What is a chemical peel?
A chemical peel is a technique performed by dermatologists in which a chemical solution is applied to the skin on the face, neck, chest, and/or hands to remove the top layer of skin. The skin that grows back tends to be smoother and look healthier than the old skin (skin resurfacing).

What are the uses for a chemical peel?
Chemical peels are used to improve the tone and texture of the skin. They are commonly used to diminish signs of aging including fine lines, wrinkles, and discoloration on the face, neck, chest, and hands. They can also be used to help treat sun spots, scarring, and certain skin conditions such as acne.

What are the different types of peels?
Chemical peels are categorized based on the depth of skin resurfacing produced. The different categories include superficial, medium, and deep chemical peels. It is important to consult a dermatologist to determine if you are a good candidate for chemical peels and to determine which type of chemical peel is the best for your skin.

Superficial chemical peels:

  • Indications: Superficial chemical peels are commonly used for the treatment of acne and mild photoaging. Treated skin will initially be red and scaly. Multiple peels on a repeated basis are usually required to achieve optimal results.
  • Recovery time: Also known as lunchtime peels, superficial chemical peels are associated with minimal downtime (usually 1 to 7 days). Mild, fragrance-free moisturizers can be applied to area. Makeup may be worn the following day.

Medium-depth chemical peels:

  • Indications: Medium-depth chemical peels are used for the treatment of fine to medium-depth wrinkles as well as pre-cancerous lesions (actinic keratosis). Skin will be red and swollen following treatment.
  • Recovery time: Medium chemical peels usually require 10 to 14 days to heal. Antiviral medication may taken for 7 days after peeling in people with a history of cold sores. Mild, fragrance-free moisturizers can be applied to area. Makeup may be worn after 7 to 10 days following the procedure.

Deep chemical peels:

  • Indications: Deep chemical peels are often used to treat deeper scars and wrinkles. Redness and swelling are seen after the procedure, and the side effects associated with deep peels tend to be more significant and persistent those of the other types of peels. The treated area will often be bandaged.
  • Recovery time: Deep chemical peels usually require 10-14 days to heal. Antiviral medication is taken for 7 days. It is important to keep the skin moist by soaking it 4 to 6 times daily in a vinegar or hypochlorous acid solution, followed by ointment application initially until the skin starts to heal. After the initial healing phase, a thick moisturizer is applied afterward. Makeup may be worn after 14 days following the procedure.

Chemical peels in skin of color
There are a variety of chemical peels that are safe for use in all skin colors and skin types, but they must be used carefully and under the supervision of an experienced dermatologist. Some of these peels will require pre-treatment with prescription strength retinoids and bleaching creams, so it is best to seek an evaluation by a board-certified dermatologist to see what types of treatments you may be a candidate for.

Patients who have received any type of chemical peel must avoid smoking and adhere to strict sun protective-measures (e.g., sunscreen, hats, limiting time in the sun, long sleeve shirts) to prevent complications such infection and scarring.

Sources:
1. Bolognia J.L.; Jorizzo JLS, J.V. . Dermatology: Elsevier Limited; 2012.
2. Chemical Peels. American Society for Dermatologic Surgery; 2022
3. Chemical peels: Overview. American Academy of Dermatology; 2022.
4. Obagi S. Chemical peels: Principles, peeling agents, and pretreatment assessment. UpToDate; 2022.