, chemical peels can be applied to the neck, chest, and the backs of the hands as well.
Chemical peels are the third most commonly performed nonsurgical cosmetic procedure in the United States. Popular options include glycolic acid peels, TCA peels (trichloroacetic acid), salicylic acid peels, and Jessner’s solution peels (a blend of lactic acid, salicylic acid, and resorcinol).
The depth of exfoliation and how much downtime you’ll need post-peel depend on the type and percentage of acid applied. An experienced provider can advise on the best type of chemical peel for you.
Pros
Cons
Your cost will depend on the type of peel you have, your provider’s level of experience, their practice location, and a few other key factors.Â
Deep phenol-Croton oil peels, the most expensive type, can cost upwards of several thousand dollars.
The chemical peel photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.
There are many different types of chemical peels designed to address a wide range of issues, so some kind of peel can benefit most people. An experienced provider can recommend an acid solution with the strength and depth best suited to your concerns and skin type.Â
However, chemical peel selection can be limited for some skin types. “People with sensitive skin or dark complexions should generally avoid deeper, more intense peels, since they could suffer burns, scars, or hyperpigmentation. I have had patients with deep skin tones get great results with lighter peels, however,” says New York City dermatologist Dr. Michele Green.
A 2018 study published in the Journal of the American Academy of Dermatology examined the safety of superficial chemical peels for Fitzpatrick skin types III–IV and found that fewer than 4% of treatments resulted in complications.
Related: 3 Pro-Strength Chemical Peels for Every Hyperpigmentation Problem
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.
Your treatment experience will depend on the strength of your peel.Â
For mild to medium peels, anesthesia isn’t usually needed. You may notice some stinging or burning until the peel is neutralized, though some providers minimize discomfort by chilling the skin during treatment with either a small fan or the Zimmer skin cooling system, depending on the strength of the peel.
Deep peels require some form of anesthesia and pain medication. For a phenol peel, expect to be sedated.
After your face has been cleansed, degreased, and numbed (via injection, if needed), the peel solution is applied and left on for anywhere from a few minutes to up to an hour, depending on the type and potency of the peel and sensitivity of your skin. You may feel mild to moderate itching, stinging, and burning while the solution is on your skin.Â
Once the peel is complete, your doctor will apply a cold gauze compress to the skin to neutralize the acid. Your face is then cleansed thoroughly with cold water compresses, and moisturizer and sunscreen are applied to soothe and protect your skin.
Light to medium peels require a day to one week of recovery time, when your skin may look sunburned and feel dry, flaky, and sensitive. The amount of visible skin peeling post-treatment isn’t always indicative of the success of the peel.Â
“Many people imagine scary scenarios from TV when it comes to healing,” says Dr. Green. But especially with light peels, “you don't have to see full-blown peeling to have good results.”
Downtime for deeper peels can last for up to a month, with additional redness and flaking for up to three months. Recovery from phenol peels will also require prescription pain medication and oral antibiotics for the first week or two.Â
Don’t pick at any peeling or flaking skin, and follow your provider’s aftercare instructions to reduce the risk of infection or scarring.
Especially with moderate to deep chemical peels, post-op care is critical to the outcome, according to doctors on RealSelf.Â
Treated skin will be very sensitive throughout the healing process. Follow these tips (and your provider’s aftercare instructions) to keep it healthy, hydrated, and protected.Â
You should begin to see improvements in your skin tone and texture as post-peel symptoms subside.Â
Your complexion will continue to improve over time as new collagen forms, with final results visible within about three months.
Related: The Treatments and Ingredients Actually Proven to Reduce Wrinkles
Mild peels can be repeated every few weeks until you get the results you’re after.Â
Medium peels require more downtime in between, but follow-up peels can improve and prolong results. Some doctors on RealSelf also recommend an annual maintenance peel.Â
Deep peel results will last for many years.
Your results could last anywhere from several months to many years. Their longevity will depend on the strength of your peel and your skincare habits, including how diligently you avoid sun exposure or use a high-SPF, broad-spectrum sunscreen.
Beyond run-of-the-mill dryness and flaking, there’s the risk of developing hyperpigmentation—especially for people with a dark skin tone (skin types V or VI on the Fitzpatrick scale) or sensitive skin. Give your provider a heads-up if you’re prone to trauma-induced post-inflammatory hyperpigmentation (red marks or scars from acne or injury).Â
If your skin is prone to acne, beware that chemical peels can trigger new breakouts. “Breakouts after a chemical peel are common. Sometimes, even if your skin appears healthy on the surface, you can have underlying bacteria and pigmentation that has not come up yet,” says Dr. Pablo Prichard, a plastic surgeon in Scottsdale, Arizona. “It's normal to have a purging phase when you first start treating the skin.”Â
If you have an acne flare or breakouts, let your treating physician know. Oral or topical antibiotics may be needed to prevent potential post-inflammatory pigmentation from the flare.
Similarly, if you’re prone to cold sores, a chemical peel can trigger an outbreak. Your provider can prescribe antiviral medication in advance of your peel to prevent this.
Deep peels come with more serious risks. As we mentioned above, phenol can cause an irregular heartbeat. Phenol toxicity can also occur if too much phenol is absorbed during treatment. Talk to your primary care physician before signing up for a deep peel, especially if you have a heart condition.
Doctors on RealSelf say to wait until you’re through pregnancy and breastfeeding to have any cosmetic treatments, including chemical peels.
Many of the exfoliating acids featured in chemical peels are available in over-the-counter peels, which tend to be milder than in-office versions. According to cosmetic chemist Rhonda Davis, “the strength of an at-home chemical peel depends on the concentration of the acid solution itself and the overall pH of the product.”Â
There are no regulations governing the maximum allowable percentages for acids used in at-home skincare products, though current recommendations from CIR—the Cosmetic Ingredient Review, a panel of scientists responsible for determining ingredient safety in the U.S.—advise using 10% or less glycolic and lactic acids and no more than 2% salicylic acid in DIY peels, notes Dr. Davis.Â
Stronger isn’t always better. “I’ve unfortunately had patients go online and buy more potent acids meant for professional use, and they end up burning themselves and causing irreversible scarring,” says Dr. Green. For safety’s sake, purchase only products sold specifically for at-home use, and never leave a chemical solution on for longer than instructed.
Additionally, if your skin type is III to VI on the Fitzpatrick scale, stick with superficial peels to avoid the risks of hypopigmentation and extensive post-inflammatory hyperpigmentation, recommends Dr. Green.
Related: How to Make the Most of Acids in Your Skin Care Routine
According to the American Academy of Dermatology, combining treatments can lead to better, longer-lasting results.Â
Both treatments exfoliate the skin, but in different ways: Microdermabrasion offers a physical exfoliation, manually scrubbing away surface skin cells, while chemical peels rely on acids to loosen the bonds between skin cells, to speed renewal.
Microdermabrasion is best for buffing away dull, rough surface skin to reveal softer, smoother skin underneath.Â
Since peels can work deeper and ramp up collagen, they can treat issues stemming from below the skin’s surface, like wrinkles, hyperpigmentation, and scars.
Laser Resurfacing: Lasers use thermal or photomechanical energy to break up pigment, stimulate cell turnover, and boost collagen production. Nonablative fractional lasers (like Fraxel) can improve fine lines, acne scars, and hyperpigmentation for effects comparable to a medium peel. For more serious sun damage and scarring, there’s the ablative CO2 laser, which gives results on par with a deeper peel.
Related: Chemical Peels vs. Lasers: Which Is Right for You?
IPL: Intense Pulsed Light treatments broadly target various types of pigment (red and brown) in the skin, improving areas of discoloration and ruddiness while giving skin a glow. IPL is not safe for skin of color. It’s also known to flare melasma.
Your provider can explain these options and recommend the best one for your skin type and concerns.
Updated September 14, 2023