Which Chemical Peel & Concentration is Right for Me?

Question

Hi, I'm a 26 year old male and have acne scarring on my face (with a 1-2 small pimples at any given time). Along with that I've uneven skin texture, even though I wash my face daily with a BHA cleanser.   I really want to get a chemical peel to improve my skin texture, and get rid of some dull-red acne marks. But I'm not sure which one to get and what concentration.  Another issue is that I shave my head (bald) so I want to do a peel over my entire head (face+scalp+neck) because If I only do it on my face I'd end up looking weired. And I want the recovery(peeling/redness) time to be no more than 2-3 days.
Here's my info: Skin Type: 4 Complexion: Olive Also: Sensitive & oily skin, easily tans  While researching peels, I've come to the conclusion that TCA & Phenol are definitely not an option for me because of the downtime and high risk of hypo/hyperpigmentation. So, I'm leaning towards Salicylic acid peel but not sure about the concentration.
As I mentioned earlier, I'd like to get maximum rejuvenation effect but can't afford more than 3 days of downtime - I should be ready to go back to work WITHOUT any redness/peeling of my skin on Monday(i'll do it on Thursday evening). 
    Which concentration of Salicyclic acid do you think is right for me?
    Also, is it safe to use your recommended concentration of SA peel on my shaved scalp?
     Is there a risk of damage to hair/follicles? 
Actually, I want to rejuvenate my scalp too with this procedure.

Nelson Lee Novick, MD · Answer

For my patients, I refer to salicylic acid peels as "Beta Washes" to distinguish them from "Fruit Washes" or alpha hydroxyacid peels (so named because at one time the latter were derived from natural products, like fruits). Both kinds are superficial peels since they do not penetrate deeply into the skin.

	Unlike its alpha hydroxyacid counterparts, salicylic acid is lipid soluble, which means that it dissolvable in fatty and oily substances, rather than water. as a result, it is better taken up by the lipid-containing follicles on the face that play such an important role in acne formation and development. It is for this reason that I recommend a series of Beta Washes, usually between three and four, spaced at monthly intervals, for my acne patients, especially when they are first starting anti-acne therapy and have to wait a few weeks for their home therapies to begin to work effectively.

	I have found that salicylic acid peels, formulated in a maximal concentration of 30 percent, to be effective for "drying up" pimples and pustules and lightening the kind of skin staining (postinflammatory hyperpigmentation) that often follows outbreaks of pimples as part of the healing process of both so-called "teenage acne" and adult acne. As an added benefit in patients with more mature skin, salicylic acid peels can help diminish the appearance of fine lines, crinkles, age- and sun-related brown spots, and shallow scarring and improve the overall quality of the skin.

Shawn Allen, MD · Answer

These are great peels because they are very safe. They are excellent for acne as well.  20-30% is a concentration that is generally safe. Another very safe alternative for you is Jessners peel with several different chemical peel agents such as salicylic, lactic, and resorcinol. This is very safe for most type 4 skin types and I use it often for this skin type. As for acne scarring none of these will do much to improve scarring as they are too superficial. You will need to go with a more downtime peel like TCA or go for a laser treatment. As an FYI you can safely do erbium yag lasers for skin type 4 if done with an experienced laser surgeon and your downtime will be 2-3 days at a modest setting that can improve acne scarring. Good luck and check credentials.

Kenneth Beer, MD · Answer

Salicylic acid peels are great for brightening the skin and may also help to break up blackheads and white heads.
They are also great for treating hyperpigmentation (darkening of the skin).
I typically recommend peels performed monthly for about 2-3 peels in most patients. The nice part of these is that they dont usually require people to miss out on work or social activities and typically have slight peeling of the skin 2-3 days after the treatment.
20-30% salicylic acid works really well and I use the peels from Theraplex (disclosure: I am a partner in this company).

S. Randolph Waldman, MD · Answer

Unless you are considering a phenol based chemical peel I doubt you will see much improvement from chemcial peeling.  Also I would urge caution with any deeper resurfacing procedure like the carbon dioxide laser or phenol based chemicals as permanent pigmentary irregularities can occur.

Which Chemical Peel & Concentration is Right for Me?

Answers (4)

Answer: Acne Scarring and Peels

Answer: Acne Scarring and Peels

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Which Chemical Peel & Concentration is Right for Me?

Answers (4)

Answer: Acne Scarring and Peels

Answer: Acne Scarring and Peels

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Everything you need to know about Chemical Peel

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