Is 50 Percent Chemical Peel Safe?

Question

Hello, I have an appointment next week to have a Chemical Peel. I've already seen a licensed RN and she said, she's gonna perform a 50% Chemical peel.She told me I won't peel, she said its not the strong kind, but I'm uncertain, I can't be out of work for a week, should I tell her I need something less than 50% and my acne scars are not that bad, but I've noticed that I scar easily and don't heal as fast as I used to. What should I do?

Kenneth D. Steinsapir, MD · Answer

Jackie

	Just be sure what your "licensed RN" is planning to do. If it is glycolic acid, it will be safe. If it is any other product, then watch out. 50% tricholoracetic acid can cause scaring. DIluted phenol solutions should only be used by expert physician peelers.

	You might also check with your state nursing board. In California, it is not legal for registered nurse to have their own aesthetic practices. Many stated have very similar regulations regarding these issues. The Nursing board may have this information on their website.

Kurtis Martin, MD · Answer

I think you are referring to a 50% glycolic peel which is very safe. A 50% TCA peel should only be performed by an experienced doctor and in someone who has very damaged skin.

Monika Soni, MD · Answer

Thank you for question! It all depends upon what agent is being used. 50% Glycolic acid is very safe when administered by an experienced practitioner. However laser resurfacing (including fractional resurfacing) is a better treatment for acne scars. Best of luck!

Robert Strimling, MD · Answer

Depends upon what agent is being used.  50% Glycolic acid is very safe; however, I have seen adverse alllergic reactions to Glycolic acid.  50% TCA (trichloroacetic acid) is not generally safe.  

	Laser resurfacing (including fractional resurfacing) is a better treatment for acne scars.

Sigmund L. Sattenspiel, MD · Answer

A 50 percent glycolic acid peel is safe especially when administered by an experienced and knowledgeable person. 50 percent glycolic acid will not improve most acne scars but it should not produce any facial skin scarring. On the other hand, I would absolutely recommend avoiding the use of a 50% TCA chemical peel as there is a very high risk of producing facial skin scarring with substance.

Stephen Mandy, MD · Answer

It all depends on the type of acid.  Glycolic at 50% is safe and has no down time, tri chloracetic acid is very risky, has 6 days of down time and can scar.  Neither do much for acne scars regardless.

Bryan K. Chen, MD · Answer

Presumably your RN is planning on giving you a 50% glycolic acid peel, a light chemical peel that is very safe when administered appropriately, with little to no down-time. If she intends to give you a 50% TCA peel (unlikely), however, turn right around and run away from her!

	Good luck, be safe and happy holidays!

Richard C. Mattison, MD (retired) · Answer

Chemical Peels are old, yet useful technology. Dr's Gordon and Baker (Miami) improved the "Phenol" peel used in south Miami to a safe and effective skin improvement in 1962. It is useful; however requires IV ringer's lactate to clear the toxicity of phenol/oil/water solution in recovery of phenol from the body. Redness continues for weeks. The benefits are reduction in skin pigment and longer term (3-6 mo) wrinkle reduction.

	Alternatively, trichloroacetic acid (TCA) is a safer chemical peel which does not require IV hydration, but must be started with lower concentrations of TCA in the range of 15-20%, repeated at 6 weeks intervals until an effective clinical result is achieved. On monthly or bi-monthly peels, wrinkle reduction is observed. Concentration of phenol or TCA is increased over monthly sessions, maxing at 70% TCA. More aggressive chemical peeling concentrations will cause scaring in a number of clients.

	Chemical peels are effective! The efficiency of laser skin rejuventation are so much better and less likely to create hypopigmentation or scaring complications that they have disappeared from an active skin rejuvenation practice.

	Current practice: skin rejuvenation

	1. Microdermabrasion: (sand blasting) superificial layer of dead skin cells is useful as a prelude to chemical peel, Independent pulsed light, photodynamic therapy (levulan + Blue light), erbium laser; fractional laser, or the current gold standard, Candela fractional CO2 laser skin resurfacing.

	2. Levulan applications, 20% aminolevulonic acid application -- 145-60 minutes incubation, followed by 16-30 minutes of ultraviolet light (1710 nm-blue) light will remove superficial brown pigmentation in one to three treatments with minimal pain and no down time.

	3. Independent pulse light (340-950 nm) light therapy will remove brown and red dyschromia in three to five monthly sessions. Minimal discomfort and no down-time is useful as a mantenance therpy.

	4. Fraxel (vertical CO2 skin penetrations) is the former winner in skin rejuvenation; however has been superceded by the Candala Quadralase due to the technology described below. Fraxel causes penetration of vertical CO2 ablations but cannot crease tangential CO2 ablation.

	5. CO2 laser skin ablation is the gold standard in wrinkle/pigmentation reduction; however has longer down-term effects. The 1995 CO2 pattern ablation removed epidermis and superficial dermis, heating the papillary dermis which was dramatically effective in immediate skin tightening. The re-growth of dermis arises from the roots of hair follicles (4-800 microns). This epidermal rejuvenation required 6-12 weeks of redness to recover a wonderful winkle reduction and two-three shade pigment reduction. It is safe only on the face (contra-indicated on neck or other non-hair bearing skin). The traditional CO2 skin ablation only offers tangential epidermal ablation.

	6. The current "gold" standard is the Candela Quadralase which can be set for vertical penetrations in 5-40% of skin serface; vertical penatrations from 100-1500 micron penetrations (power time [on skin 2-40milliseconds] -- energy wattage from 0-30 watts). Superficial skin rejuvenation can create a down-time of three days using topical anesthesia only. Deeper winkles (lips, eyelids) can be removed by the Quadralase using a traditional tangential CO2 ablation (1995 technique) which causes immediate skin wrinkle ablation with down-times of 1-3 weeks.

Is 50 Percent Chemical Peel Safe?

Answers (8)

More Chemical Peel Questions

WE SEND PRETTY
EMAILS

Answers (8)

More Chemical Peel Questions

Chemical Peel for Whiteheads and Bumps?

Are Chemical Peels Worth It?

Tips for Buying a TCA Peel Online

Chemical Peel to Enhance Absorption of Bleaching Creams?

Laser or Peels to Thicken Under Eye Skin?

Chemical Peel for Dark Neck Skin?

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS